{"Name":"Miller syndrome","DiseaseID__c":"GARD:0008410","id":8410,"encodedName":"miller-syndrome","IsDeleted":false,"Disease_Name_Full__c":"Miller syndrome","Xref_IDs__c":"66038001; C0265257; C537680; DOID:0111259; MEDGEN:120522; MONDO:0009903; OMIM:263750; ORPHA:246","USA_Estimate__c":"1,000","No_of_Specialist_Tagsa__c":5,"No_of_ClinGen_records__c":0,"No_of_GeneReviews__c":0,"No_of_HHS_records__c":1,"World_Estimate__c":"1 to 8,000","No_of_HRSA_records__c":0,"Evidence_Based_Score__c":1,"No_of_Disease_Descriptions__c":5,"Disease_Characteristics_Score__c":8,"No_of_Age_at_Onset__c":2,"Description_Source__c":"MONDO:0009903","Disease_Description__c":"A rare acrofacial dysostosis that is characterized by mandibular and malar hypoplasia, small and cup-shaped ears, lower lid ectropion, and symmetrical postaxial limb deficiencies with absence of the fifth digital rays and ulnar hypoplasia.","GARD_Name__c":"Miller syndrome","GARD_Synonym__c":"acrofacial dysostosis, genee-wiedemann type; acrofacial dysostosis, genee-wiedmann type; genee-wiedemann acrofacial dysostosis; genee-wiedemann syndrome; mandibulfacial dysostosis with postaxial limb anomalies; mandibulofacial dysostosis with postaxial limb anomalies; poads; postaxial acrodysostosis; postaxial acrofacial dysostosis; postaxial acrofacial dysostosis syndrome","Curated_Disease_Description_Source__c":"GARD:0008410","Curated_Disease_Description__c":"Miller syndrome is a rare condition that mainly affects the development of the face, arms, and legs. The severity of this disorder can vary among affected individuals. Individuals with Miller syndrome typically have facial differences, which can include underdeveloped cheek bones (malar hypoplasia), a small lower jaw (micrognathia), and an opening in the roof of the mouth (cleft palate) with or without a split in the upper lip (cleft lip). These facial differences can cause feeding problems in infants with Miller syndrome. In some affected individuals, micrognathia may restrict the airway, which can also lead to breathing problems. Other facial features can include eyes that slant downward, eyelids that turn outward so the inner surface is exposed (ectropion), and a notch in the lower eyelids called an eyelid coloboma.  Many individuals with Miller syndrome also have small, cup-shaped ears. Some affected individuals have hearing loss caused by defects in the middle ear (conductive hearing loss), which can lead to a delay in speech development.   The bones of the arms and legs often develop abnormally in people with Miller syndrome. The most common problem is the absence of the fifth (pinky) fingers and toes. Affected individuals may also have webbed or fused fingers or toes (syndactyly) and underdeveloped bones in the forearms. Another feature of Miller syndrome is the presence of extra nipples. Abnormalities of the heart have also been reported in individuals with this condition.","Curated_USA_Estimate_Source__c":null,"Curated_USA_Estimate__c":"1,000","Age_at_Onset_Snippet_Text__c":"during Pregnancy and as a Newborn","SourceID__c":"ORPHA:246","Deprecated__c":"No","Disease_Concept_Type__c":"Rare Disease Entity","MONDO_ID__c":"MONDO:0009903","ORPHANET_ID__c":"ORPHA:246","Replaced_By_ID__c":null,"Display_Spanish_Disease_Name__c":"Disostosis acrofacial postaxial","Spanish_Description_Source__c":"ORPHA:246","Spanish_Description__c":"Es una disostosis