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2.1
Pitt-Hopkins-Like Syndrome Type 2
PTHSL2

Presentation

[…] in heterozygosis, also present in the father. [elsevier.es]

Case presentation The patient was 4-year-old female child who presented with psychomotor delay and language impairment. She had frequent attacks of the respiratory tract and eye infections. [jmhg.springeropen.com]

They may not present the same facial features as individuals with mutations in chromosome 18. However, they share many of the same issues such as global developmental delay, seizures, lack of speech, breathing irregularities, and autistic features. [pitthopkins.org]

Epilepsy was present in 2/5 with a large deletion, 2/7 with a missense variant, and 1/3 with a nonsense variant. Abnormal EEGs were present in 3/5 with a large deletion, 4/7 with a missense variant, and all 3 with a nonsense variant. [jtggjournal.com]

Entire Body System

  • Poor Feeding

    […] difficulties Feeding problems Poor feeding [ more ] 0011968 Gastroesophageal reflux Acid reflux Acid reflux disease Heartburn [ more ] 0002020 Generalized hypotonia Decreased muscle tone Low muscle tone [ more ] 0001290 Hyperventilation Rapid breathing [rarediseases.info.nih.gov]

Skin

  • Dry Skin

    At 4 years of age, the patient was referred to a paediatric genetics clinic; physical examination revealed dolichocephaly, prominent forehead, coarse hair and dry skin, bitemporal hair thinning, bulbous nose, fingers with bilateral clinodactyly, autistic [elsevier.es]

Neurologic

  • Stereotypic Hand Movements

    Symptoms of these disorders can variably include: Seizures Distinctive facial features Lack of speech Developmental delay Happy disposition Abnormal breathing Stereotypic hand movements Individuals presenting with Angelman/Rett-like syndrome can now be [cureffi.org]

    Thereafter, she acquired abnormal behavior with hyperactivity, self-injury behaviors, and spells of crying, moaning, and stereotypical hand movements. [jmhg.springeropen.com]

    Children with Pitt-Hopkins syndrome also exhibit stereotypic hand movements, which include hand clapping, hand flapping, flicking hands, hand washing, fingers crossing, and frequent hand-to-mouth movements. [rarediseases.org]

    Other common findings are autism spectrum disorder symptoms, sleep disturbance, stereotypic hand movements, seizures, constipation, and severe myopia. [ncbi.nlm.nih.gov]

Workup

Clinical Evaluations and Workup If the diagnosis is suspected by exam and history, molecular testing can be ordered. [rarediseases.org]

EEG

  • Focal Epileptiform Discharges

    Focal epileptiform discharges were seen in 76%, 19% had generalized epileptiform discharges, and only one patient (4%) had a normal EEG without epileptiform discharges[3]. Attempts to evaluate genotype-phenotype correlations have been inconclusive. [jtggjournal.com]

  • Generalized Epileptiform Discharges

    Focal epileptiform discharges were seen in 76%, 19% had generalized epileptiform discharges, and only one patient (4%) had a normal EEG without epileptiform discharges[3]. Attempts to evaluate genotype-phenotype correlations have been inconclusive. [jtggjournal.com]

Other Pathologies

  • Gliosis

    For abnormal studies, findings were categorized as microcephaly, gliosis, myelination abnormalities, hypoplasia or atrophy, and dysplasia of the corpus callosum. EEGs were obtained for clinical indications. [jtggjournal.com]

Treatment

Subjects will receive treatment with NNZ-2591 oral solution (50 mg/mL) doses for a total of 13 weeks. [clinicaltrials.ucsf.edu]

Unstable or changes Psychotropic treatment 2 weeks prior to screening Excluded concomitant treatments. Actively undergoing regression or loss of skills. Unstable seizure profile. [clinicaltrials.gov]

Mowat–Wilson syndrome is seen in early infancy and is characterized by distinctive facial abnormalities.[12] Treatment[edit] Currently there is no specific treatment for this condition. It is based on symptomatology. [en.wikipedia.org]

[…] and treatment of disorders of the gastrointestinal tract), an ophthalmologist (a physician who specializes in the diagnosis and treatment of disorders of the eye), a pulmonologist (a physician who specializes in the diagnosis and treatment of disorders [rarediseases.org]

The advantage of gene therapy over pharmacological treatment is that it would solve the problem at its source. However, the search for new drugs is also promising,” Papes said. [agencia.fapesp.br]

