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Type: Journal article
Title: Prenatal exposure to phenytoin, facial development and a possible role for vitamin K
Author: Howe, A.
Lipson, A.
Sheffield, L.
Haan, E.
Halliday, J.
Jensen, F.
David, D.
Webster, W.
Citation: American Journal of Medical Genetics Part A, 1995; 58(3):238-244
Publisher: Liss
Issue Date: 1995
ISSN: 0148-7299
Statement of
Andrew M. Howe F.R.A.C.D.S., Anthony H. Lipson, Leslie J. Sheffield, Eric A. Haan, Jane L. Halliday, Fred Jenson, David J. David and William S. Webster
Abstract: Ten patients with maxillonasal hypoplasia (Binder “syndrome”), who were prenatally exposed to phenytoin (usually in combination with other anticonvulsants), were identified retrospectively. In addition to their facial anomalies, 6 of the patients were radiographed neonatally and showed punctate calcification, characteristic of chondrodysplasia punctata. Evidence is presented that the facial abnormalities seen in these children are due to anticonvulsant-induced vitamin K deficiency, causing abnormal development of the cartilaginous nasal septum. We propose that early vitamin K supplementation of at-risk pregnacies may prevent the development of maxillonasal hypoplasia, which in some patients is severely disfiguring and causes great emotional distress. Correction of this facial defect requires surgical and dental treatment over a long period of time.
Keywords: phenytoin
Binder “syndrome,”
chondrodysplasia punctata
vitamin K deficiency
Description: Article first published online: 16 MAY 2005
Rights: Copyright © 1995 Wiley-Liss, Inc., A Wiley Company
DOI: 10.1002/ajmg.1320580309
Appears in Collections:Aurora harvest
Paediatrics publications

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