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2.1
Axenfeld-Rieger Syndrome Type 3
Axenfeld Syndrome

Presentation

Some authors still subcategorize ARS in three terms, commonly with overlapping presentations. [statpearls.com]

There are some limitations in the present case: Only 1 ARS patient was presented because it is a kind of rare autosomal dominant disorder in the ophthalmic clinic. [journals.lww.com]

This is consistent with the presentation of the Chinese ARS patients of the present study. The proband presented with glaucoma and severe visual field defect in the right eye but a normal visual field in the left eye. [spandidos-publications.com]

CASE SUMMARY A 25-year-old female presented with a constant lower abdominal pain of increasing severity. [wjgnet.com]

2022/60/1/101/340346 Case Report A 32-year-old young male presented with painless defective vision in the right eye (RE) of 5 days duration. [tnoajosr.com]

Entire Body System

  • Falling

    Additional disorders such as iridogoniodysgenesis, iris hypoplasia and Peter’s anomaly fall under the umbrella of ARS. ARS is fully penetrant but shows variable expression, even within a family. [genedx.com]

    Clinical conditions falling within the phenotypic spectrum of anterior segment dysgeneses include aniridia, Axenfeld anomaly, Reiger anomaly/syndrome, Peters anomaly, and iridogoniodysgenesis. ASGD4 is an autosomal dominant disease. [genecards.org]

    Any variants that fall outside these regions are not analyzed. Any specific limitations in the analysis of these genes are also listed in the table below. [invitae.com]

    Etiology Peters’ anomaly is one disease that falls within the spectrum of anterior segment dysgenesis with the likes of Axenfeld-Rieger syndrome. [eyewiki.aao.org]

    It is possible that the different phenotypes of iris abnormality in the two eyes of this patient fall within a spectrum of iris defect in ARS. [molvis.org]

  • Pain

    CASE SUMMARY A 25-year-old female presented with a constant lower abdominal pain of increasing severity. [wjgnet.com]

    Failure of both medical and surgical therapies resulted in enucleation of a blind, painful left eye at 10 years of age. [jamanetwork.com]

    Li X, Venugopalan SR, Cao H, Pinho FO, Paine ML, et al. A model for the molecular underpinnings of tooth defects in Axenfeld-Rieger syndrome. Hum Mol Genet. 2014;23:194-208. 3. Chang TC, Summers CG, Schimmenti LA, Grajewski AL. [jomfp.in]

    Li X, Venugopalan SR, Cao H, Pinho FO, Paine ML, et al: A model for the molecular underpinnings of tooth defects in Axenfeld-Rieger syndrome. Hum Mol Genet 23:194-208 (2014). [karger.com]

    Vitreoretinal degeneration Cleft soft palate Exostoses Abnormal joint morphology Osteoarthritis Epiphyseal dysplasia Platyspondyly Retinal degeneration Pectus carinatum Abnormality of the eye Arthritis Mandibular prognathia Pectus excavatum Long philtrum Pain [mendelian.co]

  • Asymptomatic

    Although the majority of the cases are asymptomatic, torsion of a WS is seen in approximately 0.2%-0.3% of splenectomies[3]. [wjgnet.com]

    Her asymptomatic parents elected to be tested and were negative for the mutation. [karger.com]

    Case 5 A 19 year-old Caucasian daughter was examined and considered asymptomatic. The best visual acuity was equal to 20/20 in both eyes. [scielo.br]

    […] phenotypes Posterior embryotoxon Peripheral iris adhesions Iris hypoplasia Polycoria Corectopia Glaucoma is the most common and serious co-morbidity Squint may be the only feature due to sensory deprivation amblyopia Symptoms Variable severity Ranges from asymptomatic [gene.vision]

Respiratoric

  • Saddle Nose

    […] deformity Saddle nose Ski jump nose [ more ] 0011120 Cryptorchidism Undescended testes Undescended testis [ more ] 0000028 Ectopia pupillae Displaced pupil 0009918 Growth hormone deficiency 0000824 Hydrocephalus Too much cerebrospinal fluid in the brain [rarediseases.info.nih.gov]

Jaw & Teeth

  • Microdontia

    The patient showed microdontia, but no other systemic abnormalities were detected. Under diagnostic suspicion of ARS, the proband's FOXC1 and PITX2 were sequenced after obtaining informed consent. [ncbi.nlm.nih.gov]

    Back to: « Axenfeld-Rieger syndrome Symptoms of Axenfeld-Rieger syndrome type 3 Clinical features : Imported from Human Phenotype Ontology (HPO) Abnormality of head or neck Concave nasal ridge Hypertelorism Microdontia Partial congenital absence of teeth [familydiagnosis.com]