acrofacial poco frecuente caracterizada por hipoplasia mandibular y malar, orejas pequeñas en forma de copa, ectropión del párpado inferior y malformaciones simétricas y postaxiales de las extremidades con ausencia del quinto radio de la mano e hipoplasia cubital.","Spanish_Disease_Name__c":"disostosis acrofacial postaxial","Spanish_GARD_Synonym__c":"acrodisostosis postaxial; disostosis acrofacial tipo genee-wiedemann; disostosis mandibulofacial con anomalías de las extremidades postaxiales; síndrome de miller","Category_Linearization__c":"ORPHA:93890","icd10_id__c":null,"mesh_id__c":null,"omim_id__c":null,"snomed_id__c":null,"umls_id__c":null,"GARD_Disease__c":[{"Curated_Disease_Description__c":"Miller syndrome is a rare condition that mainly affects the development of the face, arms, and legs. The severity of this disorder can vary among affected individuals. Individuals with Miller syndrome typically have facial differences, which can include underdeveloped cheek bones (malar hypoplasia), a small lower jaw (micrognathia), and an opening in the roof of the mouth (cleft palate) with or without a split in the upper lip (cleft lip). These facial differences can cause feeding problems in infants with Miller syndrome. In some affected individuals, micrognathia may restrict the airway, which can also lead to breathing problems. Other facial features can include eyes that slant downward, eyelids that turn outward so the inner surface is exposed (ectropion), and a notch in the lower eyelids called an eyelid coloboma.  Many individuals with Miller syndrome also have small, cup-shaped ears. Some affected individuals have hearing loss caused by defects in the middle ear (conductive hearing loss), which can lead to a delay in speech development.   The bones of the arms and legs often develop abnormally in people with Miller syndrome. The most common problem is the absence of the fifth (pinky) fingers and toes. Affected individuals may also have webbed or fused fingers or toes (syndactyly) and underdeveloped bones in the forearms. Another feature of Miller syndrome is the presence of extra nipples. Abnormalities of the heart have also been reported in individuals with this condition.","Curated_Disease_Description_Source__c":"GARD:0008410","GARD_Synonym__c":"acrofacial dysostosis, genee-wiedemann type; acrofacial dysostosis, genee-wiedmann type; genee-wiedemann acrofacial dysostosis; genee-wiedemann syndrome; mandibulfacial dysostosis with postaxial limb anomalies; mandibulofacial dysostosis with postaxial limb anomalies; poads; postaxial acrodysostosis; postaxial acrofacial dysostosis; postaxial acrofacial dysostosis syndrome","Name":"Miller syndrome","Curated_USA_Estimate__c":"1,000","estimateUsa":"1,000"}],"Organization_Supported_Diseases__c":[{"Account_Name__c":"myFace","Website__c":"https://www.myface.org/"},{"Account_Name__c":"Foundation for Nager and Miller Syndromes","Website__c":"https://fnms.org/"}],"GARD_Disease_Tag__c":[{"Tag_Name__c":"Genetics","Tag_Category__c":"Cause;Disease Category;Specialist","category_description":"Genetic diseases affect the DNA, or genetic instructions, which directs how tissues, organs, and body systems function.","curated_tag_name":"Genetic diseases"},{"Tag_Name__c":"Ophthalmology","Tag_Category__c":"Specialist"},{"Tag_Name__c":"Congenital Abnormality","Tag_Category__c":"Disease Category","category_description":"Birth