Mucopolysaccharidosis 5 is nowadays referred to as mucopolysaccharidosis 1S or Scheie syndrome.
Presentation
Treatment options depend on the type of mucopolysaccharidosis present. [fulgentgenetics.com]
Patients with MPS1S may have little or no neurological involvement, normal stature and life span, but present development of joints stiffness, mild hepatosplenomegaly, aortic valve disease and corneal clouding. [uniprot.org]
The latter patient presented a positive family history for MPS II and comparatively post-HSCT presented a better outcome than his affected maternal uncle. [scielo.br]
Results: The intraocular pressure (IOP) measurements were noted to be high in both the patients at their initial presentation. [omicsonline.org]
Generally, severe MPS I will present within the first year of life while less severe (attenuated) forms present during childhood. [mpssociety.org]
Entire Body System
- Short Stature
Additional findings include short stature, heart abnormalities, breathing irregularities, liver and spleen enlargement (hepatosplenomegaly), and/or neurological abnormalities. [rarediseases.org]
Clinical features and disease severity are variable, but usually include short stature, hepatosplenomegaly, dysostosis multiplex, stiff joints, corneal clouding, cardiac abnormalities and facial dysmorphism. [news-medical.net]
[…] swelling of the masses, short-term pain, mild facial changes, short stature, normal joint movement, normal intelligence MPS I[edit] MPS I is divided into three subtypes based on severity of symptoms. [en.wikipedia.org]
MPS II is found almost exclusively in young males and is clinically characterized by short stature, hepatosplenomegaly, joint contractures, and coarse facies. [centogene.com]
- Dysostosis
Most patients presenting beyond the neonatal period have increased urinary glycosaminoglycans and dysostosis multiplex. [news-medical.net]
[…] de Colombia, Pasto Carlos Hernando Rosero Erazo Universidad Cooperativa de Colombia, Pasto Palabras clave: Mucopolisacaridosis tipo VI, glicosaminoglicanos, disostosis múltiples, Galsulfasa, Mucopolysaccharidosis type VI, glycosaminoglycans, multiple dysostosis [revistamedicina.net]
One of the hallmarks of dysostosis multiplex in MPS I-H is hip dysplasia, which often requires surgical intervention. [journals.lww.com]
The warning signs for these conditions vary by type, but there are some common symptoms clinicians can watch out for including hepatosplenomegaly, skeletal deformities (dysostosis multiplex), coarse facies, large tongue, short stature, and joint abnormalities [fulgentgenetics.com]
- Inguinal Hernia
hernia, umbilical hernia, multiple dysostosis, hepatosplenomegaly and difficulty in breathing; surgical history: right inguinal herniorrhaphy, umbilical herniorrhaphy, changes compatible with mucopolysaccharidosis (MPS) type VI. [revistamedicina.net]
Child with unusual appearance, inguinal hernia, accelerated growth, and developmental delay. Consultant Pediatricians. 2007;6(3):149-152. 2. Al-Jasmi F, Clarke JTR, Moldovan L. [consultant360.com]
Children with MPS I often have no signs or symptoms of the condition at birth, although some have a soft out-pouching around the belly-button (umbilical hernia) or lower abdomen (inguinal hernia). [ghr.nlm.nih.gov]
Other features of MPS VI include an enlarged liver and spleen (hepatosplenomegaly), and a soft out-pouching around the belly-button (umbilical hernia) or lower abdomen (inguinal hernia). [medlineplus.gov]
- Surgical Procedure
MPS subjects require frequent surgical and diagnostic anesthetic procedures or sedations. [hindawi.com]
Arn P, Wraith JE, Underhill L (2009) Characterization of surgical procedures in patients with mucopolysaccharidosis type I: findings from the MPS I Registry. J Pediatr 154 (6):859-64.e3. Crossref Pubmed 30. [jicna.org]
Middlebrooks, Mehmet Senoglu Ventriculoperitoneal shunt (VPS) placement is an effective and most frequently used surgical method in the treatment of hydrocephalus, but the mechanical and infective complications are often seen after this surgical procedure [jcpsp.pk]
The bones that stabilize the connection between the head and neck can be malformed (odontoid hypoplasia); in these cases, a surgical procedure called spinal cervical bone fusion can be lifesaving. [en.wikipedia.org]
Respiratoric
- Dyspnea
According to the site and severity of the obstruction, patients may be affected by stridency, dyspnea, cough, and cyanosis [6]. [hindawi.com]
Gastrointestinal
- Failure to Thrive
[…] to thrive, intellectual disability, and developmental delay.[ 5 12 ] The extensive storage of these glycosaminoglycans is also known to cause meningeal thickening.[ 4 ] Intraoperatively, our patient was noted to have thickened arachnoid membrane, which [surgicalneurologyint.com]
Liver, Gall & Pancreas
- Hepatosplenomegaly
Symptoms depend on the specific MPS, but common features include coarse facies, hepatosplenomegaly, hernias, and skeletal deformation. Treatment options depend on the type of mucopolysaccharidosis present. [fulgentgenetics.com]
