Presentation
These patients may present for implantable cardioverter defibrillator placement or left cervical ganglionectomy. [ijaweb.org]
It may sometime present as epilepsy. [1], [2] It is a cause of syncope and sudden death. [annalsofian.org]
Treatment includes beta-blockers, however if syncope or sustained ventricular arrhythmias are present, an implantable cardioverter defibrillator (ICD) is indicated to prevent sudden cardiac death. [healio.com]
Case presentation We report the case of a 10-year-old Moroccan boy with congenital hearing loss and severely prolonged QT interval who presented with multiple episodes of syncope. His parents are first-degree cousins. [jmedicalcasereports.biomedcentral.com]
Low levels of iron and increased levels of gastrin are often present in patients with JLNS, possibly leading to iron deficient anemia. [rarediseases.org]
Entire Body System
- Anemia
Iron-deficient anemia and elevated levels of gastrin are also frequent symptoms of JLNS. JLNS is inherited in an autosomal recessive manner. An estimated prevalence of disorder is 1.6 to 6 per 1 million. [asperbio.com]
Iron-deficient anemia and elevated levels of gastrin are also frequent features of JLNS. The classic presentation of JLNS is a deaf child who experiences syncopal episodes during periods of stress, exercise, or fright. [pubmed.ncbi.nlm.nih.gov]
Other pertinent clues are a history of iron deficiency anemia and elevated gastrin levels. [2] A physical exam is mostly unremarkable other than the deafness. [statpearls.com]
(出典・小児慢性特定疾病情報センター) Genes: Gene Condition ABCB7 Anemia sideroblastic and spinocerebellar ataxia ALAS2 Hereditary sideroblastic anemia GLRX5 Sideroblastic anemia 3, pyridoxine-refractory HSPA9 Anemia, sideroblastic, 4 PUS1 Myopathy, lactic acidosis, and [genelex.jp]
- Pain
Similarly, all the factors which may lead to sympathetic stimulation such as anxiety, hypothermia, hypoxia, hypercarbia, laryngoscopy and pain should be taken into consideration and anaesthesia planned accordingly. [1], [2], [3] Drugs which are known [ijaweb.org]
Some people may have mild chest pain with no loss of consciousness; others may lose consciousness completely or have grand mal seizures followed by a period of disorientation. [rarediseases.org]
[…] due to disruption of endolymph homeostasis in the cochlea and vestibular system[49] Syncope: Due to abnormal heart rhythm and is typically precipitous and without warning Seizures: Most commonly grand mal seizures Palpitations Mild to moderate chest pain [wikidoc.org]
[…] in LQTS patients with storms of shocks by the ICD,32 has a place in all J-LN patients, with the goal of minimizing the probability of an ICD shock, which, especially in young children, has a high potential to trigger storms of shocks as a result of pain [ahajournals.org]
Respiratoric
- Rhinorrhea
[…] cell membrane cell wall central apnea central compensation central core disease central deafness central hearing loss central microtubule centroblast cephalometry cephem cerebellopontine angle tumor cerebral meningitis cerebrospinal fluid cerebrospinal rhinorrhea [upslide.site]
Cardiovascular
- Heart Disease
Electrical heart disease: Genetic and molecular basis of cardiac arrhythmias in normal structural hearts. [litfl.com]
Alternative Names JLNS1 Deafness, Congenital, and Functional Heart Disease Prolonged QT Interval in EKG and Sudden Death Cardioauditory Syndrome of Jervell and Lange-Nielsen Surdo-Cardiac Syndrome WHO-ICD-10 version:2010 Diseases of the circulatory system [cags.org.ae]
Congenital deaf-mutism, functional heart disease with prolongation of the Q-T interval, and sudden death. Am Heart J 1957 ; 54 : 59 – 68. 2. Schulze-Bahr, E, Haverkamp, W, Wedekind, H, et al. [cambridge.org]
Other Names for This Condition autosomal recessive long QT syndrome (LQTS) cardio-auditory-syncope syndrome cardioauditory syndrome of Jervell and Lange-Nielsen deafness, congenital, and functional heart disease Jervell-Lange Nielsen syndrome JLNS prolonged [encyclopedia.pub]
Title Other Names: JLNS1; Deafness, congenital, and functional heart disease; Prolonged QT interval in EKG and sudden death; JLNS1; Deafness, congenital, and functional heart disease; Prolonged QT interval in EKG and sudden death; Cardioauditory syndrome [rarediseases.info.nih.gov]
