Wim Van Hul, Wendy Balemans, Els Van Hul, Frederik G

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Van Buchem Disease (Hyperostosis Corticalis Generalisata) Maps to Chromosome 17q12-q21  Wim Van Hul, Wendy Balemans, Els Van Hul, Frederik G. Dikkers, Henk Obee, Robert J. Stokroos, Peter Hildering, Filip Vanhoenacker, Guy Van Camp, Patrick J. Willems  The American Journal of Human Genetics  Volume 62, Issue 2, Pages 391-399 (February 1998) DOI: 10.1086/301721 Copyright © 1998 The American Society of Human Genetics Terms and Conditions

Figure 1 Pedigree including 13 van Buchem patients, over 10 generations. Blackened symbols represent affected individuals. The identification number of each patient is shown below the symbol. Patient 12 represents case I and patient 13 represents case II from the study by van Buchem (1971). For the other six patients described previously (patients 3–8), the numbering remained identical. For the 11 patients included in this linkage study, the alleles for marker D17S1299 are shown below each symbol. In eight patients, marker D17S1299 is homozygous for allele 3. The heterozygosity in the remaining three patients (9, 10, and 11) could have been caused by one recombination event. The American Journal of Human Genetics 1998 62, 391-399DOI: (10.1086/301721) Copyright © 1998 The American Society of Human Genetics Terms and Conditions

Figure 2 Clinical pictures of seven patients showing characteristic features of van Buchem disease. Frontal (A) and lateral (B) views of patient 3. This patient, at age 65 years, was the oldest patient studied. C–G, Pictures of the five new van Buchem patients (patients 1, 2, and 9–11, respectively). All patients showed the characteristic features of protruding chin, high forehead, and facial nerve paralysis, as illustrated in panel C. The American Journal of Human Genetics 1998 62, 391-399DOI: (10.1086/301721) Copyright © 1998 The American Society of Human Genetics Terms and Conditions

Figure 3 X-rays showing generalized sclerosis in van Buchem patients. A, Lateral view of the elbow, showing diffuse diaphyseal sclerosis. The cortex is thickened, and there is narrowing of the medullary canal. B and C, Anteroposterior and lateral views of the skull, showing extensive sclerosis of the calvarium and the skull base, enlargement of the mandible, and obliteration of the paranasal and mastoid air spaces (Van der Wouden 1971). The American Journal of Human Genetics 1998 62, 391-399DOI: (10.1086/301721) Copyright © 1998 The American Society of Human Genetics Terms and Conditions

Figure 4 Skull and mandible of one of the patients described originally by van Buchem et al. (1955). This skull of a 52-year-old female case weighs 2,357 g. Frontal (A) and lateral (B) views show the markedly enlarged and thickened hyperostotic mandible with many bone excrescences. The entire skull, including the zygomatic ouch nose, is severely thickened and has a rough surface covered with flat excrescences or exostoses. Sutures have disappeared, owing to new bone formation. The orbital, foramen opticum, and nasal openings are narrowed. The skull shows impressive thickening (C), and the mandible has a blown-up appearance (D and E), owing to massive enlargement of the entire mandible, which is covered with bony excrescences. The American Journal of Human Genetics 1998 62, 391-399DOI: (10.1086/301721) Copyright © 1998 The American Society of Human Genetics Terms and Conditions

Figure 5 Delineation of the genetic candidate region for the van Buchem gene, on chromosome 17, by analysis of key recombinants. The blackened bars represent the regions containing the disease gene, whereas the unblackened bars represent excluded regions. The vertical lines represent regions that were uninformative. A recombination event in patients 9–11 excludes the region proximal to D17S1787, whereas a recombination with D17S934 in patient 1 excludes the region distal to D17S934. The remaining candidate region, between D17S1787 and D17S934, spans 0.7 cM on the genetic map. The American Journal of Human Genetics 1998 62, 391-399DOI: (10.1086/301721) Copyright © 1998 The American Society of Human Genetics Terms and Conditions