Patients with MPS1S may have little or no neurological involvement, normal stature and life span, but present development of joints stiffness, mild hepatosplenomegaly, aortic valve disease and corneal clouding. [uniprot.org]
Symptoms may include DWARFISM, hepatosplenomegaly, gargoyle-like facies, corneal clouding, cardiac complications, and noisy breathing. [connects.catalyst.harvard.edu]
Additional findings include short stature, heart abnormalities, breathing irregularities, liver and spleen enlargement (hepatosplenomegaly), and/or neurological abnormalities. [rarediseases.org]
Clinical features and disease severity are variable, but usually include short stature, hepatosplenomegaly, dysostosis multiplex, stiff joints, corneal clouding, cardiac abnormalities and facial dysmorphism. [news-medical.net]
Skin
- Hirsutism
The main features observed were: normal appearance at birth with a progressive coarse facies, progressive neurological deterioration, corneal clouding, gibbous lumbar vertebrae, hirsutism, joint contractures, hepatosplenomegaly, short stature, and skeletal [scielo.br]
[…] bossing, hypertelorism, saddle nose, low-set ears, macroglossia, short stature, short neck, kyphosis of lumbar spine, pigeon chest, widening of wrist, bowing of legs, doubling of malleoli, abdominal distension, umbilical hernia, noisy breathing, and hirsutism [jcor.in]
Face, Head & Neck
- Short Neck
Affected children may also have an abnormally large head (macrocephaly), a short neck and broad chest, delayed tooth eruption, progressive hearing loss, and enlargement of the liver and spleen (hepatosplenomegaly). [rarediseases.org]
On examination, child had dysmorphic features such as frontal bossing, hypertelorism, saddle nose, low-set ears, macroglossia, short stature, short neck, kyphosis of lumbar spine, pigeon chest, widening of wrist, bowing of legs, doubling of malleoli, [jcor.in]
She had dysmorphic facial features, macroglossia, a short neck, a low hair line, a high arched palate, corneal haziness, Mongolian spots over back, exaggerated thoracic kyphosis, and short stout fingers. [neurologyindia.com]
Other problems include carpal tunnel syndrome or other nerve compression, stiff joints, claw hands and deformed feet, a short neck, and aortic valve disease. Some affected individuals also have obstructive airway disease and sleep apnea. [en.wikipedia.org]
Orthopedic-Bone Changes Short neck, joints stiffness [47], odontoid instability [48], hypo plastic mandible, thoracic cage restriction for kyphoscoliosis [24]. [hindawi.com]
Neurologic
- Stroke
Neurological Disorders and Stroke » [brainfacts.org]
Natl Instit Neurol Disord Stroke. USA. Mucopolysaccharidosis and Mucolipidosis. 2007. 3. Wilcox WR. Lysosomal storage disorders: the need for better pediatric recognition and comprehensive care. J Pediatr. 2004; 144(5): 3-14. 4. [revistamedicina.net]
National Institute of Neurological Disorders and Stroke: Mucopolysaccharidosis Fact Sheet. Online version. Updated May 2010. Retrieved from http://www.ninds.nih.gov/disorders/mucolipidoses/detail_mucolipidoses.htm 5. [jicna.org]
National Institute of Neurological Disorders and Stroke. 15 Nov 2017. Archived from the original on 18 August 2016. Retrieved 11 May 2018. ^ Marks DB, Swanson T, Kim SI, Glucksman M (2007). Biochemistry and molecular biology. [en.wikipedia.org]
- Papilledema
There was no papilledema on fundoscopic examination. The motor examination was normal. The social age was 2 years and 6 months, and the social quotient was 125 on Vineland Social Maturity Scale. Ultrasound abdomen showed moderate hepatomegaly. [neurologyindia.com]
Reversed papilledema in an MPS VI patient with galsulfase (Naglazyme®) therapy. Int Ophthalmol. 2008; 29(4): 267-269. 15. Harmatz P. Enzyme replacement therapy with galsulfase for mucopolysaccharidosis VI: clinical facts and figures. Turk J. [revistamedicina.net]
Workup
CASE REPORT The patient is a 6-year-old male who was referred to a pediatric clinic for an incidentally found CM-I and cervicothoracic syrinx [ Figure 1 ] identified during a preoperative workup prior to the surgical management of a progressive thoracolumbar [surgicalneurologyint.com]
Clinical Testing and Workup A specialized examination of urine of people with MPS I can reveal elevated levels of glycosaminoglycans (mucopolysaccharides), specifically heparan and dermatan sulfate. [rarediseases.org]
Diagnosis See Workup. Treatment See Treatment. Pathophysiology GAGs are long, linear polysaccharide molecules composed of repeating dimers, each of which contains a hexuronic acid (or galactose in the case of keratan sulfate) and an amino sugar. [emedicine.medscape.com]
Treatment
Emerging Treatments Pharmaceutical companies, medical researchers and clinicians are constantly working on emerging treatments for MPS. The following companies are working on therapies for MPS I. [mpssociety.org]
This treatment can prolong the lifespan of an affected child, but does not help the bone and eye issues. [myriad.com]
The goal of treatment is to prevent the health problems caused by this condition. [newbornscreening.hrsa.gov]