defects are structural changes present at birth that can affect almost any part of the body, including how the body looks, works, or both.","curated_tag_name":"Birth defects"},{"Tag_Name__c":"Orthopedics","Tag_Category__c":"Specialist"},{"Tag_Name__c":"Otolaryngology","Tag_Category__c":"Specialist"},{"Tag_Name__c":"Craniofacial Anomalies","Tag_Category__c":"Account","curated_tag_name":"Craniofacial anomalies"},{"Tag_Name__c":"Pediatrics","Tag_Category__c":"Specialist"}],"Age_At_Onset__c":[{"Age_At_Onset__c":"Neonatal","Provided_By__c":"ORPHA:246"},{"Age_At_Onset__c":"Antenatal","Provided_By__c":"ORPHA:246"}],"Diagnosis__c":[{"Type__c":"GTR","Curie__c":"MEDGEN:C0265257"}],"External_Identifier_Disease__c":[{"URL__c":"https://raresource.nih.gov/diseases/filter/0008410","Source__c":"RareSource"},{"URL__c":"https://www.orpha.net/en/disease/detail/246","Source__c":"C0265257; MONDO:0009903; ORPHA:246","Xref__c":"ORPHA:246"},{"URL__c":"https://www.ncbi.nlm.nih.gov/mesh/C537680","Source__c":"MONDO:0009903","Xref__c":"C537680"},{"URL__c":"https://browser.ihtsdotools.org/?perspective=full&conceptId1=66038001","Source__c":"C0265257; MONDO:0009903","Xref__c":"66038001"},{"URL__c":"https://www.ncbi.nlm.nih.gov/medgen/?term=120522","Source__c":"C0265257","Xref__c":"MEDGEN:120522"},{"URL__c":"https://www.ebi.ac.uk/ols4/ontologies/doid/classes?obo_id=DOID%3A0111259","Source__c":"MONDO:0009903","Xref__c":"DOID:0111259"},{"URL__c":"https://www.omim.org/entry/263750","Source__c":"C0265257; MONDO:0009903; ORPHA:246","Xref__c":"OMIM:263750"},{"URL__c":"https://uts.nlm.nih.gov/uts/umls/concept/C0265257","Source__c":"C0265257","Xref__c":"C0265257"},{"URL__c":"http://purl.obolibrary.org/obo/MONDO_0009903","Source__c":"GARD:0008410","Xref__c":"MONDO:0009903"},{"URL__c":"https://medlineplus.gov/genetics/condition/miller-syndrome","Source__c":"GARD:0008410","Xref__c":"https://medlineplus.gov/genetics/condition/miller-syndrome"}],"GARD_Disease_Gene__c":[{"GeneSymbol__c":"DHODH","GHR_URL__c":"https://medlineplus.gov/genetics/gene/dhodh","Gene_Type__c":"protein-coding gene","Causal_Gene__c":true}],"Inheritance__c":["Autosomal recessive"],"GARD_Disease_Feature__c":[{"Provided_By__c":"ORPHA:246","HPO_Frequency__c":"Very frequent (80-99%)","Feature__r":{"HPO_Description__c":"The palpebral fissure inclination is more than two standard deviations below the mean.","HPO_Feature_URL__c":"https://hpo.jax.org/browse/term/HP:0000494","HPO_Synonym__c":"Antimongoloid eye slant; Antimongoloid slant of palpebral fissures; Antimongoloid slanted palpebral fissures; Down slanting palpebral fissures; Down-slanted palpebral fissures; Down-slanting palpebral fissure; Down-slanting palpebral fissures; Downslanting palpebral fissure; Downslanting palpebral fissures; Downward slanted palpebral fissures; Downward slanting of the opening between the eyelids; Downward slanting palpebral fissures; Downward-slanting palpebral fissures; Palpebral fissures down-slanted","HPO_Name__c":"Downslanted palpebral fissures","HPO_Feature_Type__c":"Symptom"}},{"Provided_By__c":"ORPHA:246","HPO_Frequency__c":"Very frequent (80-99%)","Feature__r":{"HPO_Description__c":"Laterally protruding ear that lacks antihelical folding (including absence of inferior and superior crura).","HPO_Feature_URL__c":"https://hpo.jax.org/browse/term/HP:0000378","HPO_Synonym__c":"Cup-shaped ears; Cupped