Presentation
The expressivity of these symptoms is, however, extremely variable, even within single ATS affected families, and not all ATS patients present with the full triad of symptoms. [ncbi.nlm.nih.gov]
Patients with ATS typically present with the triad of periodic paralysis, cardiac arrhythmias, and developmental dysmorphisms. Although penetrance of ATS is high, disease expression and severity are remarkably variable. [doi.org]
The documents contained in this web site are presented for information purposes only. The material is in no way intended to replace professional medical care by a qualified specialist and should not be used as a basis for diagnosis or treatment. [orpha.net]
Cardiovascular
- Palpitations
The irregular heartbeats can lead to discomfort, such as the feeling that the heart is skipping beats (palpitations). Uncommonly, the irregular heartbeats can cause fainting (syncope), and even more rarely, sudden death. [ghr.nlm.nih.gov]
This, as in other forms of long QT syndrome, can lead to abnormal heart rhythms such as ventricular ectopy or ventricular tachycardia causing palpitations. [en.wikipedia.org]
It can result in palpitations, syncope, thromboembolic stroke, and congestive heart failure. {ECO:0000269 PubMed:15922306}. Note=The disease is caused by mutations affecting the gene represented in this entry. [genecards.org]
All seven patients reported episodes of palpitations, while three of them associated it with presyncope or syncope (42.8%). Two subjects (28.5%) had a history of periodic paralysis. [innovationsincrm.com]
Musculoskeletal
- Small Hand
[…] of finger Short finger bones 0009803 Slender long bone Long bones slender Thin long bones [ more ] 0003100 Small hand Disproportionately small hands 0200055 Syncope Fainting spell 0001279 Toe syndactyly Fused toes Webbed toes [ more ] 0001770 Triangular [rarediseases.info.nih.gov]
Additional findings include small hands and feet, loose joints, and abnormal sideways curvature of the spine (scoliosis). [rarediseases.org]
hands and feet, AND at least two of the following: Low-set ears Widely spaced eyes Small mandible Fifth-digit clinodactyly Syndactyly of toes 2 and 3 B. [ncbi.nlm.nih.gov]
The clinical diagnosis of ATS was performed by the presence of at least two of the following criteria: 1) familial periodic paralysis; 2) characteristic facies, dental abnormalities, or small hands/feet, and at least two of low-set ears, widely spaced [innovationsincrm.com]
Presence of 2 of the following 3 criteria: ‐ Periodic paralysis ‐ Symptomatic cardiac arrhythmias or ECG evidence of enlarged U‐waves, ventricular ectopy or a prolonged QTc or QUc interval ‐ Characteristic facies, dental anomalies, small hands and feet [doi.org]
Face, Head & Neck
- Bulbous Nose
nose 0000414 Cleft palate Cleft roof of mouth 0000175 Clinodactyly of the 5th finger Permanent curving of the pinkie finger 0004209 Clinodactyly of the 5th toe 0001864 Delayed eruption of permanent teeth Delayed eruption of adult teeth 0000696 Delayed [rarediseases.info.nih.gov]
Additional facial features include a round (bulbous) nose, a thin upper lip, a triangular-shaped face, highly-arched roof of the mouth (palate), a cleft palate, and underdevelopment of the cheek bones (malar hypoplasia). [rarediseases.org]
Characteristic facies include broad forehead, short palpebral fissures, wide nasal bridge with bulbous nose, hypoplasia of maxilla and mandible, thin upper lip, and a triangular face. [ncbi.nlm.nih.gov]
Urogenital
- Cryptorchidism
[…] skull, hypertelorism, bilateral ptosis, low‐set ears, broad nose, mandibular hypoplasia, aplasia of a number of teeth, defect of both the soft and osseous palate, inward bending of the fifth fingers, single transverse palmar crease of both hands, and cryptorchidism [doi.org]
Workup
Clinical Testing and Workup Because potassium levels may be reduced during an episode of periodic paralysis, a blood test to determine the serum potassium levels during an episode can be helpful in diagnosing the disorder in some cases. [rarediseases.org]
Cardiac evaluations using serial ECGs with measurements of the QTc interval are essential and should be performed on all patients undergoing workup for periodic paralysis. 23, 24, 25 References 1. [hkpp.org]
[…] more practical approach is calculation of the urine potassium-to-creatinine ratio from a spot urine specimen; a ratio greater than 1.5 mEq per mmol (13 mEq per g) is indicative of renal potassium wasting. 18 If no cause is identified with the initial workup [aafp.org]
Rhythm
- Bidirectional Ventricular Ectopy
Title Other Names: Long QT syndrome 7; LQT7; Potassium-sensitive periodic paralysis, ventricular ectopy, and dysmorphic features; Long QT syndrome 7; LQT7; Potassium-sensitive periodic paralysis, ventricular ectopy, and dysmorphic features; Andersen cardiodysrhythmic [rarediseases.info.nih.gov]
T Wave
- Prominent U Wave
Accounting for the small sample size, prominent U-waves and the “U on P sign” seem to be the most consistent across studies. [innovationsincrm.com]
ECG was notable for prominent U waves, with sinus rhythm and a normal QT interval. Genetic screening identified a heterozygous mutation in the KCNJ2 gene. The patient returned during an attack for nerve conduction and needle EMG studies. [neurologytimes.com]
U wave; (3) at least two of the following dysmorphic features: low-set ears, wide-set eyes, a small mandible, fifth-digit clinodactyly, and syndactyly; and (4) a family member with confirmed Andersen–Tawil syndrome.Genetic testing can be used to identify [en.wikipedia.org]