- Chest Pain
Some people may have mild chest pain with no loss of consciousness; others may lose consciousness completely or have grand mal seizures followed by a period of disorientation. [rarediseases.org]
[…] and is due to disruption of endolymph homeostasis in the cochlea and vestibular system[49] Syncope: Due to abnormal heart rhythm and is typically precipitous and without warning Seizures: Most commonly grand mal seizures Palpitations Mild to moderate chest [wikidoc.org]
- Hypotension
The child was hypotensive and pulseless during the episodes of convulsions. [annalsofian.org]
Psychiatrical
- Fear
Triggers for cardiac events were typically physical exercise or emotional excitement (such as stress, fear, or anger), and in ∼10% of described events two or more concurrent triggers were present. [academic.oup.com]
Neurologic
- Stroke
At the heart, it is powered by the same liquid-cooled, fuel injected 4-stroke 150cc engine as on the RS 150 that is capable of churning out a max power of 18hp at 10,000rpm and a peak torque of 14Nm at 7,500rpm. [autoconcept.in]
EBV-determined nuclear antigen eccentric rotation Echovirus ectopic goiter ectopic thyroid eczema of nasal vestibulum eczematous external otitis edematous polyp edge of anterior nare edge of inferior eyelid effective perceived noise level effective stroke [upslide.site]
- Tremor
同 difference liemen for intensity (音の)強さの弁別閾検査 " test, IDL test int 61 intensity modulated radiotherapy intention tremor interaural(intensity)level difference interaural attenuation interaural latency difference interaural time difference intercellular [upslide.site]
- Vertigo
同 ear wax 耳垢 " 耳垢腺 C 2 2 cer C cervical nodes cervical esophagectomy cervical esophagus cervical part of esophagus cervical sinus cervical tag cervical vertigo cervical wattle cestode characteristic frequency CHARGE syndrome Charlin syndrome chemical [upslide.site]
- Generalized Tonic-Clonic Seizure
He had four episodes of seizures in the last 1 day. The convulsion was brief; a generalized tonic-clonic seizure with perspiration and palpitation usually preceded the convulsion. [annalsofian.org]
Workup
During pre-anaesthesia workup, the child was still on mechanical ventilation with 100% oxygen. Chest auscultation revealed bilateral coarse crepitations (possible aspiration at the time of convulsions). [ijaweb.org]
Genetic testing was performed as part of the diagnostic workup and executed as previously described. 8 Berge K.E. Haugaa K.H. Fruh A. et al. [heartrhythmjournal.com]
QT, RR, ST Intervals
- Prolonged QT Interval
Jervell-Lange-Nielsen Syndrome is a genetic condition associated with a prolonged QT interval on the ECG and conginital hearing loss. A mutation of the cardiac potassium channel is responsible, specifically the KCNQ1 (90%) and KCNE1 (10%) genes. [healio.com]
Title Other Names: JLNS1; Deafness, congenital, and functional heart disease; Prolonged QT interval in EKG and sudden death; JLNS1; Deafness, congenital, and functional heart disease; Prolonged QT interval in EKG and sudden death; Cardioauditory syndrome [rarediseases.info.nih.gov]
Alternative Names JLNS1 Deafness, Congenital, and Functional Heart Disease Prolonged QT Interval in EKG and Sudden Death Cardioauditory Syndrome of Jervell and Lange-Nielsen Surdo-Cardiac Syndrome WHO-ICD-10 version:2010 Diseases of the circulatory system [cags.org.ae]
QT interval in EKG and sudden death surdo-cardiac syndrome [encyclopedia.pub]
[…] heart disease with prolongation of the Q-T interval and sudden death. [statpearls.com]
Treatment
[…] more than 50% of those affected will die before the age of 15. [6] However, treatment with beta blockers markedly reduces the risk of death, as does, in selected cases, implantation of a defibrillator. [6] Epidemiology [ edit ] Jervell and Lange-Nielsen [en.wikipedia.org]
[…] a history of cardiac arrest and/or failure to respond to other treatments; ensure availability of automated external defibrillators where appropriate; standard treatment for those with iron-deficiency anemia. [pubmed.ncbi.nlm.nih.gov]
