Papillorenal syndrome historical perspective: Difference between revisions

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==Overview==
[[Papillorenal syndrome]] for which another term is [[Renal-coloboma syndrome|Renal-Coloboma Syndrome (RCS]]). This condition usually consisting of [[renal]] [[anomalies]] plus [[optic nerve]] [[dysplasia]]. It is transmitted to future generations in an [[Autosomal dominant]] fashion. First clearly described by ''Weaver al in 1988''. In two brothers having [[ESRD]] with [[coloboma]] in the [[eyes]]. ''In 1995,'' the association of dominant mutations in [[PAX2 gene]] with [[RCS]] was made. It was studied in a two-generation family having [[renal]] [[dysplasia]], [[coloboma]] of the [[optic nerve]], and also the presence of [[vesicoureteral reflux]]. There are different opinions regarding the name of this condition between the observers. [[Papillorenal syndrome]] is a combination of [[renal]] and [[ocular anomalies]].  ''Eccles and Schimmenti, 1999; Negrisolo et al., 2011'' summarized Less common findings associated with expression of [[PAX2]] gene in numerous [[tissues]] with disease include [[hearing loss]], [[CNS anomalies]], [[joint problems]], [[ligament laxity]], [[soft skin]].
==Historical Perspective==
==Historical Perspective==
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[[Papillorenal syndrome]] for which another term used most commonly is [[Renal-coloboma syndrome]](RCS). This condition usually consisting of [[renal]] [[anomalies]] plus [[optic nerve]] [[dysplasia]]. It is transmitted to generations in an [[Autosomal dominant]] fashion<ref name="urlOMIM Entry - # 120330 - PAPILLORENAL SYNDROME; PAPRS">{{cite web |url=https://www.omim.org/entry/120330#clinicalFeatures |title=OMIM Entry - # 120330 - PAPILLORENAL SYNDROME; PAPRS |format= |work= |accessdate=}}</ref>.


'''''Weaver al in 1988''''' First clearly described papillorenal syndrome. In two brothers having [[ESRD]] with [[coloboma]] in the eyes.


Renal coloboma syndrome (RCS) also known as papillorenal syndrome describes a condition consisting of optic nerve dysplasia (frequently described as a coloboma) and renal malformations (OMIM 120330). The inheritance pattern is autosomal dominant. The first clear description of RCS was made by Weaver ''et al''<sup>1</sup> in 1988 in two brothers who had end-stage kidney disease with interstitial nephritis and optic nerve colobomas. In 1995, the association of RCS with autosomal dominant mutations in the transcriptional regulator, ''PAX2,'' was made in a two generation family with optic nerve colobomas, vesicoureteral reflux and renal dysplasia.<sup>2, 3</sup> Later that year, an autosomal dominant mutation in ''PAX2'' was identified in the family described by Weaver ''et al''<sup>4</sup> confirming the association of ''PAX2'' with RCS.
'''In 1995''', the association of dominant mutations in [[PAX2 gene]] with [[RCS]] was made. It was studied in a two-generation family having [[renal dysplasia]], coloboma of the optic nerve, and also the presence of vesicoureteral reflux. There are different opinions regarding the name of this condition between the observers.  
 
There are differences of opinion regarding the name of this condition between observers. RCS is the more common appellation in PubMed with 131 citations identified using the search term ‘Renal Coloboma syndrome' and 18 citations identified using the search term ‘Papillorenal syndrome' (PubMed search was performed November 26, 2010). The difference in nomenclature derives from differences in opinion regarding the description of the eye phenotype. To many ophthalmologists, the eye findings fall under the phenotype called ‘coloboma',<sup>5</sup> meaning a condition that results from failure of the optic fissure to close during eye development. To others, the optic nerve findings should be described using the more general term, ‘dysplasia'<sup>6</sup> with the preference for ‘papillorenal' syndrome where the word ‘papilla' refers to the optic papilla. In animal models, specifically mouse and zebrafish, ''Pax2/pax2a'' is expressed in the optic fissure; homozygous mutations lead to optic fissure closure defects and heterozygous mutations lead to similar defects as observed in human patients


*
'''''Rieger in 1977''''' first reported a [[family]] in whom the [[male]] died because of [[chronic kidney disease]] and bilateral [[optic disc]] [[anomalies]]. His son on examination also showed [[eye]] changes involving [[macula]] and [[retina]] but on the [[kidney]] workup was normal but on the other hand, his [[daughter]] was having normal [[vision]] with no [[eye]] abnormalities suggested from [[renal failure]]. This is a [[variable expression]] not uncommon in [[Autosomal dominant syndrome]].


