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Cerebellar Vermis Aplasia with Associated Features Suggesting Smith-Lemli-Opitz Syndrome and Meckel Syndrome
Hepatic Fibrosis-Renal Cysts-Intellectual Disability Syndrome

Presentation

Comprising 31 clinical protocols from the world's foremost clinical geneticists, Signs and Symptoms of Genetic Conditions provides a practical manual for the diagnosis and management of common human genetic conditions based on their presenting signs and [books.google.de]

A form of Diamond-Blackfan anemia, a congenital non-regenerative hypoplastic anemia that usually presents early in infancy. [nectarmutation.org]

Typical features if age of presentation is >1 y: Hematuria Proteinuria Hypertension Usual age of presentation is 30-50 y. [drdebasismaity.com]

Neonates present with hypertension, abdominal masses, and variable degrees of renal failure. Adults typically present with flank pain, hematuria, and hypertension. [emedicine.medscape.com]

The majority of patients present in infancy, although presentation can occasionally be as late as early adulthood. [hawaii.edu]

Immune System

  • Splenomegaly

    Hepatic involvement usually presents with symptoms secondary to portal hypertension, particularly varices and splenomegaly. Twenty-three percent of children with ARPKD experience variceal bleeding by a mean age of 12.5 years. [emedicine.medscape.com]

    Individuals with significant splenomegaly are fitted with spleen guards to wear when playing contact sports or performing activities that could result in splenic injury. [ncbi.nlm.nih.gov]

    Splenomegaly is a result of portal hypertension secondary to the hepatic fibrosis. Less severely affected children may present in childhood or even in adolescence. 16 Ultrasound Prenatal diagnosis has been reported as early as 14–17 weeks gestation. [adc.bmj.com]

    Splenectomy may be indicated for splenomegaly with significant complications. [homeopathyworldcommunity.ning.com]

    […] learning difficulties, progressive blindness, splenomegaly, unilateral blindness Approved renewal adalimumab bilateral chronic uveitis, cataract, keratopathy, learning difficulties, progressive blindness, splenomegaly, unilateral blindness Approved renewal [pharmac.govt.nz]

Entire Body System

  • Developmental Delay

    delay High serum iron and copper levels Hypotonia Other congenital* Cysts of nontubular origin (includes glomerular, subcapsular, and pyelocalyceal cysts) Various clinical characteristics Malformation syndromes Various clinical characteristics Tubular [msdmanuals.com]

    Related symptoms: Autosomal recessive inheritance Intellectual disability Seizures Global developmental delay Generalized hypotonia SOURCES: DOID MONDO UMLS OMIM More info about JOUBERT SYNDROME 21; JBTS21 Low match MUSCULAR DYSTROPHY-DYSTROGLYCANOPATHY [mendelian.co]

    There is usually some degree of developmental delay ranging from fine motor difficulties to intellectual disabilities. [tsbvi.edu]

    delay-chronic hepatitis syndrome Hepatic fibrosis-renal cysts-intellectual disability syndrome Hepatic veno-occlusive disease Hepatic veno-occlusive disease-immunodeficiency syndrome Hepatitis delta Hepatoencephalopathy due to combined oxidative phosphorylation [se-atlas.de]

  • Amyloidosis

    Alagille syndrome Cardiovascular Amyloidosis Cardiovascular Arrhythmogenic right ventricular cardiomyopathy (ARVD) Cardiovascular Basal cell nevus syndrome Cardiovascular Brugada syndrome Cardiovascular Cardiomyopathy (HCM/DCM) Cardiovascular Carvajal [genomediagnosticsnijmegen.nl]

    Meanings Anti-Tobacco Colon Cancer and Colorectal Cancers (The Brown ribbon is the alternate color, dark blue is the official ribbon color) Familia Polyposis Burgundy Awareness Ribbons - Causes and Meanings Adults with disabilities awareness and support Amyloidosis [disabled-world.com]

    Guidelines on the diagnosis and management of AL amyloidosis. London, UK: British Society for Haematology; February 2003. Available at: http://www.bcshguidelines.com/pdf/UKMFAL070703.pdf. Accessed May 7, 2007. Kujovich JL. [aetna.com]