[…] frontal sinuses 0005478 Prominent U wave 0025072 Scapular winging Winged shoulder blade 0003691 Scoliosis 0002650 Short foot Short feet Small feet [ more ] 0001773 Short mandibular rami 0003778 Short metacarpal Shortened long bone of hand 0010049 Short [rarediseases.info.nih.gov]
U wave or prolonged QTc. [ncbi.nlm.nih.gov]
Treatment
Standard Therapies Treatment The treatment of Andersen-Tawil syndrome is directed toward the specific symptoms that are apparent in each individual. Treatment may require the coordinated efforts of a team of specialists. [rarediseases.org]
Management and treatment Treatment depends on the individual and their reaction to potassium. Patients with severe arrhythmias may require a pacemaker. The documents contained in this web site are presented for information purposes only. [orpha.net]
Studies should include long‐term follow‐up, cost benefits of treatment, effects of treatment on permanent muscle weakness, adverse events, as well as efficacy. [doi.org]
Prognosis
Diagnosis - Andersen Tawil syndrome Prognosis - Andersen Tawil syndrome Not supplied. Treatment - Andersen Tawil syndrome Resources - Andersen Tawil syndrome [checkorphan.org]
Parents should talk to their children’s physician and medical team about their specific case, associated symptoms and overall prognosis. [rarediseases.org]
Prognosis mainly depends on management of cardiac arrhythmia. Though muscle weakness is disabling, patients usually remain ambulatory throughout life. [japi.org]
However, in general, the prognosis is good. The optimal pharmacological therapy has to be identified. Beta-blockers, flecainide, and possibly other sodium-channel blockers and calcium-channel antagonists are good candidates. [academic.oup.com]
Electrical diseases of the heart are heritable arrhythmogenic clinical entities that may share common clinical and genetic features, yet may be distinctly different in their genesis, prognosis, and management. [worldcat.org]
Etiology
Summary Etiology Mutations in KCNJ2, which encodes the alpha subunit of the potassium channel Kir2.1, account for approximately 60% of cases. [orpha.net]
This concept has proven valuable for classifying disorders and understanding their etiology. In the case of muscle channelopathies, it has been especially helpful in the understanding of a group of rare disorders that, on the surface, are different. [journals.lww.com]
Isser, Sandeep Bansal, Anandaraja Subramanian, Bidirectional ventricular tachycardia of unusual etiology, Indian Pacing and Electrophysiology Journal, 2015, 15, 6, 296 CrossRef 19 Stephen C. [onlinelibrary.wiley.com]
Epidemiology
> ; # Epidemiology schema:about http://experiment.worldcat.org/entity/work/data/1375926537#Thing/internal_medicine > ; # Internal medicine. schema:about http://experiment.worldcat.org/entity/work/data/1375926537#Topic/heart_physiology > ; # Heart--physiology [worldcat.org]
Home, Search, Index, Links, Pathology, Molecules, Syndromes, Muscle, NMJ, Nerve, Spinal, Ataxia, Antibody & Biopsy, Patient Info EPISODIC MUSCLE WEAKNESS Hypokalemic Periodic Paralysis Hypokalemic periodic paralysis, Hereditary: General features Epidemiology [neuromuscular.wustl.edu]
rare grp of disorders - mostly inherited as autosomal dominant traits Hypokalaemic periodic paralysis Aetiology & epidemiology - 1/3 cases sporadic - remainder predominantly inherited but in young men, particularly Latin Americans & Orientals may occur [aic.cuhk.edu.hk]
Relevant External Links for KCNJ2 Genetic Association Database (GAD) KCNJ2 Human Genome Epidemiology (HuGE) Navigator KCNJ2 Atlas of Genetics and Cytogenetics in Oncology and Haematology: KCNJ2 No data available for Genatlas for KCNJ2 Gene Genetic and [genecards.org]
Depending on the nature of the disease, the treatment may consist of thyrostatics (drugs that reduce production of thyroid hormone), radioiodine, or occasionally thyroid surgery. [1] [2] Epidemiology [ edit ] TPP occurs predominantly in males of Chinese [en.wikipedia.org]
Pathophysiology
[…] mostly inherited as autosomal dominant traits Hypokalaemic periodic paralysis Aetiology & epidemiology - 1/3 cases sporadic - remainder predominantly inherited but in young men, particularly Latin Americans & Orientals may occur in association with TTX Pathophysiology [aic.cuhk.edu.hk]
Brenner/Rector remains the go-to resource for practicing and training nephrologists and internists who wish to master basic science, pathophysiology, and clinical best practices. [books.google.com]
Kass, Molecular Pathophysiology of Congenital Long QT Syndrome, Physiological Reviews, 97, 1, (89), (2017). [doi.org]
This article reviews the epidemiology, etiology, pathophysiology, clinical manifestations, laboratory findings, differential diagnosis, and management of TPP. [enotes.tripod.com]
Pathophysiology All forms of the long QT syndrome involve an abnormal repolarization of the heart. The abnormal repolarization causes differences in the "refractoriness" of the myocytes. [sites.google.com]
Prevention
Treat episodes by correcting serum potassium and prevent episodes by recommending lifestyle changes. [merckmanuals.com]
Many mutations prevent a molecule called PIP2 from binding to the channels and effectively regulating their activity. [wikidoc.org]
Prevention - Andersen Tawil syndrome Not supplied. Diagnosis - Andersen Tawil syndrome Prognosis - Andersen Tawil syndrome Not supplied. Treatment - Andersen Tawil syndrome Resources - Andersen Tawil syndrome [checkorphan.org]
The treatment approach should include both management of acute attacks and prevention of attacks. [ncbi.nlm.nih.gov]