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- $Unique_ID{BRK03931}
- $Pretitle{}
- $Title{Lesch-Nyhan Syndrome}
- $Subject{Lesch-Nyhan Syndrome Hereditary Hyperuricemia Hyperuricemia
- Choreoathetosis Self-mutilation syndrome Hyperuricemia-Oligophrenia Nyhan
- syndrome Juvenile Gout Choreoathetosis Mental Retardation syndrome }
- $Volume{}
- $Log{}
-
- Copyright (C) 1986, 1990 National Organization for Rare Disorders, Inc.
-
- 255:
- Lesch-Nyhan Syndrome
-
- ** IMPORTANT **
- It is possible the main title of the article (Lesch-Nyhan syndrome) is
- not the name you expected. Please check the SYNONYMS listing to find the
- alternate names and disorder subdivisions covered by this article.
-
- Synonyms
-
- Hereditary Hyperuricemia
- Hyperuricemia, Choreoathetosis, Self-mutilation syndrome
- Hyperuricemia-Oligophrenia
- Nyhan syndrome
- Juvenile Gout, Choreoathetosis, Mental Retardation syndrome
-
- General Discussion
-
- ** REMINDER **
- The information contained in the Rare Disease Database is provided for
- educational purposes only. It should not be used for diagnostic or treatment
- purposes. If you wish to obtain more information about this disorder, please
- contact your personal physician and/or the agencies listed in the "Resources"
- section of this report.
-
-
- Lesch-Nyhan syndrome is a sex-linked hereditary neurological disorder
- caused by an enzymatic defect. Onset occurs during infancy and it progresses
- to cause aggressive behavior (including self-mutilation) and mental
- retardation.
-
- Symptoms
-
- Onset of Lesch-Nyhan syndrome occurs during infancy in males. Babies
- affected by the disorder usually appear normal and healthy until they are a
- few months old when their condition begins to deteriorate. The defect in the
- enzyme that causes Lesch-Nyhan syndrome can be detected with almost 100%
- accuracy in people affected by the syndrome and in carriers through a
- biochemical study on cultured cells. This defect causes a marked elevation
- of uric acid in their blood (hyperuricemia). Affected male babies can be
- detected before birth through the same test.
-
- Orange sand (from the urine) in the diaper is usually the first sign of
- the disorder. Stones in the urine (urolithiasis) and the appearance of
- chalky deposits of sodium urate (tophi) around joints and under the skin
- occur as early as age 8 years. As a consequence, kidney disease and
- arthritis (gout) may develop. Patients exhibit a startle reaction with
- arching of the head and back in response to sudden noise. They suffer from
- muscular weakness and perform ceaseless slow writhing movements of the
- fingers, arms, toes and face. Speech and swallowing becomes impaired.
- Patients vomit frequently.
-
- Most children with the Lesch-Nyhan syndrome are severely underweight,
- and many are quite short. In addition, part of the respiratory tract is
- constricted and the breath makes a whistling sound (aspiration). Pneumonia
- is common in patients with this disorder. A peculiar characteristic of this
- syndrome is outbursts of aggressive behavior including self-mutilation. The
- children must be protected from themselves.
-
- Causes
-
- Lesch-Nyhan syndrome is an X-linked hereditary disorder caused by a lack of
- hypoxanthine-guanine posphoribosyl transferase enzyme which participates in
- the metabolism of acid purines. (Human traits including the classic genetic
- diseases, are the product of the interaction of two genes for that condition,
- one received from the father and one from the mother. X-linked recessive
- disorders are conditions which are coded on the X chromosome. Females have
- two X chromosomes, but males have one X chromosome and one Y chromosome.
- Therefore in females, disease traits on the X chromosome can be masked by the
- normal gene on the other X chromosome. Since males have only one X
- chromosome, if they inherit a gene for a disease present on the X, it will be
- expressed. Men with X-linked disorders transmit the gene to all their
- daughters, who are carriers, but never to their sons. Women who are carriers
- of an X-linked disorder have a fifty percent risk of transmitting the carrier
- condition to their daughters, and a fifty percent risk of transmitting the
- disease to their sons.)
-
- People affected with the disorder, or carriers, can be detected through
- biochemical studies on cultured cells, even before birth. Female siblings
- and maternal aunts can be carriers of the disorder, but usually only males
- get Lesch-Nyhan syndrome.
-
- Affected Population
-
- Lesch-Nyhan syndrome affects only males, though females can be genetic
- carriers of the disorder.
-
- Therapies: Standard
-
- Allopurinol is used to treat the symptoms related to excessive production of
- uric acid in Lesch-Nyhan syndrome. Children with this disorder require
- physical restraints such as hip, chest and elbow restraints so they do not
- hurt themselves. Elbow restraints keep the hands free. Biting of fingers
- and/or lips can be prevented by extracting teeth.
-
- Therapies: Investigational
-
- Investigational studies with a mouse virus are underway. If this virus is
- injected into humans, it is hoped that it may trigger production of the
- enzyme lacking in patients with Lesch-Nyhan syndrome. This study is in its
- initial stages, and it may be some years before the technique moves out of
- the laboratory and into clinical trials.
-
- This disease entry is based upon medical information available through
- April 1990. Since NORD's resources are limited, it is not possible to keep
- every entry in the Rare Disease Database completely current and accurate.
- Please check with the agencies listed in the Resources section for the most
- current information about this disorder.
-
- Resources
-
- For more information on Lesch-Nyhan Syndrome, please contact:
-
- National Organization for Rare Disorders (NORD)
- P.O. Box 8923
- New Fairfield, CT 06812-1783
- (203) 746-6518
-
- Lesch-Nyhan Syndrome Registry
- Dr. Lowell Anderson
- New York University School of Medicine
- Bellevue Hospital Medical Center
- Dept. of Psychiatry
- 550 First Ave.
- New York, NY 10012
- (212) 263-6458
-
- NIH/National Institute of Neurological Disorders & Stroke (NINDS)
- 9000 Rockville Pike
- Bethesda, MD 20892
- (301) 496-5751
- (800) 352-9424
-
- Dr. William L. Nyhan
- Professor of Pediatrics
- UC School of Medicine, San Diego CA
- La Jolla, CA 92093
- (619) 534-4150
-
- Research Trust for Metabolic Diseases in Children
- Golden Gates Lodge, Weston Rd.
- Crewe CW1 1XN, England
- Telephone: (0270) 250244
-
- For information on genetics and genetic counseling referrals, please
- contact:
-
- March of Dimes Birth Defects Foundation
- 1275 Mamaroneck Avenue
- White Plains, NY 10605
- (914) 428-7100
-
- Alliance of Genetic Support Groups
- 35 Wisconsin Circle, Suite 440
- Chevy Chase, MD 20815
- (800) 336-GENE
- (301) 652-5553
-
- References
-
- Disorders of Purine and Pyrimidine Metabolism: Nyhan, in: Practice of
- Pediatrics: Kelley, Harper & Row (1982).
-
-