ear; Simple, cup-shaped ears","HPO_Name__c":"Cupped ear","HPO_Feature_Type__c":"Symptom"}},{"Provided_By__c":"ORPHA:246","HPO_Frequency__c":"Very frequent (80-99%)","Feature__r":{"HPO_Feature_URL__c":"https://hpo.jax.org/browse/term/HP:0007651","HPO_Synonym__c":"Lower eyelid turned out","HPO_Name__c":"Ectropion of lower eyelids","HPO_Feature_Type__c":"Symptom"}},{"Provided_By__c":"ORPHA:246","HPO_Frequency__c":"Very frequent (80-99%)","Feature__r":{"HPO_Description__c":"Underdevelopment of the radius.","HPO_Feature_URL__c":"https://hpo.jax.org/browse/term/HP:0002984","HPO_Synonym__c":"Hypoplastic radii; Hypoplastic radius; Radial hypoplasia; Short radii; Short radius; Shortening of radius; Underdeveloped outer large forearm bone","HPO_Name__c":"Hypoplasia of the radius","Feature_System__c":"Musculoskeletal System","HPO_Feature_Type__c":"Symptom"}},{"Provided_By__c":"ORPHA:246","HPO_Frequency__c":"Frequent (30-79%)","Feature__r":{"HPO_Description__c":"An abnormality of the middle ear.","HPO_Feature_URL__c":"https://hpo.jax.org/browse/term/HP:0000370","HPO_Synonym__c":"Middle ear abnormalities; Middle ear abnormality","HPO_Name__c":"Abnormality of the middle ear","HPO_Feature_Type__c":"Symptom"}},{"Provided_By__c":"ORPHA:246","HPO_Frequency__c":"Frequent (30-79%)","Feature__r":{"HPO_Description__c":"Cleft palate is a developmental defect of the palate resulting from a failure of fusion of the palatine processes and manifesting as a separation of the roof of the mouth (soft and hard palate).","HPO_Feature_URL__c":"https://hpo.jax.org/browse/term/HP:0000175","HPO_Synonym__c":"Cleft hard and soft palate; Cleft of hard and soft palate; Cleft of palate; Cleft palate; Cleft roof of mouth; Palatoschisis; Uranostaphyloschisis","HPO_Name__c":"Cleft palate","HPO_Feature_Type__c":"Symptom"}},{"Provided_By__c":"ORPHA:246","HPO_Frequency__c":"Occasional (5-29%)","Feature__r":{"HPO_Description__c":"A misalignment of the eyes so that the visual axes deviate from bifoveal fixation. The classification of strabismus may be based on a number of features including the relative position of the eyes, whether the deviation is latent or manifest, intermittent or constant, concomitant or otherwise and according to the age of onset and the relevance of any associated refractive error.","HPO_Feature_URL__c":"https://hpo.jax.org/browse/term/HP:0000486","HPO_Synonym__c":"Cross-eyed; Squint; Squint eyes","HPO_Name__c":"Strabismus","HPO_Feature_Type__c":"Symptom"}},{"Provided_By__c":"ORPHA:246","HPO_Frequency__c":"Frequent (30-79%)","Feature__r":{"HPO_Description__c":"Any structural anomaly of the heart and blood vessels.","HPO_Feature_URL__c":"https://hpo.jax.org/browse/term/HP:0030680","HPO_Synonym__c":"Abnormality of cardiovascular system morphology; Cardiovascular malformations","HPO_Name__c":"Abnormal cardiovascular system morphology","Feature_System__c":"Cardiovascular System","HPO_Feature_Type__c":"Symptom"}},{"Provided_By__c":"ORPHA:246","HPO_Frequency__c":"Frequent (30-79%)","Feature__r":{"HPO_Description__c":"The distal interphalangeal joint and/or the proximal interphalangeal joint of the fingers cannot be extended to 180 degrees by either active or passive extension.","HPO_Feature_URL__c":"https://hpo.jax.org/browse/term/HP:0100490","HPO_Synonym__c":"Camptodactyly of hands; Camptodactyly of proximal interphalangeal joint; Contractures of the proximal interphalangeal