    Intestinal Pseudo-obstruction Approved renewal hypromellose 0.3%, dextran 70 0.1% conjunctivitis sicca, dry eyes, keratitis Approved hypromellose 0.3%, dextran 70 0.1% sjogrens syndrome, conjunctivitis sicca, dry eyes, keratitis Approved renewal ibrutinib AL amyloidosis [pharmac.govt.nz]

  • Movement Disorder

    SMA is a genetic disorder that affects the control of muscle movement. [disabled-world.com]

    […] syndrome Neurological Lissencephaly Neurological Lowe oculocerebrorenal syndrome Neurological Marinesco-Sjögren syndrome Neurological Menkes disease Neurological Microcephaly-capillary malformation syndrome Neurological Motor neuropathy Neurological Movement [genomediagnosticsnijmegen.nl]

    Hyperkinetic movement disorders in children. In: UpToDate Online Journal [serial online]. Waltham, MA: UpToDate; updated April 2007. Weber S, Tonshoff B. [aetna.com]

    choreoathetoid movements, excessive oral secretions, excessive sweating, global development delay, hyponatraemia, severe GI dysmotility Approved trihexyphenidyl Complex Mitochondrial Disorder, choreoathetoid movements, excessive oral secretions, excessive [pharmac.govt.nz]

  • Lymphedema

    […] failure-multisystemic involvement syndrome Acute liver failure African iron overload Alagille syndrome Alpha-1-antitrypsin deficiency Autoimmune hepatitis Biliary atresia with splenic malformation syndrome Budd-Chiari syndrome CADDS Caroli disease Cholestasis-lymphedema [se-atlas.de]

    […] syndrome Skin Mal de Meleda Skin Melanoma-pancreatic cancer syndrome Skin Milroy-like lymphedema Skin Monilethrix Skin Multiple cutaneous and mucosal venous malformations Skin Nonne-Milroy lymphedema Skin Odonto onychodermal dysplasia Skin Oligodontia [genomediagnosticsnijmegen.nl]

    Light blue ribbon Addisons Disease Behcets Disease Chronic Illness Cushing Syndrome DiGeorge Syndrome Edwards Syndrome (Trisomy 18) Graves Disease Hyperaldosteronism Klinefelter's Syndrome Lymphedema Men's Health Prostate cancer awareness Shprintzen Syndrome [disabled-world.com]

Musculoskeletal

  • Macrocephaly

    / Autism Syndrome Macrocephaly, Benign Familial Monosomy 18q Mosaic Trisomy 9 Mucolipidosis Type IV Non-Distal Monosomy 10q Peho Syndrome Ptosis-Upper Ocular Movement Limitation-Absence Of Lacrimal Punctum Syndrome Relapsing Polychondritis Short-Limb [familydiagnosis.com]

    Conductive hearing impairment Choanal atresia Sensorineural hearing impairment Congenital onset Cerebellar vermis hypoplasia Agenesis of corpus callosum Abnormality of the dentition Coloboma Ventriculomegaly Oxycephaly Severe global developmental delay Coma Macrocephaly [mendelian.co]

    […] anomalies (MCA) Limb-Mammary syndrome Multiple congenital anomalies (MCA) Loeys-Dietz syndrome Multiple congenital anomalies (MCA) Lowe oculocerebrorenal syndrome Multiple congenital anomalies (MCA) Lujan-Fryns syndrome Multiple congenital anomalies (MCA) macrocephaly [genomediagnosticsnijmegen.nl]

    or At least 2 biopsy-proven trichilemmomas; or Macrocephaly plus one other major criteria Footnotes * ; or Three major criteria Footnotes * without macrocephaly; or One major and at least three minor criteria Footnotes * ; or Four or more minor criteria [aetna.com]

Neurologic

  • Apraxia

    The most common clinical features include delayed psychomotor development, hypotonia, abnormal respiratory patterns in the neonatal period, oculomotor apraxia, and cerebellar ataxia. [mendelian.co]

    (both in the horizontal and vertical directions), and hypometric saccades if oculomotor apraxia is not complete. [jscimedcentral.com]

