STAR syndrome

STAR syndrome is an extremely rare X-linked dominant syndrome that is caused by single FAM58A gene point mutations or deletions of FAM58A and its flanking genes.^[3]

STAR syndrome
Other names	Syndactyly with renal and anogenital malformation
Diagram showing X-linked dominant inheritance scenarios for the mother being affected
Specialty	Genetics
Symptoms	Syndactyly, telecanthus, anogenital malformations, renal malformations, and short stature[1]
Usual onset	Birth[1]
Diagnostic method	Clinical features and genetic testing[2]
Differential diagnosis	VATER syndrome[2]
Frequency	Fewer than 100 documented cases[3]

STAR syndrome is distinguished by a variety of facial dysmorphisms and malformations outlined by its acronym, Syndactyly Telecanthus Anogenital malformations Renal malformations.^[3]

Signs and symptoms

The name STAR stands for the syndrome's primary signs and symptoms:^[1]

Syndactyly Telecanthus Anogenital malformations Renal malformations.

Other bone abnormalities, hearing loss, epilepsy, retinal abnormalities, syringomyelia, tethered spinal cord, and several other birth defects have been documented in STAR syndrome.^[4]

Ocular signs include telecanthus and eyelid abnormalities, as well as peripheral anterior synechiae in the anterior segment. Retinal findings such as macular drusen and macular hypoplasia have also been identified.^[5]

Causes

STAR syndrome is caused by either point mutations or deletions of the FAM58A gene, which is located on chromosome Xq28. This gene encodes Cyclin M, a Cyclin-dependent kinase 10 (CDK10) binding partner. The Cyclin M/CDK10 interactions regulate the division of cells and development by suppressing ETS2-driven MAPK pathway activation. Cyclin M/CDK10 interaction has been demonstrated to be defective in STAR syndrome patients. The abnormalities of the FAM58A gene in STAR syndrome suggest that it is X-linked dominant. Since STAR syndrome has only been observed in female patients it is most likely lethal in males.^[3]

References

1. "Syndactyly-telecanthus-anogenital and renal malformations syndrome — About the Disease". Genetic and Rare Diseases Information Center. January 8, 2021. Retrieved October 9, 2023.
2. Zarate, Yuri A.; Farrell, Jessica M.; Alfaro, Maria P.; Elhassan, Nahed O. (April 6, 2015). "STAR syndrome is part of the differential diagnosis of females with anorectal malformations". American Journal of Medical Genetics Part A. 167 (8). Wiley: 1940–1943. doi:10.1002/ajmg.a.37078. ISSN 1552-4825.
3. Bedeschi, Maria F.; Giangiobbe, Sara; Paganini, Leda; Tabano, Silvia; Silipigni, Rosamaria; Colombo, Lorenzo; Crippa, Beatrice L.; Lalatta, Faustina; Guerneri, Silvana; Miozzo, Monica (October 31, 2017). "STAR syndrome plus: The first description of a female patient with the lethal form". American Journal of Medical Genetics Part A. 173 (12). Wiley: 3226–3230. doi:10.1002/ajmg.a.38484. ISSN 1552-4825.
4. "STAR syndrome — National Organization for Rare Disorders". National Organization for Rare Disorders. June 16, 2022. Retrieved October 9, 2023.
5. Li, Alexa L.; Borooah, Shyamanga; Nudleman, Eric (2022). "Multimodal imaging of retinal findings in syndactyly, telecanthus, anogenital, and renal malformations (STAR) syndrome". American Journal of Ophthalmology Case Reports. 25. Elsevier BV: 101284. doi:10.1016/j.ajoc.2022.101284. ISSN 2451-9936. PMC 8810370.