    Microdontia, hypodontia were present but redundant umbilical fold was absent. He was operated for congenital heart disease at the age of 5 years. Diagnosis of Axenfeld-Riger syndrome with NVG was made. [casereports.in]

Ears

  • Hearing Impairment

    Diseases related with Hearing impairment and Midface retrusion In the following list you will find some of the most common rare diseases related to Hearing impairment and Midface retrusion that can help you solving undiagnosed cases. [mendelian.co]

    However, they often have a sensorineural hearing impairment and many have cardiac valvular and septal defects not usually seen in RIEG1. [disorders.eyes.arizona.edu]

Eyes

  • Corneal Opacity

    (enophthalmos), Rieger anomaly, and Teething delay. 8.3 Differential Diagnosis 8.3.1 Peters Anomaly (OMIM 604229) Peters anomaly (OMIM 604229) is characterized by central corneal opacity with posterior corneal defect, and iridocorneal and/or lenticular [entokey.com]

    Peters’ anomaly is one disease in a constellation of diseases that causes corneal opacity due to dysgenesis of the anterior segment during development. Peters’ anomaly can cause devastating corneal opacity in an infant leading to severe amblyopia. [eyewiki.aao.org]

    Absence of other corneal abnormalities, such as megalocornea, sclerocornea and corneal opacity are useful in distinguishing ARS from other anterior segment disorders. [orpha.net]

    Failures of proper interaction result in a number of developmental disorders such Peters’ anomaly (PA), Axenfeld-Rieger syndrome (ARS) or aniridia.[1] PA is characterized by a central corneal opacity with defects in the corneal endothelium, Descemet's [journals.lww.com]

  • Corneal Edema

    The fundus photography of bilateral eyes was not clear because of corneal edema and cataract (A, B lower). Figure 2: Corneal specular microscopy of bilateral eyes performed in the patient. [journals.lww.com]

    The biomicroscopic exam showed bilateral posterior embryotoxon ( Figure 2 ) and guttata with corneal edema and Descemet membrane's folds, characterizing Fuchs endothelial dystrophy. Gonioscopic view was not possible because of the corneal edema. [scielo.br]

    Chandler’s syndrome is produced when the pathologic changes are confined to the inner corneal surface with dysfunction of the endothelial pump resulting in corneal edema. [eyewiki.aao.org]

  • Blurred Vision

    Case 1 A 56 year-old female (mother) had blurred vision complaints. Her best visual acuity was 20/25 in the right eye and 20/50 in the left eye. [scielo.br]

    This patient also had a younger sister of 5-year-old, who also suffered from blurred vision and had developmental anomalies in maxillary anterior teeth. 3 Discussion ARS was first described by German ophthalmologist Theodor Axenfeld in 1920 as featured [journals.lww.com]

    The proband complained of blurred vision for the past 2 weeks in the right eye. Upon initial examination, the patient's best corrected visual acuity (BCVA) was HM/10 cm OD and 20/100 OS. [spandidos-publications.com]

    The proband complained of blurred vision for the past 6 months in both eyes. She did not receive any ophthalmic medications in the past, except 0.5 % timolol 2 times daily for the last 2 years after the diagnosis of glaucoma. [bmcophthalmol.biomedcentral.com]

  • Visual Impairment

    In addition, early-onset visual impairment can have a negative impact on a child’s early general development. [gene.vision]

    National Association for Parents of the Visually Impaired. PO Box 317, Watertown, MA 02472. (617) 972-7441 or (800) 562-6265.. National Association for Visually Handicapped. 22 West 21st Street, New York, NY 10010. (212) 889-3141.. [hourlybook.com]

  • Visual Impairment

    In addition, early-onset visual impairment can have a negative impact on a child’s early general development. [gene.vision]

    National Association for Parents of the Visually Impaired. PO Box 317, Watertown, MA 02472. (617) 972-7441 or (800) 562-6265.. National Association for Visually Handicapped. 22 West 21st Street, New York, NY 10010. (212) 889-3141.. [hourlybook.com]

Psychiatrical

  • Suggestibility

    Neither of the mother's parents are phenotypically affected with the condition and neither have the same mutation, suggesting a de novo event in the patient's mother. [karger.com]

    There are clues suggesting a disturbance of regulation of apoptosis 7, while other studies suggest that the disturbance occurs on terminal differentiation of the neural crest-derived corneal endothelium 8-9. [scielo.br]

    Currently, it is suggested that all these abnormalities are actually part of the same syndrome: Axenfeld-Rieger syndrome [5]. The authors declare no conflict of interest. [heraldopenaccess.us]

    Results Congenital Axenfeld-Rieger anomaly and glaucoma were inherited by both the proband and her male half-sibling from a phenotypically positive father and 2 different phenotypically negative mothers, suggesting an autosomal dominant inheritance. [jamanetwork.com]

