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Congenital diarrhea 5 with tufting enteropathy(DIAR5; CTE)

MedGen UID:
413031
Concept ID:
C2750737
Disease or Syndrome
Synonyms: Congenital tufting enteropathy; INTESTINAL EPITHELIAL CELL DYSPLASIA
Modes of inheritance:
Autosomal recessive inheritance
MedGen UID:
141025
Concept ID:
C0441748
Intellectual Product
Source: Orphanet
A mode of inheritance that is observed for traits related to a gene encoded on one of the autosomes (i.e., the human chromosomes 1-22) in which a trait manifests in individuals with two pathogenic alleles, either homozygotes (two copies of the same mutant allele) or compound heterozygotes (whereby each copy of a gene has a distinct mutant allele).
 
Gene (location): EPCAM (2p21)
 
Monarch Initiative: MONDO:0013184
OMIM®: 613217
Orphanet: ORPHA92050

Definition

Congenital tufting enteropathy (CTE) is a rare inherited intractable diarrhea of infancy characterized by villous atrophy and absence of inflammation, with intestinal epithelial cell dysplasia manifesting as focal epithelial tufts in the duodenum and jejunum. CTE presents in the first few months of life with chronic watery diarrhea and failure to thrive, and most affected individuals require parenteral nutrition for normal growth and development (summary by Sivagnanam et al., 2008). Semiquantitative assessment of the epithelial surface in CTE patients revealed that 80 to 90% contained tufts, compared to only 16% in patients with celiac disease and less than 10% in normal jejunum (Reifen et al., 1994). For a discussion of genetic heterogeneity of diarrhea, see DIAR1 (214700). [from OMIM]

Clinical features

From HPO
Small for gestational age
MedGen UID:
65920
Concept ID:
C0235991
Finding
Smaller than normal size according to sex and gestational age related norms, defined as a weight below the 10th percentile for the gestational age.
Failure to thrive
MedGen UID:
746019
Concept ID:
C2315100
Disease or Syndrome
Failure to thrive (FTT) refers to a child whose physical growth is substantially below the norm.
Villous atrophy
MedGen UID:
154306
Concept ID:
C0554101
Finding
The enteric villi are atrophic or absent.
Intractable diarrhea
MedGen UID:
148164
Concept ID:
C0743178
Disease or Syndrome
Crypt hyperplasia
MedGen UID:
482134
Concept ID:
C3280504
Finding
Crypt hyperplasia denotes elongation of the length of the crypts of Lieberkuhn, a process that initially precedes villous atrophy. Elongation may be caused by expansion of the lamina propria as a result of the proliferation of stromal cells, an influx of inflammatory cells and tissue remodeling.
Arthritis
MedGen UID:
2043
Concept ID:
C0003864
Disease or Syndrome
Inflammation of a joint.

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVCongenital diarrhea 5 with tufting enteropathy
Follow this link to review classifications for Congenital diarrhea 5 with tufting enteropathy in Orphanet.

Recent clinical studies

Etiology

Caralli M, Roman C, Coste ME, Roquelaure B, Buffat C, Bourgeois P, Badens C, Fabre A
J Pediatr Gastroenterol Nutr 2021 Jun 1;72(6):826-832. doi: 10.1097/MPG.0000000000003049. PMID: 33976085
Ranganathan S, Schmitt LA, Sindhi R
Am J Surg Pathol 2014 Feb;38(2):265-72. doi: 10.1097/PAS.0000000000000106. PMID: 24418860
Salomon J, Goulet O, Canioni D, Brousse N, Lemale J, Tounian P, Coulomb A, Marinier E, Hugot JP, Ruemmele F, Dufier JL, Roche O, Bodemer C, Colomb V, Talbotec C, Lacaille F, Campeotto F, Cerf-Bensussan N, Janecke AR, Mueller T, Koletzko S, Bonnefont JP, Lyonnet S, Munnich A, Poirier F, Smahi A
Hum Genet 2014 Mar;133(3):299-310. Epub 2013 Oct 19 doi: 10.1007/s00439-013-1380-6. PMID: 24142340
Lemale J, Coulomb A, Dubern B, Boudjemaa S, Viola S, Josset P, Tounian P, Girardet JP
J Pediatr Gastroenterol Nutr 2011 Jun;52(6):734-9. doi: 10.1097/MPG.0b013e31820731db. PMID: 21478758
Roche O, Putterman M, Salomon J, Lacaille F, Brousse N, Goulet O, Dufier JL
Am J Ophthalmol 2010 Jul;150(1):116-121.e1. Epub 2010 May 5 doi: 10.1016/j.ajo.2010.01.034. PMID: 20447614