joints of the fingers; Flexion contractures of proximal interphalangeal joints; Permanent flexion of the finger; Proximal interphalangeal finger joint contractures","HPO_Name__c":"Camptodactyly of finger","Feature_System__c":"Musculoskeletal System","HPO_Feature_Type__c":"Symptom"}},{"Provided_By__c":"ORPHA:246","HPO_Frequency__c":"Very frequent (80-99%)","Feature__r":{"HPO_Description__c":"Underdevelopment of the malar prominence of the jugal bone (zygomatic bone in mammals), appreciated in profile, frontal view, and/or by palpation.","HPO_Feature_URL__c":"https://hpo.jax.org/browse/term/HP:0000272","HPO_Synonym__c":"Decreased size of malar bone; Depressed malar region; Flat cheekbone; Malar hypoplasia; Underdevelopment of malar bone; Zygomatic flattening","HPO_Name__c":"Malar flattening","Feature_System__c":"Musculoskeletal System","HPO_Feature_Type__c":"Symptom"}},{"Provided_By__c":"ORPHA:246","HPO_Frequency__c":"Frequent (30-79%)","Feature__r":{"HPO_Description__c":"Webbing or fusion of the fingers, involving soft parts only or including bone structure. Bony fusions are referred to as \\\"bony\\\" Syndactyly if the fusion occurs in a radio-ulnar axis. Fusions of bones of the fingers in a proximo-distal axis are referred to as \\\"Symphalangism\\\".","HPO_Feature_URL__c":"https://hpo.jax.org/browse/term/HP:0006101","HPO_Synonym__c":"Partial syndactyly","HPO_Name__c":"Finger syndactyly","Feature_System__c":"Musculoskeletal System","HPO_Feature_Type__c":"Symptom"}},{"Provided_By__c":"ORPHA:246","HPO_Frequency__c":"Very frequent (80-99%)","Feature__r":{"HPO_Description__c":"A type of abnormal location of the ears in which the position of the ears is characterized by posterior rotation (the superior part of the ears is rotated towards the back of the head, and the inferior part of the ears towards the front).","HPO_Feature_URL__c":"https://hpo.jax.org/browse/term/HP:0000358","HPO_Synonym__c":"Ear, posterior angulation, increased; Ears rotated toward back of head; Posteriorly angulated ears; Posteriorly rotated; Posteriorly rotated auricles; Posteriorly-angulated ears; Posteriorly-rotated ears","HPO_Name__c":"Posteriorly rotated ears","HPO_Feature_Type__c":"Symptom"}},{"Provided_By__c":"ORPHA:246","HPO_Frequency__c":"Very frequent (80-99%)","Feature__r":{"HPO_Description__c":"An abnormality of dermatoglyphs (fingerprints), which are present on fingers, palms, toes, and soles.","HPO_Feature_URL__c":"https://hpo.jax.org/browse/term/HP:0007477","HPO_Synonym__c":"Abnormal fingerprints; Dermatoglyphic abnormalities","HPO_Name__c":"Abnormal dermatoglyphics","Feature_System__c":"Skin System","HPO_Feature_Type__c":"Symptom"}},{"Provided_By__c":"ORPHA:246","HPO_Frequency__c":"Frequent (30-79%)","Feature__r":{"HPO_Description__c":"An abnormality of vibrational conductance of sound to the inner ear leading to impairment of sensory perception of sound.","HPO_Feature_URL__c":"https://hpo.jax.org/browse/term/HP:0000405","HPO_Synonym__c":"Conduction deafness; Conductive deafness; Conductive hearing loss; Hearing loss, conductive","HPO_Name__c":"Conductive hearing impairment","HPO_Feature_Type__c":"Symptom"}},{"Provided_By__c":"ORPHA:246","HPO_Frequency__c":"Frequent (30-79%)","Feature__r":{"HPO_Description__c":"Clefting (gap or groove) of the upper lip affecting the lateral portions of the upper lip rather than the midline/median