Hyperreflexia, and Large fontanelles

Diseases related with Hyperreflexia and Large fontanelles

In the following list you will find some of the most common rare diseases related to Hyperreflexia and Large fontanelles that can help you solving undiagnosed cases.

Top matches:

Neonatal adrenoleukodystrophy (NALD) is the variant of intermediate severity of the PBD-Zellweger syndrome spectrum (PBD-ZSS; see this term), charcterized by hypotonia, leukodystrophy, and vision and sensorineural hearing deficiencies. Phenotypic overlap is seen between NALD and infantile Refsum disease (IRD) (see this term).

NEONATAL ADRENOLEUKODYSTROPHY Is also known as nald

Related symptoms:

  • Intellectual disability
  • Seizures
  • Global developmental delay
  • Short stature
  • Generalized hypotonia


SOURCES: OMIM ORPHANET MENDELIAN

More info about NEONATAL ADRENOLEUKODYSTROPHY

X-linked lissencephaly with abnormal genitalia (XLAG) is a rare, genetic, central nervous system malformation disorder characterized, in males, by lissencephaly (with posterior predominance and moderately thickened cortex), complete absence of corpus callosum, neonatal-onset (mainly perinatal) intractable seizures, postnatal microcephaly, severe hypotonia, poor responsiveness and hypogonadism (micropenis, hypospadias, cryptorchidism, small scrotal sac). Defective temperature regulation and chronic diarrhea may be additionally observed.

X-LINKED LISSENCEPHALY WITH ABNORMAL GENITALIA Is also known as xlisg|xlag (x-linked lissencephaly with abnormal genitalia) syndrome|lissencephaly, x-linked, with ambiguous genitalia|x-linked lissencephaly-corpus callosum agenesis-genital anomalies syndrome|xlag|x-linked lissencephaly with ambiguous genitalia

Related symptoms:

  • Intellectual disability
  • Seizures
  • Global developmental delay
  • Generalized hypotonia
  • Microcephaly


SOURCES: OMIM MESH ORPHANET MENDELIAN

More info about X-LINKED LISSENCEPHALY WITH ABNORMAL GENITALIA

Heart and brain malformation syndrome is a severe autosomal recessive multiple congenital anomaly syndrome characterized by profoundly delayed psychomotor development, dysmorphic facial features, microphthalmia, cardiac malformations, mainly septal defects, and brain malformations, including Dandy-Walker malformation (summary by Shaheen et al., 2016).

Related symptoms:

  • Seizures
  • Global developmental delay
  • Generalized hypotonia
  • Microcephaly
  • Growth delay


SOURCES: OMIM MENDELIAN

More info about HEART AND BRAIN MALFORMATION SYNDROME; HBMS

Other less relevant matches:

De Barsy syndrome, or autosomal recessive cutis laxa type III (ARCL3), is characterized by cutis laxa, a progeria-like appearance, and ophthalmologic abnormalities (summary by Kivuva et al., 2008).For a phenotypic description and a discussion of genetic heterogeneity of autosomal recessive cutis laxa, see {219100}. Genetic Heterogeneity of de Barsy SyndromeAlso see ARCL3B (OMIM ), caused by mutation in the PYCR1 gene (OMIM ) on chromosome 17q25.

CUTIS LAXA, AUTOSOMAL RECESSIVE, TYPE IIIA; ARCL3A Is also known as de barsy syndrome a|cutis laxa, corneal clouding, and mental retardation|progeroid syndrome of de barsy

Related symptoms:

  • Intellectual disability
  • Seizures
  • Global developmental delay
  • Short stature
  • Generalized hypotonia


