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What Does The Presence Of Single Palmar Crease In An Infant Indicate?

Posted on Thu, 1 Oct 2015

Question: hi, my baby is 2 months old, he had his first development check with the nurse couple days ago, and she said that she thinks he has a single palmer crease in one of his hand, that is associated with Down syndrome, but my baby doesn't have Down syndrome, he's perfectly healthy, he plays, he smiles, he understands everything, also on my 12 week ultrasound for nuchal translucency it was everything perfect and also with the blood test, the 20 week ultrasound was perfect as well, so I went to my family gp, he said my baby is perfectly normal and healthy, that I have nothing to worry about, that he doesn't have a single palmer crease that is not a straight line, so I was still worried and went to another doctor for a second opinion, she say same thing, that my baby is perfectly healthy that she's sure of that, I am still worried cause the nurse really scared me, so I made an appointment with a paediatrician to make sure, the line for sure is not a single straight line, I have pictures, what do you think?? Thank you very much

Answered by Dr. Pradeep Kumar Jain (40 minutes later)

Brief Answer:
Please attach the image

Detailed Answer:
Hello

Thanks for asking on this platform

I can understand your concern.Down syndrome is a constellation of various features and single palmer crease (simian crease) is only one of those.
I suggest you to attach the image of baby including face(to see up slanting of eye,depressed and wide nasal bridge),hand(for simian crease,brachydactyly) and feet (for sandle gap,gap between first and second toe).
If the nuchal translucency and development is normal and two of your physicians have cleared the baby,I won't get overly worried.

Waiting for your response.
Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Pradeep Kumar Jain (14 minutes later)

Hi, I have uploaded the pictures. Thank you

Answered by Dr. Pradeep Kumar Jain (6 hours later)

Brief Answer:
Details below

Detailed Answer:
Thanks for follow up

I have seen the images.After going through the image of feet I could not find 'sandle gap' a characteristic of Down syndrome.
In one image hand is visible and I agree that there is single crease in one hand (called simian crease).
Only presence of simian crease does not confirm the diagnosis of Down syndrome.Single craese in hand can be there in 5-10 % of general population.There must be other features for diagnosis of Down syndrome.

I could not find image of face and close view of both the hands.
I request you to attach the images of face and both hand so that I better able to help you out.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Pradeep Kumar Jain (1 hour later)

I have uploaded the picture. Thank you

Answered by Dr. Pradeep Kumar Jain (36 minutes later)

Brief Answer:
Don't worry.Features are not suggestive of Down syndrome

Detailed Answer:
Thanks for attaching the pictures

After going through the image,his features are not suggestive of Down syndrome.
In Down syndrome there is up slanting of eye(outer canthus directs upward) and ears are low set which is not your baby.
So, I suggest you not to get worried.Get a regular checkup done as per appointment of pediatrician.

Wish your baby all good health.
Regards

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar