Monday, September 15, 2008

VACTERL association

V- Vertebral anomalies
A- Anal Atresia
C- Cardiovascular anomalies
T- Tracheoesophageal fistula
E-Esophagial Atresia
R- Renal anomalies or Radial anomalies
L- Limb anomalies

This is an association not a syndrome because of a lack of one single pathogenic gene. PubMed as of 9/15/08 does not give any psychological sequelae to this association. That is odd, given the neuroectodermal involvement as evidenced by the vertebral anomalies.
One paper found that IQ did not tend to be different from any other children hence the need to address individual anomalies early on is essential. Like any other chronic disease the earlier any barriers to development are removed the more "normal" the development.
Here is a network for family and children with VACTERL .
I have seen one child with this syndrome with anger issues. I did not have the opportunity to engage in a psychiatric interview though so I cannot delineate the etiology of the anger.

More research needed. :)