SOURCES: OMIM MENDELIAN

More info about CUTIS LAXA, AUTOSOMAL RECESSIVE, TYPE IIIA; ARCL3A

Glutaric aciduria II (GA2) is an autosomal recessively inherited disorder of fatty acid, amino acid, and choline metabolism. It differs from GA I (GA1 ) in that multiple acyl-CoA dehydrogenase deficiencies result in large excretion not only of glutaric acid, but also of lactic, ethylmalonic, butyric, isobutyric, 2-methyl-butyric, and isovaleric acids. GA II results from deficiency of any 1 of 3 molecules: the alpha (ETFA) and beta (ETFB) subunits of electron transfer flavoprotein, and electron transfer flavoprotein dehydrogenase (ETFDH). The clinical picture of GA II due to the different defects appears to be indistinguishable; each defect can lead to a range of mild or severe cases, depending presumably on the location and nature of the intragenic lesion, i.e., mutation, in each case (Goodman, 1993; Olsen et al., 2003).The heterogeneous clinical features of patients with MADD fall into 3 classes: a neonatal-onset form with congenital anomalies (type I), a neonatal-onset form without congenital anomalies (type II), and a late-onset form (type III). The neonatal-onset forms are usually fatal and are characterized by severe nonketotic hypoglycemia, metabolic acidosis, multisystem involvement, and excretion of large amounts of fatty acid- and amino acid-derived metabolites. Symptoms and age at presentation of late-onset MADD are highly variable and characterized by recurrent episodes of lethargy, vomiting, hypoglycemia, metabolic acidosis, and hepatomegaly often preceded by metabolic stress. Muscle involvement in the form of pain, weakness, and lipid storage myopathy also occurs. The organic aciduria in patients with the late-onset form of MADD is often intermittent and only evident during periods of illness or catabolic stress (summary by Frerman and Goodman, 2001).Importantly, riboflavin treatment has been shown to ameliorate the symptoms and metabolic profiles in many MADD patients, particularly those with type III, the late-onset and mildest form (Liang et al., 2009).

MULTIPLE ACYL-COA DEHYDROGENASE DEFICIENCY; MADD Is also known as ema|ethylmalonic-adipicaciduria|glutaric aciduria ii|ga ii|glutaric acidemia ii|ga2

Related symptoms:

  • Intellectual disability
  • Seizures
  • Global developmental delay
  • Generalized hypotonia
  • Ataxia


SOURCES: OMIM ORPHANET MENDELIAN

More info about MULTIPLE ACYL-COA DEHYDROGENASE DEFICIENCY; MADD

Multiple congenital anomalies-hypotonia-seizures syndrome type 2 is a rare, genetic, lethal, neurometabolic malformation syndrome characterized by multiple, variable, congenital cardiac (systolic murmur, atrial septal defect), urinary (duplicated collecting system, vesicoureteral reflux) and central nervous system (thin corpus callosum, cerebellar hypoplasia) malformations associated with neonatal hypotonia, early-onset epileptic encephalopathy, and myoclonic seizures. Craniofacial dysmorphism (prominent occiput, enlarged fontanel, fused metopic suture, upslanted palpebral fissures, overfolded helix, depressed nasal bridge, anteverted nose, malar flattening, microstomy with downturned corners, Pierre-Robin sequence, high arched palate, short neck) and other manifestions (joint contractures, hyperreflexia, dysplastic nails, developmental delay) are also observed.

MULTIPLE CONGENITAL ANOMALIES-HYPOTONIA-SEIZURES SYNDROME TYPE 2 Is also known as epileptic encephalopathy, early infantile, 20|gpibd4|mcahs type 2|glycosylphosphatidylinositol biosynthesis defect 4|eiee20

Related symptoms:

  • Intellectual disability
  • Seizures
  • Global developmental delay
  • Generalized hypotonia
  • Hearing impairment


SOURCES: ORPHANET OMIM MENDELIAN

More info about MULTIPLE CONGENITAL ANOMALIES-HYPOTONIA-SEIZURES SYNDROME TYPE 2

Isolated complex I deficiency is a rare inborn error of metabolism due to mutations in nuclear or mitochondrial genes encoding subunits or assembly factors of the human mitochondrial complex I (NADH: ubiquinone oxidoreductase) and is characterized by a wide range of manifestations including marked and often fatal lactic acidosis, cardiomyopathy, leukoencephalopathy, pure myopathy and hepatopathy with tubulopathy. Among the numerous clinical phenotypes observed are Leigh syndrome, Leber hereditary optic neuropathy and MELAS syndrome (see these terms).

