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Mucopolysaccharidosis Type 1S
Mucopolysaccharidosis 1S

Mucopolysaccharidosis 5 is nowadays referred to as mucopolysaccharidosis 1S or Scheie syndrome.

Presentation

Treatment options depend on the type of mucopolysaccharidosis present. [fulgentgenetics.com]

One change must be present in the copy of the IDUA gene that the individual inherits from their mother, and another change must be present in the copy of the IDUA gene the individual inherits from their father. [chop.edu]

The severity of the condition depends on how much IDUA activity is present. IDUA activity shows how well your baby can break down GAGs. High levels of GAGs can damage many parts of the body. [newbornscreening.hrsa.gov]

Skin

  • Hirsutism

    […] 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]

    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]

Psychiatrical

  • Denial

    “He is upset but [son's] dad has always been in denial, since the day he was born and we found out all this news he could never accept it, he was just always in denial. [ojrd.biomedcentral.com]

  • Impulsivity

    These cells convert light into nerve impulses to be sent along the optic nerve to the brain to be converted into images. The optic nerve, which is the main nerve of the eye, may also break down (optic atrophy). [rarediseases.org]

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]

  • Depressed Nasal Bridge

    Distinct facial features (including flat face, depressed nasal bridge, and bulging forehead) become more evident in the second year. By age 2, the ribs have widened and are oar-shaped. The liver, spleen, and heart are often enlarged. [en.wikipedia.org]

    Common features across types of MPS include a big head with depressed nasal bridge, thick bulging lips, enlarged tongue and coarse straggly hair – visible signs which contribute to the characteristic look of these patients. [ojrd.biomedcentral.com]

Neurologic

  • Cervical Cord Compression

    The most common findings consistent with CNS involvement are mental retardation, hydrocephalus, progressive spasticity, seizures, cerebral infarction, ataxia, cervical cord compression and myelopathy, sleep apnea, optic atrophy, hearing impairment, and [ajnr.org]

Workup

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]

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]

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

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]

Neither treatment will completely prevent symptoms of disease, and other treatments/procedures are still commonly recommended, even for patients who have undergone transplant. [chop.edu]

Prognosis

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]

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]

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

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]

[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]

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]

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]

Morquio Syndrome as a rare cause of disproportionate short stature. pathophysiological, diagnostic and therapeutic approach. about a case. Rev venez Endocrinol Metab. 2016;5(P 90):217–25. Zarante I, Suárez F. [revistapediatria.org]

Prevention

The goal of treatment is to prevent the health problems caused by this condition. [newbornscreening.hrsa.gov]

There is no diet that can prevent the storage of GAGs because they are actually created by the body. [babysfirsttest.org]

As a result, be sure to take general preventive measures — for example, get your child a flu shot and ensure your child receives all necessary vaccinations. Prevention Hunter syndrome is a genetic disorder. [mayoclinic.org]

Delivery of therapeutic protein for prevention of neurodegenerative changes: comparison of different CSF-delivery methods. Exp Neurol. 2015;263:79-90. [consultant360.com]

Neither treatment will completely prevent symptoms of disease, and other treatments/procedures are still commonly recommended, even for patients who have undergone transplant. [chop.edu]

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.

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