Prognosis

Prognosis The course of the disease is non-progressive. The documents contained in this web site are presented for information purposes only. [orpha.net]

Parents should talk to their children’s physician and medical team about their specific case, associated symptoms and overall prognosis. Infants with Pitt-Hopkins syndrome may have diminished muscle tone (hypotonia) and appear abnormally “floppy.” [rarediseases.org]

Sensory integration, speech, and behavioural therapies can help increase the quality of life for an affected individual. (8) Prognosis Most treatment strategies for the genetic disorders do not alter the underlying genetic mutation. [syndromespedia.com]

PMID: 22378662 Prognosis Matricardi S, Bonanni P, Iapadre G, Elia M, Cesaroni E, Danieli A, Negrin S, Zagaroli L, Operto FF, Carotenuto M, Pisani F, Turco EC, Orsini A, Bonuccelli A, Savasta S, Concolino D, Di Cara G, Striano P, Verrotti A Eur J Neurol [ncbi.nlm.nih.gov]

Larger studies are needed to confirm this observation, which may guide the prognosis and diagnosis of epilepsy in PTHS. PTHS patients have three types of paroxysmal events: epileptic seizures, abnormal breathing spells, and motor stereotypies. [jtggjournal.com]

Etiology

Because loss of TCF4 prevents neurons from functioning currently, our scientist believe that studying Pitt Hopkins will also give us important insight into other neurological disorders with no known etiology like Alzheimers, Autism and Epilepsy. o Facebook [milliondollarbikeride.org]

Keywords Pitt Hopkins Syndrome, Hyperventilation, Intellectual Disability, Syndrome, Facies, NNZ-2591 Eligibility You can join if… Open to people ages 3-17 Clinical diagnosis of PTHS with a documented disease-causing genetic etiology for the disorder. [clinicaltrials.ucsf.edu]

Codes: ICD-10: Q87.0 ORPHA: 2896 Estimated occurrence 2-3:100,000 live births Etiology Pitt-Hopkins syndrome (PTHS) occurs due to a de novo mutation on gene TCF4, which is on chromosome 18q21.1. [mun-h-center.se]

Etiology The syndrome is caused by heterozygous de novo mutations in the TCF4 gene (18q21), coding for a ubiquitous b-HLH transcription factor. [orpha.net]

Point mutations in ZBTB18 and HNRNPU were implicated etiologies. [jmhg.springeropen.com]

Epidemiology

This new edition contains several chapters on the associated problems of autism, such as intellectual disability, epilepsy, tics, eating disorders and sleep problems, as well as a chapter on epidemiology that documents the historical increase in autism [books.google.de]

Summary Epidemiology About 50 cases have been reported worldwide. Males and females are equally affected. [orpha.net]

Past 2-week symptoms of depression were assessed using the Center for Epidemiologic Studies Depression Scale [29,30]. The post-traumatic stress disorder (PTSD) Checklist Civilian Version was used to assess for past-month PTSD symptoms [31,32]. [journals.lww.com]

Epidemiology No population-based prevalence or incidence figures for PTHS are available at present. Until 2007, PTHS was rarely reported, but increasing numbers of patients have been published since molecular testing became available. [karger.com]

Pathophysiology

Stephen Haggarty at Harvard has created the largest repository of Pitt Hopkins tissue samples to expand our understanding of the biology and pathophysiology of Pitt Hopkins Syndrome. [pitthopkinscare.org]

Aim of the project Mutations in a specific gene, Neurexin 1 (NRXN1), have been implicated in the pathophysiology of autism and other neuropsychiatric conditions. [autismresearchtrust.org]

Prevention

Because loss of TCF4 prevents neurons from functioning currently, our scientist believe that studying Pitt Hopkins will also give us important insight into other neurological disorders with no known etiology like Alzheimers, Autism and Epilepsy. o Facebook [milliondollarbikeride.org]

The prevention of unintended pregnancy is a cornerstone of efforts to prevent mother-to-child transmission of HIV [9]. [journals.lww.com]

Haggarty’s long-term goal is to translate this knowledge into the discovery of novel targeted therapeutics for the treatment and prevention of neuropsychiatric disorders. Learn more. More Information GeneReviews® from the U.S. [massgeneral.org]

For long term storage, store at -20C in small aliquots to prevent freeze-thaw cycles. Concentration: Batch dependent within range: 100 ul at 0.5 - 1 mg/ml [avivasysbio.com]

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