region.","HPO_Feature_URL__c":"https://hpo.jax.org/browse/term/HP:0100335","HPO_Synonym__c":"Non-midline cleft of the upper lip; Paramedian cleft of the upper lip","HPO_Name__c":"Non-midline cleft of the upper lip","HPO_Feature_Type__c":"Symptom"}},{"Provided_By__c":"ORPHA:246","HPO_Frequency__c":"Very frequent (80-99%)","Feature__r":{"HPO_Description__c":"Presence of more than two nipples.","HPO_Feature_URL__c":"https://hpo.jax.org/browse/term/HP:0002558","HPO_Synonym__c":"accessory mamilla; Accessory nipple; Increased nipple number","HPO_Name__c":"Supernumerary nipple","HPO_Feature_Type__c":"Symptom"}},{"Provided_By__c":"ORPHA:246","HPO_Frequency__c":"Very frequent (80-99%)","Feature__r":{"HPO_Description__c":"Underdevelopment of the external ear.","HPO_Feature_URL__c":"https://hpo.jax.org/browse/term/HP:0008551","HPO_Synonym__c":"Bilateral microtia; Hypoplasia of the external ear; Hypoplastic ears; Hypoplastic pinna; Small ears; Small pinnae; Underdeveloped ears","HPO_Name__c":"Microtia","HPO_Feature_Type__c":"Symptom"}},{"Provided_By__c":"ORPHA:246","HPO_Frequency__c":"Very frequent (80-99%)","Feature__r":{"HPO_Description__c":"Developmental hypoplasia of the mandible.","HPO_Feature_URL__c":"https://hpo.jax.org/browse/term/HP:0000347","HPO_Synonym__c":"Decreased size of lower jaw; Decreased size of mandible; Hypoplasia of lower jaw; Hypoplasia of mandible; Hypoplastic mandible; Hypoplastic mandible condyle; Hypotrophic lower jaw; Hypotrophic mandible; Little lower jaw; Little mandible; Lower jaw deficiency; Lower jaw hypoplasia; Mandibular deficiency; Mandibular hypoplasia; Mandibular micrognathia; Micrognathia of lower jaw; Micromandible; Robin mandible; Severe hypoplasia of mandible; Small jaw; Small lower jaw; Small mandible; Underdevelopment of lower jaw; Underdevelopment of mandible","HPO_Name__c":"Micrognathia","Feature_System__c":"Musculoskeletal System","HPO_Feature_Type__c":"Symptom"}},{"Provided_By__c":"ORPHA:246","HPO_Frequency__c":"Very frequent (80-99%)","Feature__r":{"HPO_Description__c":"Underdevelopment of the ulna.","HPO_Feature_URL__c":"https://hpo.jax.org/browse/term/HP:0003022","HPO_Synonym__c":"Hypoplastic ulna; Short ulna; Short ulnae; Ulnar hypoplasia; Underdeveloped inner large forearm bone; Underdeveloped ulna","HPO_Name__c":"Hypoplasia of the ulna","Feature_System__c":"Musculoskeletal System","HPO_Feature_Type__c":"Symptom"}},{"Provided_By__c":"ORPHA:246","HPO_Frequency__c":"Very frequent (80-99%)","Feature__r":{"HPO_Description__c":"A short discontinuity of the margin of the lower or upper eyelid.","HPO_Feature_URL__c":"https://hpo.jax.org/browse/term/HP:0000625","HPO_Synonym__c":"Cleft eyelid; Full thickness defect of the eyelid; Notched eyelid","HPO_Name__c":"Eyelid coloboma","HPO_Feature_Type__c":"Symptom"}}],"tags":{"Cause":["Genetics"],"Disease Category":["Genetics","Congenital Abnormality"],"Specialist":["Genetics","Ophthalmology","Orthopedics","Otolaryngology","Pediatrics"],"Account":["Craniofacial Anomalies"]},"synonyms":["acrofacial dysostosis, genee-wiedemann type"," acrofacial dysostosis, genee-wiedmann type"," genee-wiedemann acrofacial dysostosis"," genee-wiedemann syndrome"," mandibulfacial dysostosis with postaxial limb anomalies"," mandibulofacial dysostosis with postaxial limb anomalies"," poads"," postaxial acrodysostosis"," postaxial acrofacial dysostosis"," postaxial acrofacial dysostosis syndrome"]}