{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T13:43:05Z","timestamp":1790516585544,"version":"4.1.0"},"reference-count":27,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2015,9,30]],"date-time":"2015-09-30T00:00:00Z","timestamp":1443571200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["American J of Med Genetics Pt A"],"published-print":{"date-parts":[[2015,12]]},"abstract":"<jats:sec><jats:label\/><jats:p>Myhre syndrome, a connective tissue disorder characterized by deafness, restricted joint movement, compact body habitus, and distinctive craniofacial and skeletal features, is caused by heterozygous mutations in <jats:italic>SMAD4<\/jats:italic>. Cardiac manifestations reported to date have included patent ductus arteriosus, septal defects, aortic coarctation and pericarditis. We present five previously unreported patients with Myhre syndrome. Despite varied clinical phenotypes all had significant cardiac and\/or pulmonary pathology and abnormal wound healing. Included herein is the first report of cardiac transplantation in patients with Myhre syndrome. A progressive and markedly abnormal fibroproliferative response to surgical intervention is a newly delineated complication that occurred in all patients and contributes to our understanding of the natural history of this disorder. We recommend routine cardiopulmonary surveillance for patients with Myhre syndrome. Surgical intervention should be approached with extreme caution and with as little invasion as possible as the propensity to develop fibrosis\/scar tissue is dramatic and can cause significant morbidity and mortality. \u00a9 2015 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ajmg.a.37273","type":"journal-article","created":{"date-parts":[[2015,9,30]],"date-time":"2015-09-30T06:01:33Z","timestamp":1443592893000},"page":"2893-2901","source":"Crossref","is-referenced-by-count":44,"title":["Myhre syndrome: Clinical features and restrictive cardiopulmonary complications"],"prefix":"10.1002","volume":"167","author":[{"given":"Lois J.","family":"Starr","sequence":"first","affiliation":[{"name":"Division of Clinical Genetics University of Nebraska Medical Center Munroe\u2010Meyer Institute for Genetics and Rehabilitation Omaha Nebraska"},{"name":"University of Nebraska Medical Center Munroe\u2010Meyer Institute for Genetics and Rehabilitation Human Genetics Laboratory Omaha Nebraska"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorothy K.","family":"Grange","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Division of Genetics and Genomic Medicine Washington University School of Medicine St. Louis Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey W.","family":"Delaney","sequence":"additional","affiliation":[{"name":"Division of Cardiology Children's Hospital and Medical Center Omaha Nebraska"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anji T.","family":"Yetman","sequence":"additional","affiliation":[{"name":"Division of Cardiology Children's Hospital and Medical Center Omaha Nebraska"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James M.","family":"Hammel","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery Children's Hospital and Medical Center Omaha Nebraska"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer N.","family":"Sanmann","sequence":"additional","affiliation":[{"name":"University of Nebraska Medical Center Munroe\u2010Meyer Institute for Genetics and Rehabilitation Human Genetics Laboratory Omaha Nebraska"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah A.","family":"Perry","sequence":"additional","affiliation":[{"name":"Division of Pediatric Pathology Children's Hospital and Medical Center Omaha Nebraska"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. Bradley","family":"Schaefer","sequence":"additional","affiliation":[{"name":"Division of Medical Genetics Arkansas Children's Hospital Little Rock Arkansas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann Haskins","family":"Olney","sequence":"additional","affiliation":[{"name":"Division of Clinical Genetics University of Nebraska Medical Center Munroe\u2010Meyer Institute for Genetics and Rehabilitation Omaha Nebraska"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,9,30]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejmg.2012.05.006"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.a.35440"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCD.0b013e3283468043"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/jmg.40.7.546"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajhg.2011.12.011"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.a.36544"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2009.03.110"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCD.0000000000000068"},{"key":"e_1_2_5_10_1","first-page":"1355","article-title":"Micro RNA\u201034a regulates cardiac fibrosis after myocardial infarction by targeting Smad4","volume":"12","author":"Huang Y","year":"2014","journal-title":"Expert Opin Ther Targets"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1179\/0886963413Z.00000000024"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000000314"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/cge.12365"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.c.31337"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/ng.1016"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.a.32719"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.a.35374"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/00019605-200404000-00007"},{"key":"e_1_2_5_19_1","first-page":"e553","article-title":"Clinical features and respiratory complications in Myhre syndrome","volume":"54","author":"McGowan R","year":"2011","journal-title":"Euro J Med Genet"},{"key":"e_1_2_5_20_1","doi-asserted-by":"publisher","DOI":"10.1038\/ejhg.2013.288"},{"key":"e_1_2_5_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-0004.1981.tb01798.x"},{"key":"e_1_2_5_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2015.04.005"},{"key":"e_1_2_5_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.a.35892"},{"key":"e_1_2_5_24_1","doi-asserted-by":"publisher","DOI":"10.1038\/ejhg.2013.283"},{"key":"e_1_2_5_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.a.30444"},{"key":"e_1_2_5_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.1517"},{"key":"e_1_2_5_27_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.RES.0000185833.42544.06"},{"key":"e_1_2_5_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00418-012-0974-8"}],"container-title":["American Journal of Medical Genetics Part A"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fajmg.a.37273","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ajmg.a.37273","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,6]],"date-time":"2023-10-06T23:27:08Z","timestamp":1696634828000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ajmg.a.37273"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,9,30]]},"references-count":27,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2015,12]]}},"alternative-id":["10.1002\/ajmg.a.37273"],"URL":"https:\/\/doi.org\/10.1002\/ajmg.a.37273","archive":["Portico"],"relation":{},"ISSN":["1552-4825","1552-4833"],"issn-type":[{"value":"1552-4825","type":"print"},{"value":"1552-4833","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,9,30]]}}}