Abstract

BackgroundCrouzon syndrome (CS), which results from fibroblast growth factor receptor 2 mutations, is associated with craniosynostosis, exophthalmos, and other symptoms. Herein, we report the genetic abnormalities detected in a Chinese family with autosomal dominant CS, combined with luxation of the eyeball. This luxation was a consequence of the trauma to the shallow orbits.Case presentationThe proband was a 4-year-old boy. He accidentally fell, following which luxation of the bulbus oculi occurred immediately. Computed tomography and magnetic resonance imaging clearly revealed ocular proptosis. Upon physical examination, the proband, his father, and grandfather had ocular proptosis, shallow orbits, and mid-face hypoplasia. However, their hands and feet were clinically normal. Genomic DNA was extracted from the peripheral blood through a polymerase chain reaction performed for the target sequence. Genetic assessments revealed a heterozygous missense mutation (c.1012G > C, p.G338R) in exon 10 of the human FGFR2, cosegregated with the disease phenotype in this family. These findings confirmed the diagnosis of CS.DiscussionCS is usually caused by FGFR2 mutations. While there are a few reports of luxation of the bulbus oculi in Chinese families with CS, the ocular proptosis, shallow orbits, combined with luxation of eyeball after trauma observed in this patient were particularly interesting. Our findings enhance the current knowledge of traumatic luxation concomitant with CS.

Highlights

  • Crouzon syndrome (CS), which results from fibroblast growth factor receptor 2 mutations, is associated with craniosynostosis, exophthalmos, and other symptoms

  • CS is usually caused by fibroblast growth factor receptor 2 (FGFR2) mutations

  • While there are a few reports of luxation of the bulbus oculi in Chinese families with CS, the ocular proptosis, shallow orbits, combined with luxation of eyeball after trauma observed in this patient were interesting

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Summary

Discussion

CS is usually caused by FGFR2 mutations and accounts for 4.8% of cases with craniosynostoses. Our patient presented with luxation of the bulbus oculi and hypophasis of the left eye. Mutant-type FGFR2 (c.1012G > C) can affect craniofacial growth, by increasing alkaline phosphatase gene and osteocalcin gene expression, inevitably leading to CS [11]. The clinical characteristics of our patient supported a diagnosis of CS, while there are a few reports of luxation of the bulbus oculi in Chinese families with CS. It is of interest that our patient had ocular proptosis and shallow orbits, combined with luxation of the eyeball after trauma. The shallow orbits observed in patients with CS patients have limited space to accommodate edematous tissue. These patients are more likely to develop eyeball luxation. Our findings enhance the current knowledge of CS concomitant with traumatic luxation of the eyeball

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