Cherubism

Alternative Names

  • CRBM
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WHO-ICD-10 version:2010

Diseases of the digestive system

Diseases of oral cavity, salivary glands and jaws

OMIM Number

118400

Mode of Inheritance

Autosomal dominant

Gene Map Locus

4p16.3

Description

Cherubism is a rare fibro-osseous disorder of childhood, generally limited to the lower half of the face, the maxilla, and mainly, the mandible. The age of onset ranges between 6 and 10 years of age and symptoms include bilateral painless swelling of the jaw (as bone is replaced by cyst-like growths), abnormal teeth, thick gums, multicystic bone tumours, and eyes-to-heaven look. In severe cases, the disorder causes problems with speech, breathing, swallowing, and vision. The disorder has inconsistent expressivity and penetrance with a 100% penetrance in males and 50-70% penetrance in females. Cherubism might regress without treatment and in rare cases develop gradually. Surgical treatment for correcting the jaw deformities is rarely indicated and should be performed following puberty. Calcitonin and interferon-alpha are being examined for their benefits in treating cherubism.

Cherubism is linked to mutations in the SH3BP2 (SH3 Domain Binding Protein 2) gene, which encodes a protein that is involved in signal transduction mainly in cells associated with bone remodeling and immune system. Mutations in this gene may lead to over-expression of proteins that affect osteoclasts leading to the destruction of bone in the upper and lower jaws. The combination of inflammation and bone loss possibly causes the cyst-like growths leading to the disorder.

Epidemiology in the Arab World

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Other Reports

Algeria

Vaillant et al. (1988) reported three children diagnosed with cherubism from the same Algerian family. Radiographic examinations helped in the characterization of the disease and all 3 patients successfully underwent surgical treatment.

Kuwait

Petkovska et al. (2004) reported four members of a family diagnosed with cherubism. The cases were discovered at Al-Adan Hospital following the admission of a healthy 5 year old girl who experienced swelling of the cheeks and mandibular angels. The child underwent a panoramic radiograph of the jaw and a CT scan, revealing multilocular osteolytic lesions bilaterally in the mandible with centrally dislocated teeth and large multilocular cystic expansile lesions. The patients' family members were screened, three other members including two sisters aged 7 and 10 years and their father aged 32 years were found to experience the same symptoms. The four cases demonstrated a round face with fullness of the infraorbital regions and cheeks, medially dislocated teeth, premature loss of deciduous teeth, misplaced unerupted and absent permanent teeth.

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