Vaginal atresia and Bardet-Biedl syndrome association: A component or a distinct entity?

Bardet-Biedl syndrome is an autosomal recessive disorder. It is characteriz ed by cardinal anomalies including retinal dystrophy, digital malformations , mental retardation, obesity, and hypogonadism. Recently, renal anomalies also are mentioned among the cardinal signs. Although association of genita l anomalies among affected boys are well known, the association of vaginal atresia and other structural genital anomalies are not mentioned among the less-common manifestations of Bardet-Biedl syndrome in girls. Two girls wit h Bardet-Biedl syndrome presented with hematometrocolpos in the preadolesce nt period and vaginal atresia was diagnosed. After surgical treatment and e xtended hospitalization, uncontrolled sepsis resulted in progressive renal failure and death of both patients. Vaginal atresia is often delayed or mis sed in the early childhood period. In girls with Bardet-Biedl syndrome, Vag inal atresia or other structural genital anomalies should be evaluated more systematically during the initial diagnosis of the syndrome. In infancy, t he evaluation of a child with vaginal atresia also should include the diffe rential diagnosis of Bardet-Biedl syndrome. Vaginal atresia may either form a component of the syndrome, or girls who present with vaginal atresia in addition to other components of Bardet-Biedl syndrome might form a distinct entity.