RIDDLE syndrome

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RIDDLE syndrome
Other names	Radiosensitivity-immunodeficiency-dysmorphic features-learning difficulties syndrome
Riddle syndrome is inherited in an autosomal recessive pattern.

RIDDLE syndrome is a rare genetic syndrome. The name is an acronym for Radiosensitivity, ImmunoDeficiency Dysmorphic features and Learning difficulties.

The features of this condition include:^{[citation needed]}

• Facial dysmorphism
• Short stature
• Mild motor control and learning difficulties
• Mild ataxia
• Microcephaly
• Normal intelligence
• Conjunctival telangiectasia
• Recurrent sinus infections
• Decreased serum IgA
• Late onset of pulmonary fibrosis
• Increased alpha-fetoprotein
• Increased radiosensitivity

This condition is due to mutations in the RNF168 gene. It is inherited in an autosomal recessive fashion. The gene encodes a ubiquitin ligase and is located on the long arm of chromosome 3 (3q29) on the Crick (minus strand).^[1]

The DDx is ^{[citation needed]}

• Ataxia telangectasia
• Artemis deficiency
• Immunodeficiency 26 (PKCS gene deficiency)
• LIG4 syndrome
• Nijmegen breakage syndrome
• Severe combined immunodeficiency with Cernunnos
• X-linked agammaglobulinemia

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This condition is extremely rare. Only four cases have been described up to 2017.^[2]

This syndrome was first described by Stewart et al. 2007.^[3]