ISOLATED COMPLEX I DEFICIENCY Is also known as isolated nadh-ubiquinone reductase deficiency|nadh:q(1) oxidoreductase deficiency|isolated nadh-coq reductase deficiency|isolated mitochondrial respiratory chain complex i deficiency|isolated nadh-coenzyme q reductase deficiency|nadh-coenzyme q reductase

Related symptoms:

  • Intellectual disability
  • Seizures
  • Global developmental delay
  • Generalized hypotonia
  • Hearing impairment


SOURCES: ORPHANET MESH OMIM MENDELIAN

More info about ISOLATED COMPLEX I DEFICIENCY

Rubinstein-Taybi syndrome is a multiple congenital anomaly syndrome characterized by mental retardation, postnatal growth deficiency, microcephaly, broad thumbs and halluces, and dysmorphic facial features. The facial appearance is striking, with highly arched eyebrows, long eyelashes, downslanting palpebral fissures, broad nasal bridge, beaked nose with the nasal septum, highly arched palate, mild micrognathia, and characteristic grimacing or abnormal smile. Affected individuals also have an increased risk of tumor formation (Rubinstein and Taybi, 1963; review by Hennekam, 2006).Floating-Harbor syndrome (OMIM ), which shows phenotypic overlap with Rubinstein-Taybi syndrome, is caused by mutation in the SRCAP gene (OMIM ), a coactivator for CREBBP. Genetic Heterogeneity of Rubinstein-Taybi SyndromeRubinstein-Taybi syndrome-1 (RSTS1) constitutes about 50 to 70% of patients with the disorder. Rubinstein-Taybi syndrome-2 (RSTS2 ) comprises about 3% of patients and is primarily due to de novo heterozygous mutation in the EP300 gene (OMIM ) on chromosome 22q13 (Bartsch et al., 2010).See also chromosome 16p13.3 deletion syndrome (OMIM ), a severe form of Rubinstein-Taybi syndrome resulting from a contiguous gene deletion involving the CREBBP gene as well as other neighboring genes.

RUBINSTEIN-TAYBI SYNDROME 1; RSTS1 Is also known as broad thumbs and great toes, characteristic facies, and mental retardation|rubinstein syndrome|rsts|broad thumb-hallux syndrome

Related symptoms:

  • Intellectual disability
  • Seizures
  • Short stature
  • Generalized hypotonia
  • Hearing impairment


SOURCES: OMIM MENDELIAN

More info about RUBINSTEIN-TAYBI SYNDROME 1; RSTS1

Related symptoms:

  • Intellectual disability
  • Seizures
  • Generalized hypotonia
  • Microcephaly
  • Low-set ears


SOURCES: OMIM MENDELIAN

More info about EPILEPTIC ENCEPHALOPATHY, EARLY INFANTILE, 5; EIEE5

Congenital muscular dystrophy-dystroglycanopathy with brain and eye anomalies (type A), which includes both the more severe Walker-Warburg syndrome (WWS) and the slightly less severe muscle-eye-brain disease (MEB), is an autosomal recessive disorder with characteristic brain and eye malformations, profound mental retardation, congenital muscular dystrophy, and death usually in the first years of life. It represents the most severe end of a phenotypic spectrum of similar disorders resulting from defective glycosylation of alpha-dystroglycan (DAG1 ), collectively known as 'dystroglycanopathies' (summary by Roscioli et al., 2012).For a general phenotypic description and a discussion of genetic heterogeneity of muscular dystrophy-dystroglycanopathy type A, see MDDGA1 (OMIM ).

MUSCULAR DYSTROPHY-DYSTROGLYCANOPATHY (CONGENITAL WITH BRAIN AND EYE ANOMALIES), TYPE A, 7; MDDGA7 Is also known as walker-warburg syndrome or muscle-eye-brain disease, ispd-related

Related symptoms:

  • Intellectual disability
  • Generalized hypotonia
  • Cataract
  • Low-set ears
  • Macrocephaly


SOURCES: OMIM MENDELIAN

More info about MUSCULAR DYSTROPHY-DYSTROGLYCANOPATHY (CONGENITAL WITH BRAIN AND EYE ANOMALIES), TYPE A, 7; MDDGA7

Top 5 symptoms//phenotypes associated to Hyperreflexia and Large fontanelles

Symptoms // Phenotype % cases
Generalized hypotonia Very Common - Between 80% and 100% cases
Intellectual disability Very Common - Between 80% and 100% cases
Seizures Very Common - Between 80% and 100% cases
Global developmental delay Common - Between 50% and 80% cases
Wide anterior fontanel Common - Between 50% and 80% cases

Other less frequent symptoms

Patients with Hyperreflexia and Large fontanelles. may also develop some of the following symptoms:

Common Symptoms - More than 50% cases

Low-set ears

Uncommon Symptoms - Between 30% and 50% cases

High palate

Common Symptoms - More than 50% cases

Microcephaly

Uncommon Symptoms - Between 30% and 50% cases

Abnormal facial shape

Common Symptoms - More than 50% cases

Muscular hypotonia

Uncommon Symptoms - Between 30% and 50% cases

Hypoplasia of the corpus callosum Respiratory failure Spasticity Micrognathia Macrocephaly Patent ductus arteriosus Strabismus Cataract Hearing impairment Gliosis Ventricular septal defect Agenesis of corpus callosum Failure to thrive Depressed nasal bridge Wide nasal bridge Growth delay Anteverted nares Respiratory insufficiency Atrial septal defect High forehead Encephalopathy Frontal bossing Prominent forehead Vomiting Dysphagia Respiratory distress Cerebral atrophy Retrognathia Short stature Narrow mouth Pachygyria Hypertelorism Feeding difficulties in infancy Polyhydramnios Posteriorly rotated ears Areflexia Cryptorchidism Abnormality of the liver Developmental regression Cerebellar atrophy Infantile spasms Brain atrophy Flexion contracture Ptosis Abnormality of the pinna Cardiorespiratory arrest Hepatomegaly Visual impairment Muscular hypotonia of the trunk Severe global developmental delay