The patient's liver function was monitored throughout his 6-month treatment. Of note, prophylactic second line treatment for TB in Latvia has been available for only the past 2 years. [frontiersin.org]
Parents of children receiving home treatment expressed satisfaction with moving from weekly hospital ERT to home-based treatment. [ojrd.biomedcentral.com]
Prognosis
Prognosis Prognosis depends on the severity of the disease and on the quality of care, which can allow patients to survive beyond the age of 50. The documents contained in this web site are presented for information purposes only. [orpha.net]
What Is the Prognosis for a Person with MPS I? The prognosis for individuals with severe MPS I is generally poor. They need special education and assistance to perform ordinary daily functions and are often wheelchair-bound. [myriad.com]
Prognosis The mucopolysaccharidoses syndromes share many clinical features but have varying degrees of severity. [brainfacts.org]
The prognosis (long-term outlook) depends upon the particular type of MPS. There are a number of different types of MPS that are designated somewhat confusingly by number (and letter), by syndrome name, and by precising what enzyme is lacking. [medicinenet.com]
The decision for surgery should be taking into account, the characterization of the metabolic disorder, its course, prognosis, and life expectancy. [neurologyindia.com]
Etiology
Etiology A deficiency in one of the two enzymes required for the degradation of keratan sulfate (KS) is responsible for the MPS IV subtypes: N-acetylgalactosamine-6-sulfate sulfatase in MPS IVA, and beta-D-galactosidase in MPS IVB. [orpha.net]
View PDF SYSTEMATIC REVIEW Myocardial Ischemia Presenting with Hiccups By Shi-Min Yuan Myocardial infarction/ischemia can be an underlying etiology and a major causative risk factor of cardiovascular hiccups. [jcpsp.pk]
Posterior fossa arachnoid cysts and mega cisterna magna represent CSF-filled spaces of unknown etiology, though splitting or duplication of the arachnoid matter, brain structure agenesis, and disturbances of CSF circulation represent the most predominant [ajnr.org]
Epidemiology
Summary Epidemiology Prevalence is approximately 1/250 000 for type IVA but incidence varies widely between countries. MPS IVB is even rarer. [orpha.net]
A retrospective epidemiological survey covering the period between 1970 and 2010 was implemented. Multiple ascertainment sources were used to identify affected patients. [link.springer.com]
An epidemiologic study of the mucopolysaccharidoses in Western Australia using multiple ascertainment sources was performed and the incidence rate for the period 1969-1996 was estimated. [emedicine.medscape.com]
The overall frequency of either p.R59H or 1622-1627insG was 57.7% of the disease-causing alleles, and this epidemiological study suggested a carrier frequency of 1:58 for this population 31. [centogene.com]
Pathophysiology
[Frontiers in Bioscience, Landmark, 22, 385-406, January 1, 2016] Mucopolysaccharidosis VI: Pathophysiology, diagnosis and treatment 1 UCSF Benioff Children’s Hospital Oakland, Department of Gastroenterology, Oakland, CA, USA, 2 BioMarin Pharmaceutical [bioscience.org]
Pathophysiology of muclopolysaccharidosis Each type of mucopolysaccharidosis is caused by a deficiency in the activity of a single, specific lysosomal enzyme required for the degradation of glycosaminoglycans. [news-medical.net]
Although the detailed mechanism and disease pathophysiology, as well as the domain-specific function of VPS33A remain to be elucidated, the author found that VPS33A regulates lysosomal acidification and glycosaminoglycan metabolism rather than the expected [medlink.com]
Very little is known on LSDs pathophysiology and even less on the determinants of their neurological impairment. [research.unipd.it]
Mucopolysaccharidosis type I: current knowledge on its pathophysiological mechanisms. Metab Brain Dis. 2012 Jun;27(2):121-9. doi: 10.1007/s11011-012-9302-1. Epub 2012 Apr 14. Review. Clarke LA. [ghr.nlm.nih.gov]
Prevention
The goal of treatment is to prevent the health problems caused by this condition. [newbornscreening.hrsa.gov]
Delivery of therapeutic protein for prevention of neurodegenerative changes: comparison of different CSF-delivery methods. Exp Neurol. 2015;263:79-90. [consultant360.com]
Business Media, 06.12.2012 - 310 Seiten The study of inherited metabolic disease became a subject of more than academic interest in 1953 when Bickel, Gerrard and Hickmans dis covered that the totally disabling consequences of phenylketonuria could be prevented [books.google.de]
There is no diet that can prevent the storage of GAGs because they are actually created by the body. [babysfirsttest.org]
Biomicroscopy is not useful because the opacity of the anterior corneal layers prevents the endothelial microscopy examination. [ijponline.biomedcentral.com]
Summary
Mucopolysaccharidosis 5 is now classified as a form of mucopolysaccharidosis 1, referred to as mucopolysaccharidosis 1S (MPS1S) or Scheie syndrome. MPS1S is the mildest form of mucopolysaccharidosis 1.