Morquio syndrome

Last revised by Dr Sonam Vadera on 26 Jan 2022

Morquio syndrome (in older literature it is sometimes called Morquio-Brailsford syndrome) is an autosomal recessive mucopolysaccharidosis (MPS) type IV.

Incidence estimated at ~1:40,000.

Many cases present at ~2 years of age and have normal intelligence. Clinical features:

  • severe dwarfism (<4 foot)
  • joint laxity
  • corneal opacification/clouding
  • lymphadenopathy
  • progressive deafness
  • spinal kyphoscoliosis
  • prominent mandible and lower face 
  • short neck

It results from an excess of keratan sulphate due to a deficit in its degradation pathway. Keratan sulphate accumulates in various tissues inclusive of cartilage, the nucleus pulposus of the intervertebral discs and corneas.

  • short and wide tubular bones
  • metaphyseal flaring in long bones
  • multiple epiphyseal centers
  • wide metacarpals with proximal pointing of index to little finger
  • irregular carpal bones 
  • flattened proximal femoral epiphyses; risk of lateral subluxation and dislocation
  • coxa valga
  • genu valgum
  • anterior sternal bowing, increased AP chest diameter, wide ribs

Life expectancy ranges between 30-40 years. The most common cause of death is cervical myelopathy from C2 abnormality. Patients are also particularly vulnerable to respiratory infection.

Named after Luis Morquio, an Uruguayan pediatrician (1867-1935) 5. James Brailsford (1889-1961) 6 a renowned British radiologist made an important contribution to the understanding of the radiographic appearances of this condition.

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Cases and figures

  • Case 1: showing wide proximal pointing metacarpals
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  • Case 2
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  • Case 3: diffuse platyspondyly
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  • Case 4: mucopolysaccharidoses
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