Papillorenal syndrome is a combination of renal and ocular anomlies. Eccles and Schimmenti, 1999; Negrisolo et al., 2011 summarized Less common findings associated with expression of PAX2 gene in numerous tissues with disease include hearing loss, CNS anomlies, joint problems, ligament laxity, soft skin.  
'''''Karcher in 1979''''' described a combined case of [[father]] and [[son]] from a [[family]] showing some [[eye]] anomalies and [[renal disease]] as well. The [[eye anomalies]] found in his son was named [[Morning glory disc anomaly|morning glory]] [[optic disc]] [[anomaly]]. There was a high uncertainty that whether [[Morning glory disc anomaly|morning glory]] includes colobomatous defects or its just the abnormal [[regression]] of [[mesodermal]] [[embryonic disc]] structures. ''Bron et al in 1989'' described the same disorder under the term [[Papillorenal syndrome]].  


. The disorder shows wide inter- and intrafamilial variability. The renal features are part of a spectrum of malformations termed congenital anomalies of the kidney and urinary tract (CAKUT; see, e.g., 610805), and some patients with PAX2 mutations may present with CAKUT without obvious ocular abnormalities. In these patients, ocular abnormalities may be subtle and difficult to detect without advanced screening methods or may be normal (summary by Negrisolo et al., 2011; Iatropoulos et al., 2012).
'''''Schimmenti et al. & Sanyanusin et al. in 1995''''' four individuals ( One father and 3 sons) of having coloboma of the optic nerve, kidney anomalies, and also the presence of vesicoureteral reflux. The father on workup was found to be having normal with respect to the [[renal]] function. Although [[Eye]] examination showed the presence of [[myopia]] a [[coloboma]] in the [[eyes]] bilaterally. But all 3 sons were having [[kidneys]] and [[eyes]] affected to a variable extent.
Eye anomalies associated with PAX2 mutations consist of a wide and sometimes excavated dysplastic optic disc with the emergence of the retinal vessels from the periphery of the disc, designated optic nerve 'coloboma' or 'morning glory' anomaly. Associated findings may include a small corneal diameter, retinal coloboma, scleral staphyloma, optic nerve cyst, microphthalmia, and pigmentary macular dysplasia. The kidneys are small and abnormally formed (renal hypodysplasia), and have fewer than the normal number of glomeruli, which are enlarged (oligomeganephronia). These ocular and renal anomalies result in decreased visual acuity and retinal detachment, as well as hypertension, proteinuria, and renal insufficiency that frequently progresses to end-stage renal disease (summary by Schimmenti, 2011). *****


'''''Parsa in 1998''''' concluded that this is most likely a condition of the [[dysplastic]] disc rather than being called [[coloboma]], so the [[Paillorenal syndrome|papillorenal syndrome]] was the most appropriate term designated.


''<u><span lang="en" dir="ltr">Rieger in 1977</span></u>'' first reported a [[family]] in whom the [[male]] died because of [[chronic kidney disease]] and bilateral [[optic disc]] [[anomalies]]. His son on examination also showed [[eye]] changes involving [[macula]] and [[retina]] but on the [[kidney]] workup was normal but on the other hand, his [[daughter]] was having normal [[vision]] with no [[eye]] abnormalities suggested from [[renal failure]]. This is a [[variable expression]] not uncommon in [[Autosomal dominant syndrome]].
'''''Amiel et al. in 2000'''''  described a family of 3 members with striking [[ocular]] [[phenotypic]] variability. One of them was having [[renal]] [[hypoplasia]] along with [[eye]] manifestation while the other 2 were having [[renal]] anomalies ( Unilateral cystic renal hypoplasia) with [[optic disc]] anomalies bilaterally.


