Weismann-Netter-Stuhl syndrome is an extremely rare inherited skeletal disorder characterized by the abnormal development of bone (osseous dysplasia). Affected individuals exhibit bowing of the long portions (shafts) of the shinbone (tibia) and the outer, smaller bone of the leg below the knee (fibula). In some individuals, other bones may also be affected, such as the ribs, pelvis, spinal column, and/or bones in the arms. The primary characteristic of Weismann-Netter-Stuhl syndrome is short stature (dwarfism). In most cases, this disorder is thought to be inherited as an autosomal dominant trait.
The major physical characteristics of Weismann-Netter-Stuhl syndrome include short stature (dwarfism) and bowing of the front (anterior) of the long portions (shafts) of the shinbone (tibia) and the smaller bone of the leg below the knee (fibula). Individuals affected by Weismann-Netter-Stuhl syndrome rarely have any major functional limitations. In many cases, the diagnosis of Weismann-Netter-Stuhl syndrome may not be made until adolescence or adulthood because of the lack of serious complications associated with this disorder.
Along with the characteristic bowing of the tibia and fibula, affected individuals may also exhibit bowing of the sides (lateral bowing) of the thigh bones (femur) and/or outward curvature of the tibia (saber shins). Additional bones may also be affected including the ribs and pelvis.
Individuals with Weismann-Netter-Stuhl syndrome may also exhibit bowing of certain bones in the forearms (i.e., ulna and radius), malformation of a part of the hip bone (ilium), improper development of bone toward the bottom of the spinal column (horizontal sacrum), widening of the marrow cavities inside bones, and/or thickening of the outer layers (cortexes) of the long bones (diaphyseal dysplasia). In addition, some affected individuals may exhibit a sideways curvature of the spine (scoliosis) and/or a front-to-back curvature of the spine (kyphosis).
About 20 percent of children with Weismann-Netter-Stuhl syndrome have mild mental retardation. Most affected individuals begin to walk later than is normally expected, however, the reason for this delay is not understood.
In most cases, Weismann-Netter-Stuhl syndrome is thought to be inherited as an autosomal dominant trait. Genetic diseases are determined by two genes, one received from the father and one from the mother.
Dominant genetic disorders occur when only a single copy of an abnormal gene is necessary for the appearance of the disease. The abnormal gene can be inherited from either parent, or can be the result of a new mutation (gene change) in the affected individual. The risk of passing the abnormal gene from affected parent to offspring is 50% for each pregnancy regardless of the sex of the resulting child.
Weismann-Netter-Stuhl syndrome is an extremely rare skeletal disorder that affects males and females in equal numbers. Approximately, 70 cases have been reported in the medical literature since the disorder’s original description in 1954. However, because rare disorders like Weismann-Netter-Stuhl syndrome often go unrecognized, these disorders are under-diagnosed, making it difficult to determine the true frequency Weismann-Netter-Stuhl syndrome in the general population.
The diagnosis of Weismann-Netter-Stuhl syndrome may be confirmed by x-ray studies of the skeleton that reveal distinctive bowing of the long bones of the legs, lateral bowing of the femur, thickened outer layers of bones, and widened marrow cavities. Other x-ray findings may include bowing of certain arm bones (i.e., ulna and radius), malformation of part of the hip bone (ilium), abnormal development of part of the spinal column (horizontal sacrum), and/or hardening of a membrane that surrounds the brain and spinal cord (dural calcification).
The treatment of Weismann-Netter-Stuhl syndrome is directed toward the specific symptoms that are apparent in each individual. Genetic counseling will be of benefit for affected individuals and their families. A supportive team approach for children with Weismann-Netter-Stuhl syndrome may be helpful. Such a team approach may include physical therapy and other medical, social, or vocational services. Other treatment is symptomatic and supportive.
Information on current clinical trials is posted on the Internet at www.clinicaltrials.gov. All studies receiving U.S. government funding, and some supported by private industry, are posted on this government web site.
For information about clinical trials being conducted at the NIH Clinical Center in Bethesda, MD, contact the NIH Patient Recruitment Office:
Tollfree: (800) 411-1222
TTY: (866) 411-1010
For information about clinical trials sponsored by private sources, contact:
Buyce ML, ed. Birth Defects Encyclopedia. Dover, MA: Blackwell Scientific Publications; For: The Center for Birth Defects Information Services Inc; 1990: 1549-50.
Magalini SI, et al., eds. Dictionary of Medical Syndromes. 3rd ed.New York, NY: Lippincott Company; 1990: 927-28.
Coimbra AV, et al. Weismann-Netter-Stuhl syndrome: first Brazilian case reports. Joint Bone Spine. 2000;67:539-43.
Kurtoglu S, et al. Patient with Weismann-Netter and Stuhl (toxopachyosteosis) syndrome with communicant hydrocephalus and arachnoid cyst. J Pediatr Endocrinol Metab. 2000;13:211-15.
Nores JM, et al. Tibioperoneal diaphyseal toxopachyosteosis or Weismann-Netter-Stuhl syndrome: difficulties encountered in classifying this syndrome and differentiation from rickets. Clin Exp Rheumatol. 19997;15:105-09.
Nores JM, et al. Identification and classification of tibioperoneal diaphyseal toxopachyosteosis (Weismann-Netter-Stuhl syndrome): based on two new cases and a review of the literature. Eur J Radiol. 1997;24:71-76.
Tieder M, et al. The Weismann-Netter, Stuhl syndrome: a rare pediatric skeletal dysplasia. Pediatr Radiol. 1995;25:37-40.
Hary S, et al. Weismann-Netter and Stuhl toxopachyosteosis. Apropos of 30 cases. Rev Rhum Mal Osteoartic. 1992;59:65-71.
Hary S, et al. A case of Weismann-Netter and Stuhl toxopachyosteosis with new bone sites. Rev Rhum Mal Osteoartic. 1992;59:73-75.
Zakarian H, et al. Weismann-Netter and Stuhl disease. A review of the literature. Apropos of a case with uncommon radiologic signs. J Radiol. 1989;70:133-37.
Robinow M, et al. The Weismann-Netter syndrome. Am J Med Genet. 1988;29:573-79.
Amendola MA, et al. Weismann-Netter-Stuhl syndrome: toxopachyosteose diaphysaire tibioperoniere. AJR Am J Roentgenol. 1980;135:1211-15.
Pieron R, et al. Toxopachyosteosis of the tibial and fibular diaphyses (Weismann-Netter and Stuhl syndrome. Sem Hop. 1982;58:1043-45.
FROM THE INTERNET
McKusick VA, ed. Online Mendelian Inheritance in Man (OMIM). Baltimore. MD: The Johns Hopkins University; Entry No:112350; Last Update:8/15/94.
The information in NORD’s Rare Disease Database is for educational purposes only and is not intended to replace the advice of a physician or other qualified medical professional.
The content of the website and databases of the National Organization for Rare Disorders (NORD) is copyrighted and may not be reproduced, copied, downloaded or disseminated, in any way, for any commercial or public purpose, without prior written authorization and approval from NORD. Individuals may print one hard copy of an individual disease for personal use, provided that content is unmodified and includes NORD’s copyright.
National Organization for Rare Disorders (NORD)
55 Kenosia Ave., Danbury CT 06810 • (203)744-0100