A cardio-facio-cutaneous syndrome case with tight Achilles tendons.

Cardio-facio-cutaneous syndrome (CFCS) is a multiple congenital anomaly disorder characterized by craniofacial features, cardiac defects, ectodermal anomalies and neurocognitive delay. Clinical findings of patients with CFCS show similarities to those of patients with Costello Syndrome (CS). CFCS and CS are caused by mutations in genes encoding proteins of the RAS-MAPK signaling pathway. Musculoskeletal findings including tight Achilles tendons and contractures of elbows, shoulders or hips have been reported in CS patients. However, limited extension of joints were observed in some patients with CFCS. According to the literature, no tight Achilles tendons have been reported in CFCS patients so far. In this case report, we present a male CFCS patient with tight Achilles tendons with a de-novo heterozygote N581D mutation in the BRAF gene detected by DNA sequence analysis.

Steroid myopathy in a child with juvenile rheumatoid arthritis. Case report.

An 8-year-old boy who had been diagnosed as systemic-onset juvenile rheumatoid arthritis were on treatment for 8 months with methotrexate and additional steroids during activation. At the end of the 8th month when the corticosteroid dose was 12.5 mg/day, he began to suffer from numbness and weakness in his hands. Physical examination, laboratory findings and electromyography results demonstrated myopathy. Steroid myopathy was considered. Corticosteroids were tapered and stopped. At follow-up clinical findings remitted and electromyography became normal at the 4th month. We present here this case to direct attention to drug-induced myopathy besides myopathy due to primary disease in connective tissue disorders whenever myopathy exists.