Diagnosis

Nakato G, Morimura S, Lu M, Feng X, Wu C, Udey MC
Cells 2020 Aug 6;9(8) doi: 10.3390/cells9081847. PMID: 32781650Free PMC Article
Overeem AW, Posovszky C, Rings EH, Giepmans BN, van IJzendoorn SC
Dis Model Mech 2016 Jan;9(1):1-12. doi: 10.1242/dmm.022269. PMID: 26747865Free PMC Article
Ranganathan S, Schmitt LA, Sindhi R
Am J Surg Pathol 2014 Feb;38(2):265-72. doi: 10.1097/PAS.0000000000000106. PMID: 24418860
Lemale J, Coulomb A, Dubern B, Boudjemaa S, Viola S, Josset P, Tounian P, Girardet JP
J Pediatr Gastroenterol Nutr 2011 Jun;52(6):734-9. doi: 10.1097/MPG.0b013e31820731db. PMID: 21478758
Roche O, Putterman M, Salomon J, Lacaille F, Brousse N, Goulet O, Dufier JL
Am J Ophthalmol 2010 Jul;150(1):116-121.e1. Epub 2010 May 5 doi: 10.1016/j.ajo.2010.01.034. PMID: 20447614

Therapy

Pathak SJ, Mueller JL, Okamoto K, Das B, Hertecant J, Greenhalgh L, Cole T, Pinsk V, Yerushalmi B, Gurkan OE, Yourshaw M, Hernandez E, Oesterreicher S, Naik S, Sanderson IR, Axelsson I, Agardh D, Boland CR, Martin MG, Putnam CD, Sivagnanam M
Hum Mutat 2019 Feb;40(2):142-161. Epub 2018 Nov 29 doi: 10.1002/humu.23688. PMID: 30461124Free PMC Article
Aydin M, Ganschow R, Jankofsky M
Turk J Pediatr 2017;59(1):93-96. doi: 10.24953/turkjped.2017.01.018. PMID: 29168373

Prognosis

Aydin M, Ganschow R, Jankofsky M
Turk J Pediatr 2017;59(1):93-96. doi: 10.24953/turkjped.2017.01.018. PMID: 29168373
Kahvecioğlu D, Yıldız D, Kılıç A, İnce-Alkan B, Erdeve Ö, Kuloğlu Z, Atasay B, Ensari A, Yılmaz R, Arsan S
Turk J Pediatr 2014 Jul-Aug;56(4):440-3. PMID: 25818968
Martin BA, Kerner JA, Hazard FK, Longacre TA
Am J Surg Pathol 2014 Oct;38(10):1387-95. doi: 10.1097/PAS.0000000000000314. PMID: 25188866
Ranganathan S, Schmitt LA, Sindhi R
Am J Surg Pathol 2014 Feb;38(2):265-72. doi: 10.1097/PAS.0000000000000106. PMID: 24418860
Lemale J, Coulomb A, Dubern B, Boudjemaa S, Viola S, Josset P, Tounian P, Girardet JP
J Pediatr Gastroenterol Nutr 2011 Jun;52(6):734-9. doi: 10.1097/MPG.0b013e31820731db. PMID: 21478758

Clinical prediction guides

Liu Y, Yin P, Cui J, Sun C, Chen L, Hong N
J Comput Assist Tomogr 2023 Sep-Oct 01;47(5):766-773. Epub 2023 May 26 doi: 10.1097/RCT.0000000000001475. PMID: 37707407Free PMC Article
Nakato G, Morimura S, Lu M, Feng X, Wu C, Udey MC
Cells 2020 Aug 6;9(8) doi: 10.3390/cells9081847. PMID: 32781650Free PMC Article
Azzopardi C, Pullicino E, Coleiro B, Galea Soler S
BMJ Case Rep 2016 Aug 24;2016 doi: 10.1136/bcr-2016-215252. PMID: 27558188Free PMC Article
Lemale J, Coulomb A, Dubern B, Boudjemaa S, Viola S, Josset P, Tounian P, Girardet JP
J Pediatr Gastroenterol Nutr 2011 Jun;52(6):734-9. doi: 10.1097/MPG.0b013e31820731db. PMID: 21478758
Roche O, Putterman M, Salomon J, Lacaille F, Brousse N, Goulet O, Dufier JL
Am J Ophthalmol 2010 Jul;150(1):116-121.e1. Epub 2010 May 5 doi: 10.1016/j.ajo.2010.01.034. PMID: 20447614

Recent systematic reviews

Caralli M, Roman C, Coste ME, Roquelaure B, Buffat C, Bourgeois P, Badens C, Fabre A
J Pediatr Gastroenterol Nutr 2021 Jun 1;72(6):826-832. doi: 10.1097/MPG.0000000000003049. PMID: 33976085

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