Treatment

In fact, the treatment only involved the use of RPE and fixed orthodontic treatment for alignment of the dental elements. [head-face-med.biomedcentral.com]

More Types of Axenfeld-Rieger syndrome type 3 » Genetics of Axenfeld-Rieger syndrome type 3 Treatments See also the following treatment articles: Treatments for Axenfeld-Rieger syndrome Names and Terminology References Source: GTR (NCBI/NIH): ncbi.nlm.nih.gov [familydiagnosis.com]

After treatment with 10 μM DEAB, treatment with 0.1 nM and 1 nM RA did not affect EOM organization (O, P). Treatment with 10 nM RA with 10 μM DEAB resulted in EOMs that were thickened and disorganized as the IO muscles were connected to each other. [iovs.arvojournals.org]

In case of glaucoma, the goal of treatment is to reach low IOP. Surgery is performed if eye drops are not sufficient in lowering IOP. [orpha.net]

Treatment - Axenfeld-Rieger syndrome The treatment of Rieger syndrome is symptomatic and supportive and prostheses are used for dental malformations. Also, Genetic counseling may be of benefit for patients and their families. [checkorphan.org]

Prognosis

Diagnosis and Prognosis: Your eye doctor is the one to diagnose this condition. [disorders.eyes.arizona.edu]

Prognosis Prognosis is good, particularly in the absence of glaucoma. The documents contained in this web site are presented for information purposes only. [orpha.net]

Diagnosis - Axenfeld-Rieger syndrome Prognosis - Axenfeld-Rieger syndrome Not supplied. Treatment - Axenfeld-Rieger syndrome The treatment of Rieger syndrome is symptomatic and supportive and prostheses are used for dental malformations. [checkorphan.org]

Etiology

Etiology Patients with ARS have been found to have mutations in the transcription factor genes PITX2 (4q25) and FOXC1 (6p25). A large number of different mutations have been identified but there is no clear genotype-phenotype relationship. [orpha.net]

Several theories have been proposed to explain the etiology of FECD. [scielo.br]

Epidemiology

Summary Epidemiology The syndrome has an estimated prevalence of 1/200,000. Clinical description The clinical manifestations of ARS are highly variable. Features can be divided into ocular and non-ocular findings. [orpha.net]

The discussion covers the phenotype spectrum, epidemiology, mode of inheritance, pathogenesis, and clinical profile of each condition, all of which is accompanied by a wealth of illustrations. [books.google.it]

Pathophysiology

Pathophysiology, diagnosis, and management of glaucoma associated with Sturge-Weber syndrome. Int Ophthalmol. 2018 Feb. 38 (1):409-416. [Medline]. Kargi SH, Koc F, Biglan AW, Davis JS. Visual acuity in children with glaucoma. [emedicine.medscape.com]

Axenfeld syndrome is a rare autosomal dominant [2] disorder, which affects the development of the teeth, eyes, and abdominal region. [3] Pathophysiology [ edit ] The molecular genetics of Axenfeld syndrome are poorly understood, but center on three genes [en.wikipedia.org]

[…] follows: Detection of any of these mutations can give patients a clear diagnosis and prenatal procedures such as preimplantation genetic diagnosis, Chorionic villus sampling and Amniocentesis can be offered to patients and prospective parents. [11] Pathophysiology [ipfs.io]

Approximately 10% to 30% of patients with ARS present PITX2 mutations in 4q25 [6][9], and 40% to 70% present either FOXC1 or PITX2 gene abnormalities.[5] Heterozygous mutations in the FOXC1 gene and PITX2 cause 16% and 10% of cases respectively.[9] Pathophysiology [statpearls.com]

Pathophysiology Normal corneal development depends on neural crest migration which occurs in 3 distinctive waves during embryogenesis to produce the structures of the anterior chamber. This typically occurs during the 7th week of gestation. [eyewiki.aao.org]

Prevention

Early detection of ARS can also prevent serious ophthalmological problems. [hindawi.com]

Early detection of ARS and periodically reviewing potentially elevated intraocular pressure helps physicians to prevent visual field loss and improve the overall prognosis. [saudijos.org]

Rieger syndrome, Iridogoniodysgenesis with somatic anomalies, Goniodysgenesis hypodontia, RGS Symptoms - Axenfeld-Rieger syndrome Causes - Axenfeld-Rieger syndrome Prevention - Axenfeld-Rieger syndrome Not supplied. [checkorphan.org]

The prognosis is excellent in the absence of glaucoma but monitoring via periodic eye examinations is important throughout life as glaucoma can appear at any time and must be treated to prevent blindness. [disorders.eyes.arizona.edu]

CONCLUSION Early diagnosis of WS in the emergency department is important to prevent pedicle torsion or splenic necrosis and to avoid splenectomy. [wjgnet.com]

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2.1
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