Hereditary Connective Tissue Disorders: a Modern Approach to Classification and Diagnosis (Review)

Hereditary connective tissue disorders — a genetically and clinically heterogeneous group of diseases united by common congenital mesenchymal abnormalities — is one of the most debatable problems of clinical medicine. A great while, from the whole variety of hereditary connective tissue disorders, only “differentiated” (with concerted diagnostic recommendations), monogenic syndromes registered in OMIM, have been the focus of attention of medical community. However, numerous unclassifiable forms with multi-factorial development mechanisms or so called dysplastic phenotypes have not been taken into account when estimating the disease prognosis and determining treatment policy. The review represents the current concepts of the nomenclature of hereditary connective tissue disorders, and considers the diagnostic criteria of the classified monogenic syndromes (Marfan syndrome and Ehlers–Danlos syndrome, MASS-phenotype, primary mitral valve prolapse, joint hypermobility syndrome) and unclassifiable dysplastic phenotypes (МASS-like phenotypes, marfanoid appearance, Ehlers-like phenotype, benign joint hypermobility, unclassifiable phenotype) in the view of recent international and domestic recommendations. Congenital mesenchymal disorders have been represented in the form of a continuous list in order of decreasing clinical intensity of their manifestations and prognostic value reduction (“phenotypic continuum”): from monogenic syndromes through dysplastic phenotypes to unclassifiable phenotypes. The authors have laid emphasis on the difficulties of clinical identification of hereditary connective tissue disorders related to non-specificity of external and visceral markers of connective tissue weakness and certain conventionality of diagnostic criteria. The review has shown the debating aspects of diagnosis and interpretation of clinical significance of some hereditary connective tissue disorders.

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Klemenov А.V., Suslov А.S. Hereditary Connective Tissue Disorders: a Modern Approach to Classification and Diagnosis (Review). Sovremennye tehnologii v medicine 2014; 6(2): 127