Herein we describe an additional patient of LMHD having both, classical and atypical features, which may add to the clinical spectrum of this phenotypically variable disorder.
LMHD is a distinct form of craniotubular bone disorder characterized by disproportionately large head, craniotubular hyperostosis with wide open fontannels and delayed closure of sutures, ectodermal dysplasia that includes loose, atrophic/wrinkled skin with prominent veins on the scalp (Cutis laxa) and enamel hypolasia, brachymesophalangy with proximal symphalangism.
Recently, the genetic basis of LMHD has been discovered.
This case describes an infant with LMHD who has both the classical and non-classical features of the syndrome.
Hydrocephalus in patients with LMHD has been reported twice previously by Wattanasirichaigoona et al9 and Shoja et al.10 In a patient with communicating hydrocephalus, Wattanasirichaigoon et al, reported a decent response to carbonic anhydrase inhibitor, and attributed the cause of hydrocephalus to an attenuation of inferior sigmoid sinuses and jugular bulbs which may interfere with absorption of CSF and cause impaired intracranial venous drainage while Shoja et al, suggested narrowing of foramen magnum as a possible cause of hydrocephalus.
The LMHD levelling feet are designed with a bottom seal which protects the area beneath the foot plate from dirt and a sealing ring above the adjustment sleeve which enables fastening without creating a dead space.
The Elesa LMHD levelling feet are part of a special series of standard components that meet the requirements of the EHEDG and the 3-A Sanitary Standards manufactured with FDA and EU compliant plastics and elastomers.
Further information regarding Elesa LMHD levelling feet may be found at: www.elesa.com/en/elesab2bstoreuk/Levelling-elements-and-supports--Levelling-elements-Hygienic-Design--LM-HD-SST or follow them on twitter: www.twitter.com/ElesaUK.