Melora was born in 2011. She spent two weeks in the NICU because she had a lot of trouble feeding and her ability to breathe on her own was questionable. She was evaluated by an orthopedic surgeon and a geneticist for “multiple dysmorphic features”; she has mild joint contractures in her hands and feet (distal arthrogryposis) and limited flexibility in her knees and hips. After she came home, we started early intervention services. She’s been in occupational, speech, and physical therapies since she was 4 months old. Melora has always had a lot of muscle weakness (hypotonia), causing delays in her physical development. Her small muscles are also affected, causing eye-muscle weakness (for which she wears glasses) and feeding difficulties (we have to choose her foods carefully so she doesn’t choke on them). Her level of intellectual disability is hard to determine due to apraxia of speech (she can’t talk).
We’ve been seeing her geneticist since she was born, trying to find the cause of her difficulties and differences. After previous testing failed to provide answers, we got a whole exome sequencing and found (after almost four years) that Melora has a mutation in the gene “ZC4H2” (XQ11.1). Mutations in this gene are the cause of Wieacker-Wolff Syndrome (aka Wieacker Syndrome or WWS). Simply put, ZC4H2 helps with nervous system development and the creation of neurolomuscular connections. In other words, Melora’s brain has trouble telling her body what to do. And her joint contractures were caused by minimal prenatal movement (she got stuck because she couldn’t move).
While Melora’s specific mutation hasn’t been seen before, WWS is itself almost as rare. With “fewer than 30 affected individuals” (Orpha.net), it would be impossible for us to come up with a prognosis. Her future is very uncertain. Her neurologist says she will likely start having seizures at some point, but there’s no way to know how soon. We don’t know whether she’ll get better or worse since we currently have no others to compare her to. We hope, with this page, to find others like her and raise awareness for rare disease in general. And maybe if treatments or a cure are found for another rare disease, it could possibly help Melora.
Websites that have helpful information:
This article is one of two studies that we’ve found online: