Recognition of the phenotype of thalidomide embryopathy in countries endemic for leprosy: new cases and review of the main dysmorphological findings

Clin Dysmorphol. 2013 Apr;22(2):59-63. doi: 10.1097/MCD.0b013e32835ffc58.

Abstract

Thalidomide is the best-known teratogen worldwide. It was first marketed as a sedative in the late 1950s, but the birth of ~10 000 children with birth defects resulted in the withdrawal of thalidomide from the market in 1962. Thalidomide embryopathy affects almost all organs but the main defects are concentrated in the limbs, eyes, ears, and heart. Shortly after the withdrawal of thalidomide from the market, its effectiveness in the treatment of erythema nodosum leprosum, an inflammatory condition resulting from leprosy, was reported and since the mid-1990s, the drug has been used widely in the treatment of cancers and autoimmune diseases, among other conditions. 40 000 new cases of leprosy are diagnosed every year in Brazil. Although there is a strict legislation for the prescription and use of thalidomide in Brazil, cases of thalidomide embryopathy have continued to be reported. Here, we present two new cases of thalidomide embryopathy identified in 2011 and review the major clinical findings in the literature that can aid the identification of the embryopathy.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Brazil / epidemiology
  • Endemic Diseases
  • Erythema Nodosum / drug therapy
  • Female
  • Fetal Diseases / chemically induced*
  • Humans
  • Hypnotics and Sedatives / adverse effects
  • Legislation, Drug
  • Leprosy / drug therapy
  • Leprosy / epidemiology*
  • Leprosy / pathology
  • Male
  • Polydactyly / chemically induced
  • Thalidomide / adverse effects*

Substances

  • Hypnotics and Sedatives
  • Thalidomide