You may also want to contact a university or tertiary medical center in your area, because these centers tend to see more complex cases and have the latest technology and treatments. [rarediseases.info.nih.gov]
Prognosis
Myocardial problems such as myopathies and ischemia and central nervous system injuries.[12] Prognosis More than half of untreated children with JLNS die before age 15.[2] Prognosis is highly dependent on which gene is mutated, gender, and baseline QTc [statpearls.com]
However, the prognosis is generally regarded as poor as most of the untreated patients die around the age of 15 years.[46] The prognosis varies with the gender, gene mutation and baseline QTc interval. [wikidoc.org]
In this context, if the patient has had syncopal episodes or history of cardiac arrest, an implantable cardiac defibrillator should be used in addition to a beta blocker such as propranolol. [3] Prognosis [ edit ] The risk of arrhythmias is higher for [en.wikipedia.org]
Etiology
Differential Diagnosis The other most common etiologies of long QT syndromes are Romano-Ward syndrome, Timothy syndrome, Andersen-Tawil syndrome, and acquired. [statpearls.com]
There was a marked prolongation of the QT interval on electrocardiographic studies with no other identifiable cause for the patient’s fainting spells.[1] Etiology JLNS is a congenital disorder that is inherited in an autosomal recessive manner. [ncbi.nlm.nih.gov]
Genetics evaluation guidelines for the etiologic diagnosis of congenital hearing loss. Genetic evaluation of congenital hearing loss expert panel. Available online. 2002. Accessed 10-18-21. - PMC - PubMed American College of Medical Genetics. [pubmed.ncbi.nlm.nih.gov]
LQTS is more likely to be a congenital etiology in children. [4] The congenital form of LQTS can be either a hereditary or nonhereditary sporadic form. [annalsofian.org]
Epidemiology
[…] degree of QT prolongation, without treatment more than 50% of those affected will die before the age of 15. [6] However, treatment with beta blockers markedly reduces the risk of death, as does, in selected cases, implantation of a defibrillator. [6] Epidemiology [en.wikipedia.org]
Most cases are due to deletion mutations in the KCNQ1 (90%) and KCNE1 genes, which encode proteins essential in the functions of the potassium channels in the heart and cochlea. [2] Epidemiology The prevalence of the disorder highly depends on the population [statpearls.com]
Epidemiology of symptomatic drug-induced long QT syndrome and Torsade de Pointes in Germany. Europace. 2014;16(1):101-108. doi: 10.1093/europace/eut214. [journal-grsmu.by]
Pathophysiology
Review the pathophysiology of Jervell and Lange Nielsen Syndrome. Outline the interprofessional team's strategies for improving care coordination and communication regarding the management of patients with Jervell and Lange Nielsen syndrome. [statpearls.com]
Locus Gene Mutation Protein Involved Jervell and Lange-Nielsen syndrome 1 11p15.5-p15.4 KCNQ1 Potassium voltage-gated channel subfamily KQT member 1 Jervell and Lange-Nielsen syndrome 2 21q22.12 KCNE1 Potassium voltage-gated channel subfamily E member 1 Pathophysiology [wikidoc.org]
The role of the sympathetic nervous system in the long QT syndrome: the long road from pathophysiology to therapy. Long QT syndrome. Cardiac Electrophysiology Clinics, volume 4, number 1. Editors: Priori SG, Thakur RK, Natale A. [romanianjournalcardiology.ro]
Prevention
This device detects an abnormal rhythm and sends an electrical shock to the heart, preventing syncope. Regular follow-up with the patient’s pediatrician/primary care doctor and cardiologist are important in preventing complications. [statpearls.com]
Treatment includes beta-blockers, however if syncope or sustained ventricular arrhythmias are present, an implantable cardioverter defibrillator (ICD) is indicated to prevent sudden cardiac death. [healio.com]
Propranolol and nadolol have been shown to be superior to metoprolol in preventing cardiac events. [ncbi.nlm.nih.gov]
Mutations in these genes alter the usual structure and function of potassium channels or prevent the assembly of normal channels. [encyclopedia.pub]