    Autosomal Recessive Polycystic Kidney Disease Congenital Hepatic Fibrosis Caroli's Disease Polycystic Kidney Disease Joubert Syndrome Cerebro-Oculo-Renal Syndromes COACH Syndrome Senior-Loken Syndrome Dekaban-Arima Syndrome Cogan Oculomotor Apraxia Nephronophthisis [clinicaltrials.gov]

    Oculomotor apraxia is one of the most characteristic and frequent abnormalities, that manifests with the inability to follow objects visually with compensatory head movements. Primary position nystagmus is also common. [annalsofian.org]

    A disorder presenting with cerebellar ataxia, oculomotor apraxia, hypotonia, neonatal breathing abnormalities and psychomotor delay. [nectarmutation.org]

  • Tremor

    Some common symptoms include rapid heartbeat, shortness of breath, changes in eyes and vision, tremors and muscle weakness, anxiety, difficulty concentrating and insomnia. [tsbvi.edu]

    These symptoms can include speech problems, muscle tremors, weakness in the limbs, restricted movement, and reduced vision. See also: vision loss, paralysis. [ykassd.com]

    - Silver Ribbon with a bell (Also Blue Ribbon) Brain Disabilities Brain disorders awareness Campaign for the Brain Charcot-Marie-Tooth (CMT) Cortical Visual Impairment (CVI) Awareness Disabled Children Dyslexia Elderly Abuse Encephalitis Essential Tremor [disabled-world.com]

    […] kinesigenic dyskinesia Neurological Episodic pain syndrome Neurological Erythermalgia, primary or idiopathic Neurological Familial infantile convulsions with paroxysmal choreoathetosis Neurological Febrile seizures Neurological Fragile-X associated tremor [genomediagnosticsnijmegen.nl]

    In some cases, tremor has been reported [ 20 ]. [ojrd.biomedcentral.com]

  • Dysarthria

    He demonstrated severe dysarthria, moderate ataxia of stance of gait, poor judgment, and borderline intelligence. His abnormal eye movements were less prominent and his hyperpnea had diminished. [jscimedcentral.com]

    Affected individuals typically present with asymmetric focal weakness of the extremities (stumbling or poor handgrip) or bulbar findings (dysarthria, dysphagia). [aetna.com]

  • Difficulty Concentrating

    Some common symptoms include rapid heartbeat, shortness of breath, changes in eyes and vision, tremors and muscle weakness, anxiety, difficulty concentrating and insomnia. [tsbvi.edu]

    Intellectual disability is characterized by a low IQ, developmental delays, dependence on others for help with daily tasks, and difficulty concentrating, learning, or socializing. [ykassd.com]

  • Slurred Speech

    Neurologic examination was remarkable for slurred speech, vertical gaze palsy, slight dysmetria, and mild gait ataxia. The ocular fundus examination was normal bilaterally. [pnas.org]

Workup

Progress logically from the histologic pattern, through the appropriate workup, around the pitfalls, to the best diagnosis. [books.google.de]

A clinical geneticist or genetic counselor familiar with Alagille syndrome should review the results of the workup of a parent or relative to try to determine the recurrence risk for the individual. [chop.edu]

X-Ray

  • Multiple Renal Cysts

    The kidneys are bilaterally enlarged with multiple cysts. CT scan of the same patient (70-year-old woman with autosomal dominant polycystic kidney disease [ADPKD]) demonstrating multiple hepatic cysts. [homeopathyworldcommunity.ning.com]

    Three patients had ultrasound evidence of multiple renal cysts but they had normal renal function. [annalsofian.org]

    However, those are usually solitary, whereas in TSC they are commonly multiple and bilateral. About 20-30% of people with TSC have renal cysts, causing few problems. However, 2% may also have autosomal dominant polycystic kidney disease. [en.wikipedia.org]

    A B multiple cysts, typically small cortical ones. [slideshare.net]

  • Pericardial Effusion

    effusion, Pleural Effusion, Rheumatic Heart Disease, valve replacement Approved co-enzyme q autosomal recessive cerebellar atrophy Approved co-enzyme q autosomal recessive cerebellar atrophy Approved renewal coenzyme q 10 alpers' disease, mitochondrial [pharmac.govt.nz]

