Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Perinatal/Neonatal Case Presentation
  • Published:

Perinatal/Neonatal Case Presentation

ARC syndrome in preterm baby

Abstract

A preterm female infant born of 32 weeks gestational age was presenting with musculoskeletal abnormalities, and cholestasis that later on resolved. Later on, she developed renal tubular acidosis (RTA), poor weight gain, unexplained intermittent fever and recurrent spontaneous bleeding episodes. ARC is an acronym that stands for arthrogryposis, renal dysfunction and cholestasis. ARC syndrome is a rare disorder that is difficult to diagnose and is associated with poor outcomes. We present a case of ARC syndrome in an infant with a history of failure to thrive, early cholestasis and RTA. There are many unique features about this case that should add to our understanding of this genetic condition. To our knowledge this is the first identified case of ARC syndrome in a preterm infant. Although the specific mutation found in our patient has not been reported previously, the type and location of this mutation is consistent with our genetic understanding of this disorder.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Gissen P, Johnson CA, Morgan NV, Stapelbroek JM, Forshew T, Cooper WN et al. Mutations in VPS33B, encoding a regulator of SNARE-dependent membrane fusion, cause arthrogryposis-renal dysfunction-cholestasis (ARC) syndrome. Nat Genet 2004; 36 (4): 400–404.

    Article  CAS  Google Scholar 

  2. Cullinane AR, Straatman-Iwanowska A, Zaucker A, Wakabayashi Y, Bruce CK, Luo G et al. Mutations in VIPAR cause an arthrogryposis, renal dysfunction and cholestasis syndrome phenotype with defects in epithelial polarization. Nat Genet 2010; 42 (4): 303–312.

    Article  CAS  Google Scholar 

  3. Nili F, Akbari-Asbaghe P, Oloomi-Yazdi Z, Hadjizadeh N, Nayeri F, Amini E et al. Wide spectrum of clinical features in a case of arthrogryposis-renal tubular dysfunction-cholestasis syndrome. Arch Iran Med 2008; 11 (5): 569–572.

    PubMed  Google Scholar 

  4. Bull LN, Mahmoodi V, Baker AJ, Jones R, Strautnieks SS, Thompson RJ et al. VPS33B mutation with ichthyosis, cholestasis, and renal dysfunction but without arthrogryposis: incomplete ARC syndrome phenotype. J Pediatrics 2006; 148 (2): 269–271.

    Article  CAS  Google Scholar 

  5. Gissen P, Tee L, Johnson CA, Genin E, Caliebe A, Chitayat D et al. Clinical and molecular genetic features of ARC syndrome. Hum Genet 2006; 120 (3): 396–409.

    Article  CAS  Google Scholar 

  6. Benet B, Lainey E, Fenneteau O, Baudouin V, Hurtaud-Roux MF . Usefulness of gray platelets observation in ARC syndrome. Ann Biol Clin (Paris) 2010; 68 (4): 485–489.

    Google Scholar 

  7. Kim SM, Chang HK, Song JW, Koh H, Han SJ . Agranular platelets as a cardinal feature of ARC syndrome. J Pediatr Hematol Oncol 2010; 32 (4): 253–258.

    Article  Google Scholar 

  8. Arhan E, Yusufoglu AM, Sayli TR . Arc syndrome without arthrogryposis, with hip dislocation and renal glomerulocystic appearance: a case report. Eur J Pediatr 2009; 168 (8): 995–998.

    Article  Google Scholar 

  9. Eastham KM, McKiernan PJ, Milford DV, Ramani P, Wyllie J, van’t Hoff W et al. ARC syndrome: an expanding range of phenotypes. Arch Dis Child 2001; 85 (5): 415–420.

    Article  CAS  Google Scholar 

  10. Cullinane AR, Straatman-Iwanowska A, Seo JK, Ko JS, Song KS, Gizewska M et al. Molecular investigations to improve diagnostic accuracy in patients with ARC syndrome. Hum Mutat 2009; 30 (2): E330–E337.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to A Elmeery.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Elmeery, A., Lanka, K. & Cummings, J. ARC syndrome in preterm baby. J Perinatol 33, 821–822 (2013). https://doi.org/10.1038/jp.2013.62

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/jp.2013.62

Keywords

Search

Quick links