Rare Symptoms - Less than 30% cases

Cardiac arrest Elevated serum creatine phosphokinase Coloboma Malar flattening Exercise intolerance Talipes equinovarus Acidosis Scoliosis Delayed speech and language development Increased serum lactate Intrauterine growth retardation Skeletal muscle atrophy Tremor Congenital glaucoma Myopathy Absent speech Ragged-red muscle fibers Weak cry Redundant skin Adducted thumb Hyperammonemia Medulloblastoma Ataxia Muscle weakness Acute pancreatitis Decreased fetal movement Coarctation of aorta Feeding difficulties Joint hypermobility Febrile seizures Corpus callosum atrophy Hernia Hypsarrhythmia Fatigue Cardiomyopathy Poor eye contact Postnatal growth retardation Joint laxity Difficulty walking Edema Congestive heart failure Behavioral abnormality Pancreatitis Delayed skeletal maturation Arrhythmia Pectus excavatum Hypoglycemia Gastroesophageal reflux Prominent occiput Lactic acidosis Glaucoma Limb muscle weakness Thin upper lip vermilion Global brain atrophy Hyperactivity Long philtrum Diarrhea Ventriculomegaly Motor delay Heterotopia Polar cataract Adrenal insufficiency Generalized myoclonic seizures Hepatic steatosis Hepatic failure Decreased liver function Metabolic acidosis Epileptic encephalopathy High, narrow palate Coma Abnormality of movement Cardiomegaly EEG abnormality Tetraplegia Optic atrophy Epicanthus Sensorineural hearing impairment Nystagmus Pulmonary hypoplasia Micropenis Hypertrophic cardiomyopathy Deeply set eye Pneumonia Sepsis Cerebellar hypoplasia Dandy-Walker malformation Myoclonus Myalgia Microphthalmia Leukodystrophy Respiratory tract infection Proximal muscle weakness Anemia Duane anomaly Abnormality of eye movement Left ventricular hypertrophy Abnormality of the eye Intellectual disability, profound Apnea Lissencephaly Lethargy Stroke Postnatal microcephaly Aganglionic megacolon Stiff neck Cerebral edema Abnormal mitochondria in muscle tissue Wolff-Parkinson-White syndrome Severe lactic acidosis Acute necrotizing encephalopathy Downslanted palpebral fissures Neoplasm Decreased activity of mitochondrial respiratory chain Axial dystonia Biventricular hypertrophy Infantile encephalopathy Congenital lactic acidosis Necrotizing encephalopathy Nemaline bodies Macrovesicular hepatic steatosis Hypertension Cardiogenic shock Progressive macrocephaly Exercise-induced lactic acidemia Increased CSF lactate Renal insufficiency Aspiration pneumonia High anterior hairline Blindness Peripheral neuropathy Abnormality of the pons Birth length greater than 97th percentile Olfactory lobe agenesis Alveolar ridge overgrowth Triangular mouth Micronodular cirrhosis Duplicated collecting system Hemoglobinuria Seborrheic dermatitis Breech presentation Developmental stagnation Pierre-Robin sequence Hyporeflexia Epileptic spasms Central hypotonia Absent septum pellucidum Large for gestational age Overfolded helix Scaling skin Elevated alkaline phosphatase Deep philtrum Widely spaced teeth Multicystic kidney dysplasia Cerebral visual impairment Gingival overgrowth Tall stature Dystonia Babinski sign Mitochondrial myopathy Congenital diaphragmatic hernia Progressive encephalopathy Optic neuropathy Renal tubular acidosis Basal ganglia calcification Progressive spasticity Pericardial effusion Oral-pharyngeal dysphagia Incoordination Leukoencephalopathy Shock Horizontal nystagmus Aspiration Ventricular hypertrophy Optic disc pallor Kyphoscoliosis Pigmentary retinopathy Cyanosis Migraine Premature birth Progressive cerebellar ataxia Abnormal cerebellum morphology Dyskinesia Stage 5 chronic kidney disease Talipes Abnormal pyramidal sign Retinopathy Pallor Irritability Mental deterioration Abnormality of the dentition Low anterior hairline Syndactyly Frontal upsweep of hair Premature thelarche Narrow maxilla Large foramen magnum Agoraphobia Bifid uterus Vascular ring Duplication of phalanx of hallux Dyscalculia Chorioretinal dystrophy Keloids Prominent fingertip pads Bimanual synkinesia Talon cusp Short upper lip Parietal foramina Abnormality of the cervical spine Facial grimacing Tethered cord Phonophobia Broad distal phalanx of finger Rhabdomyosarcoma Nasolacrimal duct obstruction Abnormal cornea morphology Pheochromocytoma Avascular necrosis of the capital femoral epiphysis Deviated nasal septum Enlarged tonsils Flared iliac wings Muscular dystrophy Agyria Type II lissencephaly Peters anomaly Retinal dysplasia Gonadal dysgenesis Partial agenesis of the corpus callosum Hypoplasia of the brainstem Congenital muscular dystrophy Optic nerve hypoplasia Encephalocele Retinal detachment Polymicrogyria Microtia Papillary cystadenoma of the epididymis Facial palsy Hydrocephalus Small anterior fontanelle Atrophy/Degeneration affecting the brainstem CNS hypomyelination Progressive microcephaly Spastic tetraplegia Intellectual disability, severe Plantar crease between first and second toes Radial deviation of thumb terminal phalanx Abnormal number of teeth High axial triradius Abnormality of refraction Dyslexia Immunodeficiency Thick eyebrow Low posterior hairline Convex nasal ridge Otitis media Prominent nose Dental malocclusion Hypoplasia of the maxilla Recurrent fractures Single transverse palmar crease Highly arched eyebrow Iris coloboma Hirsutism Unsteady gait Broad thumb Pulmonic stenosis Leukemia Abnormality of the kidney