Serum

  • Thrombocytosis

    […] hypogonadism, secondary pancreatitis to azathioprine, Ulcerative Colitis Approved renewal pipobroman essential thrombocytosis, polycythaemia rubra vera Approved pipobroman essential thrombocytosis, polycythaemia rubra vera Approved renewal pipobroman [pharmac.govt.nz]

Colonoscopy

  • Polyps

    Fibroids, endometrial polyps, foreign bodies such as an intrauterine device, scar tissue, malformations of the uterus that exist since birth and infections such as chronic endometriosis are all common causes of problems in the uterus. [thebridgeclinic.com]

    […] colorectum; or Multiple pathologically confirmed juvenile polyps throughout the GI tract; or Any number of pathologically confirmed juvenile polyps and a family history of juvenile polyps. [aetna.com]

Biopsy

  • Liver Biopsy

    biopsy may show congenital hepatic fibrosis Microscopic (histologic) images Images hosted on other servers: Tubules with thickened basal membrane (PAS) Dilated tubules, thickened basal membrane (PAS) Deformed tubules with thickened basal membrane in [pathologyoutlines.com]

    Histopathologic findings on liver biopsy are the gold standard for diagnosis of CHF. [ncbi.nlm.nih.gov]

    The proband underwent a liver biopsy at age 6 y. [pnas.org]

    Renal biopsy is generally not required, especially in patients who fulfill the diagnostic criteria for ARPKD or who have positive genetic testing. Liver biopsy may be helpful. [hawaii.edu]

    Sometimes a liver biopsy is helpful to make the diagnosis of Alagille syndrome, though this is not mandatory to make the diagnosis. [chop.edu]

Treatment

Treatment may include: Pain medication Surgery to shrink cysts and relieve pain Treatment for high blood pressure Treatment for urinary tract infections Dialysis Kidney transplantation Autosomal recessive PKD (inherited) Autosomal recessive PKD is a rare [stanfordchildrens.org]

Information about a therapy, service, product or treatment does not in any way endorse or support such therapy, service, product or treatment and is not intended to replace advice from your doctor or other registered health professional. [betterhealth.vic.gov.au]

TREATMENT: No cure. Those who survive require treatment for hypertension, CCF, renal and hepatic failure. Portal hypertension is dealt with Warrant Shunt. ? Treatment of oesophageal varices, if needed. [drdebasismaity.com]

This research will directly benefit individuals with JSRD and their families through improved diagnostic, prognostic and recurrence risk information, as well as monitoring and early treatment for medical complications. [grantome.com]

Part 2 - Medical Conditions Chronic or end stage organ failure where the child is receiving organ specific treatment and/or awaiting transplant. [dss.gov.au]

Prognosis

FAVOREVOLE CON MODESTA COMPROMISSIONE FUNZIONALE 9323 NEOPLASIE A PROGNOSI FAVOREVOLE CON GRAVE COMPROMISSIONE FUNZIONALE 9324 SINDROME DI TURNER 9325 NEOPLASIE A PROGNOSI INFAUSTA O PROBABILMENTE SFAVOREVOLE NONOSTANTE ASPORTAZIONE CHIRURGICA 9326 SCLERODERMIA [studioaquilani.it]

The prognosis of patients depends mainly on the degree of brain malformation. 1. Joubert M, Eisenring JJ, Robb JP, Andermann F. Familial agenesis of the cerebellar vermis. [annalsofian.org]

ESRD in persons with the PKD1 genotype occurs at a mean age of 53 years, while the onset of ESRD in persons with the PKD2 genotype occurs at a mean age of 69 years. [7] In addition, studies have suggested that the type of PDK1 mutation also affects prognosis [emedicine.medscape.com]

Prognosis Soon after birth, prognosis is related to the extent and severity of breathing dysregulation. In particular, recurrent episodes of prolonged apneas can be life-threatening and require assisted ventilation. [ojrd.biomedcentral.com]

