TN 7 (08-12)

DI 23022.885 Rhizomelic Chondrodysplasia Punctata

COMPASSIONATE ALLOWANCE INFORMATION

RHIZOMELIC CHONDRODYSPLASIA PUNCTATA

ALTERNATE NAMES

RCDP; RCP; Chondrodysplasia Punctata Rhizomelic; Rhizomelic Chondrodysplasia Punctata Classic Type; Rhizomelic Chondrodysplasia Punctata Type 1; RCDP1; Rhizomelic Chondrodysplasia Punctata Type 2; RCDP2; Rhizomelic Chondrodysplasia Punctata Type 3; RCDP3

DESCRIPTION

Rhizomelic Chondrodysplasia Punctata (RCDP) is a rare, inherited disorder that results in congenital skeletal abnormalities with shortening of proximal long bones, distinctive facial features, intellectual disability, and recurrent respiratory problems. Painful joint contractures, poor growth, cataracts developing in infancy, hearing loss, and seizures also occur frequently. Most children with this condition do not achieve developmental milestones such as sitting without support, feeding themselves, or speaking in phrases.

DIAGNOSTIC TESTING, PHYSICAL FINDINGS, AND ICD-9-CM CODING

Diagnostic testing: The diagnosis is confirmed by biochemical or genetic testing of the gene mutation resulting in abnormal enzyme activity:

Type 1--peroxisomal enzyme function, including red blood cell concentration of plasmalogens (deficient), plasma concentration of phytanic acid (elevated), and plasma concentration of very long chain fatty acids (VLCFA) (normal) (PEX7);

Type 2--glyceronephosphate O-Acyl transferase (GNPAT);

Type 3--alkyldihydroxyacetonephosphate synthase (AGPS).

Physical findings: Developmental delays, growth failure, cataracts, midface hypoplasia (prominent forehead, widely set eyes, sunken appearance of the middle of the face, small nose with upturned nostrils, and full cheeks), shortening of bones in upper extremities and femurs, and joint contractures.

ICD-9: 277.86

ONSET AND PROGRESSION

Most survive only into childhood; it is rare for an affected child to live past age 10. Death is usually caused by recurrent respiratory infections.

TREATMENT

There is no current cure for RCDP. Treatment is supportive and many include physical therapy, anti-seizure medication, hearing amplification, and cataract removal.

SUGGESTED PROGRAMMATIC ASSESSMENT*

Suggested MER for evaluation:

  • Clinical history and examination that describes diagnostic features of the impairment and genetic testing to confirm the diagnosis

  • Development assessment or psychological testing to address allegations of mental impairment may be warranted.

Suggested Listings for Evaluation:

DETERMINATION

LISTING

REMARKS

Meets Listing

110.08B

 

Medical Equals

  

* Adjudicators may, at their discretion, use the Medical Evidence of Record or Listings suggested to evaluate the claim. However, the decision to allow or deny the claim rests with the adjudicator.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0423022885
DI 23022.885 - Rhizomelic Chondrodysplasia Punctata - 08/10/2012
Batch run: 08/10/2012
Rev:08/10/2012