Intellectual disability, moderate Pes planus Proptosis Autism Polydactyly Constipation Clinodactyly of the 5th finger Abnormal heart morphology Hypospadias Mitral regurgitation Hypoplasia of dental enamel Meningioma Neurofibromas Short attention span Hypoplastic iliac wing Low hanging columella Capillary hemangioma Obstructive sleep apnea Self-mutilation Patellar dislocation Poor coordination Overweight Shawl scrotum Neuroblastoma Dislocated radial head Truncal obesity Long eyelashes Delayed cranial suture closure Broad hallux Impulsivity Laryngomalacia Recurrent upper respiratory tract infections Bicuspid aortic valve Spina bifida occulta Narrow palate Cafe-au-lait spot Exotropia Stereotypy Dental crowding Inflammatory abnormality of the skin Excessive daytime somnolence Small nail Hypotelorism Poor suck Hyperextensible skin Cutis laxa Opacification of the corneal stroma Wormian bones Congenital hip dislocation Elbow flexion contracture Thin skin Fine hair Blue sclerae Underdeveloped nasal alae Mild short stature Triangular face Distal amyotrophy Thin vermilion border Abnormality of skin pigmentation Hip dislocation Corneal opacity Blepharophimosis Scarring Sparse hair Protruding ear Athetosis Multiple joint contractures Macrotia Dermal translucency Depressivity Headache Gait disturbance Fever Dysarthria Pain Prominent superficial blood vessels Hypoargininemia Corneal arcus Wide cranial sutures Calcaneovalgus deformity Neurodevelopmental delay Narrow nasal ridge Excessive wrinkled skin Overlapping fingers Premature skin wrinkling Progeroid facial appearance Severe failure to thrive Severe intrauterine growth retardation Subcapsular cataract Prematurely aged appearance Thin ribs Reduced subcutaneous adipose tissue Umbilical hernia Mandibular prognathia Weight loss Malabsorption Long upper lip Hydranencephaly Profound global developmental delay Exocrine pancreatic insufficiency Hypohidrosis Chronic diarrhea Ambiguous genitalia Hypoplasia of penis Specific learning disability Decreased testicular size Prominent nasal bridge Temperature instability Elevated long chain fatty acids Primary adrenal insufficiency Abnormality of neuronal migration Abnormal palate morphology Bilateral single transverse palmar creases Abnormality of retinal pigmentation Esotropia Retinal dystrophy Dolichocephaly Low-set, posteriorly rotated ears Abnormality of metabolism/homeostasis Abnormality of temperature regulation Type I lissencephaly Brachycephaly Delayed CNS myelination Osteoporosis Severe short stature Inguinal hernia Visual loss Midface retrusion Kyphosis Abnormality of the skeletal system Myopia Hand clenching Interrupted aortic arch Widow's peak Cleft lip Prominent metopic ridge Hyperactive deep tendon reflexes Aplasia/Hypoplasia of the corpus callosum Thick lower lip vermilion Cerebellar vermis hypoplasia Interphalangeal joint contracture of finger Narrow forehead Everted lower lip vermilion Camptodactyly of finger Abnormal cardiac septum morphology Camptodactyly Gait ataxia Dyspnea Generalized-onset seizure Arthralgia of the hip Fatigable weakness of neck muscles Fatigable weakness of distal limb muscles Hypersarcosinemia Ethylmalonic aciduria Reye syndrome-like episodes Reduced protein C activity Elevated plasma acylcarnitine levels Ketotic hypoglycemia Increased muscle lipid content Glutaric acidemia Gastrointestinal inflammation Defective dehydrogenation of isovaleryl CoA and butyryl CoA Narcolepsy Cataplexy Renal cortical cysts Limb tremor Impaired mastication Nonketotic hypoglycemia Hypoglycemic coma Personality disorder Progressive spastic quadriplegia Glutaric aciduria Oliguria Abnormality of branched chain family amino acid metabolism Hepatic periportal necrosis Respiratory arrest Short distal phalanx of finger Limb undergrowth Overgrowth Microdontia Neuronal loss in central nervous system Webbed neck Vesicoureteral reflux Delayed myelination Hemolytic anemia Downturned corners of mouth Wide nose Cirrhosis Electron transfer flavoprotein-ubiquinone oxidoreductase defect Ichthyosis Wide mouth Neonatal hypotonia Coarse facial features Cerebral cortical atrophy Upslanted palpebral fissure Obesity Short nose Short neck Cleft palate Abnormality of blood glucose concentration Generalized aminoaciduria Loss of ability to walk Arthralgia Generalized muscle weakness Spastic tetraparesis Scapular winging Type I diabetes mellitus Clonus Anorexia Renal dysplasia Abnormality of the genital system Tetraparesis Waddling gait Aciduria Muscle cramps Poor head control Renal cyst Nausea Joint hyperflexibility Nausea and vomiting Congenital cataract Abnormality of the cerebral white matter Dilated cardiomyopathy Hyperlordosis Telecanthus Elevated hepatic transaminase Jaundice Mutism Easy fatigability Abnormal corpus callosum morphology Myoglobinuria Abnormality of the renal tubule Episodic vomiting Proximal tubulopathy Exercise-induced myalgia Hypoketotic hypoglycemia Organic aciduria Chronic fatigue Ketonuria Progressive proximal muscle weakness Ketosis Drowsiness Slurred speech Fatigable weakness Acute kidney injury Rhabdomyolysis Glycosuria Difficulty climbing stairs Restrictive ventilatory defect Ventricular fibrillation Stridor Hemiplegia Back pain Polycystic kidney dysplasia Remnants of the hyaloid vascular system


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