PATOLOGIA NEOPLASTICA min. max. fisso 9322 NEOPLASIE A PROGNOSI FAVOREVOLE CON MODESTA COMPROMISSIONE FUNZIONALE 0 0 11 9323 NEOPLASIE A PROGNOSI FAVOREVOLE CON GRAVE COMPROMISSIONE FUNZIONALE 0 0 70 9325 NEOPLASIE A PROGNOSI INFAUSTA O PROBABILMENTE [asimas.it]

Etiology

Renal cell carcinoma (RCC) develops in as many as 40% of patients. [25] Acquired cystic renal disease Acquired renal cystic disease (ARCD) may be found in patients with all etiologies of ESRD, particularly in those who are dialysis dependent. [emedicine.medscape.com]

Candidates for diagnostic testing include infants, children, and adults with generalized hypotonia and proximal muscle weakness of unknown etiology. [aetna.com]

Acquired cystic renal disease Acquired cystic disease may be found in patients with all etiologies of ESRD, particularly in patients who are dialysis-dependent. Hemorrhagic cysts occur in 50% of patients. [homeopathyworldcommunity.ning.com]

A detailed three-generation family history focusing on hepatorenal fibrocystic disease, CHF/CS, liver or kidney disease of unknown etiology, and the associated findings of the multisystem disorders discussed in this GeneReview can be used to help determine [ncbi.nlm.nih.gov]

Epidemiology

Autosomal Recessive Polycystic Kidney Disease (ARPKD) REMEMBER: Epidemiology: Incidence is 1:40,000 live births If not apparent at birth, disease will be apparent in late childhood upto 13 y of age. [drdebasismaity.com]

[…] general Group of autosomal recessive disorders characterized by corticomedullary cysts, atrophy and interstitial fibrosis "Phthisis" (Greek): dwindling or wasting away Also referred to as juvenile nephronophthisis medullary cystic kidney disease complex Epidemiology [pathologyoutlines.com]

Epidemiology [ edit ] TSC occurs in all races and ethnic groups, and in both genders. The live-birth prevalence is estimated to be between 10 and 16 cases per 100,000. [en.wikipedia.org]

Epidemiology Although the incidence of JSRD has not been precisely determined, it may range between 1/80,000 and 1/100,000 live births, but may be underestimated [ 16, 17 ]. [ojrd.biomedcentral.com]

Screening and diagnosis for the fragile X syndrome among the mentally retarded: An epidemiological and psychological survey. Am J Hum Genet. 1997;61:660-667. Gonnaud PM, Sturtz F, Bonnebouche C, et al. [aetna.com]

Pathophysiology

Pathophysiology [ edit ] Hamartin and tuberin function as a complex which is involved in the control of cell growth and cell division. [en.wikipedia.org]

Pathophysiology Cysts develop from renal tubule segments and most detach from the parent tubule after they grow to a few millimeters in size (Psora/ Syphilis). [homeopathyworldcommunity.ning.com]

Clinical manifestations, pathophysiology, and diagnosis of atrioventricular (AV) canal defects. UpToDate [online serial]. Waltham, MA: UpToDate; reviewed December 2013. Altman CA. [aetna.com]

Prevention

Metabolic defects prevent the body from properly breaking down food to create energy. [m.kidshealth.org]

Greater understanding of the development/function of the brain, retina, kidney and liver through the study of this relatively rare disorder will facilitate the prevention and treatment of more common disorders of these organ systems and benefit society [grantome.com]

In the pancreas, the mucus prevents the release of digestive enzymes that allow the body to break down food and absorb vital nutrients. Cystic Fibrosis occurs at a rate of 1 in 2,500–6,000 newborns. [eloxxpharma.com]

The child has a change (mutation) in the UBE3A gene on chromosome 15, which prevents its expression or function. (This causes ~11 per cent of cases.) The child inherits two copies of chromosome 15 from the father. [betterhealth.vic.gov.au]

[…] endometriosis (when tissue usually found in the uterus is found outside the uterus which can develop into cysts), a previous ectopic pregnancy (when the egg implants somewhere outside the uterus), and tubal ligation (when the Fallopian tubes have been tied to prevent [thebridgeclinic.com]

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