<u>''<span lang="en" dir="ltr">Karcher in 1979</span>''</u> described a combined case of [[father]] and [[son]] from a [[family]] showing some [[eye]] anomalies and [[renal disease]] as well. The [[eye anomalies]] found in his son was named [[Morning glory disc anomaly|morning glory]] [[optic disc]] [[anomaly]]. There was a high uncertainty that whether [[Morning glory disc anomaly|morning glory]] includes colobomatous defects or its just the abnormal [[regression]] of [[mesodermal]] [[embryonic disc]] structures. Bron et al in 1989 described the same disorder under the term [[Papillorenal syndrome]]. In 1998 then Parsa concluded that this is most likely a condition of the [[dysplastic]] disc rather than being called [[coloboma]], so the [[paillorenal syndrome]] was the most appropriate term designated.  
'''According to ''PubMed search performed in November 2010'''''<nowiki/>'',''  The RCS is more common with 131 citations identified when the people searched for the term '[[Renal-coloboma syndrome]]' as compared to only 18 citations that have been identified when people used the search term as '[[Papillorenal syndrome]]'. The difference in results and the observation is mainly due to the differences in the explanation or description of [[phenotypic]] changes in the [[eye]]. For many [[ophthalmologists]], the eye findings are mainly due to the failure of the [[optic fissure]] to close during eye development and should be called [[coloboma]]. For others, eye manifestation should be regarded as [[Dysplasia]].


''<u>Schimmenti et al. & Sanyanusin et al. in 1995</u>'' four individuals ( One father and 3 son) of having coloboma of optic nerve, kidney anomalies and also the presence of vesicoureteral reflux. The father on workup was found to be having normal with respect to the renal function. Although Eye examination showed the presence of myopia an coloboma in eyes bilaterally. But all 3 son was having kidneys and eyes affected to variable extent.
'''''Eccles and Schimmenti, 1999; Negrisolo et al., 2011'''''<ref name="urlPAX2-Related Disorder - GeneReviews® - NCBI Bookshelf">{{cite web |url=https://www.ncbi.nlm.nih.gov/books/NBK1451/ |title=PAX2-Related Disorder - GeneReviews® - NCBI Bookshelf |format= |work= |accessdate=}}</ref> summarized Less common findings associated with expression of the [[PAX2 gene]] in numerous [[tissues]] with the [[disease]] include [[hearing loss]], [[CNS anomalies]], [[joint problems]], [[ligament laxity]], [[soft skin]].


<u>''Amiel et al. in 2000''</u>  described a family of 3 members with striking ocular phenotypic variability. One of them was having renal hypoplasia along with eye manifestation while other 2 were having renal anomalies ( Unilateral cystic renal hypoplasia) with optic disc anomalies bilaterally.
'''''Schimmenti in 2011-''' Summarized'' The [[ocular]] and [[renal]] anomalies result in a wide range of manifestations. They commonly result in decreased [[visual activity]] along with [[retinal detachment]], [[renal insufficiency]], [[proteinuria]], [[hypertension]], which can rapidly go on to develop [[end-stage renal disease]].


<br />
'''''Negrisolo et al., 2011; latropoulos at al., 2012''.-''' This disorder has shown a wide variety of familial variability with a variable presentation in different family members. The patients under the category of [[CAKUT]] that are '[[congenital anomalies of the kidney and urinary tract]]' present with [[renal]] features without remarkable [[ocular]] changes, the same is the case with some patients having [[PAX2]] [[mutations]]<ref name="pmid31060108">{{cite journal |vauthors=Deng H, Zhang Y, Xiao H, Yao Y, Liu X, Su B, Zhang H, Xu K, Wang S, Wang F, Ding J |title=Diverse phenotypes in children with PAX2-related disorder |journal=Mol Genet Genomic Med |volume=7 |issue=6 |pages=e701 |date=June 2019 |pmid=31060108 |pmc=6565600 |doi=10.1002/mgg3.701 |url=}}</ref><ref name="pmid21654726">{{cite journal |vauthors=Schimmenti LA |title=Renal coloboma syndrome |journal=Eur. J. Hum. Genet. |volume=19 |issue=12 |pages=1207–12 |date=December 2011 |pmid=21654726 |pmc=3230355 |doi=10.1038/ejhg.2011.102 |url=}}</ref>. In these patients the [[ocular]] manifestations may be hard to detect without the use of advanced screening techniques or it can be normal.


==References==
==References==

Latest revision as of 14:41, 10 September 2020

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Shivam Singla, M.D.[2]

Overview

Papillorenal syndrome for which another term is Renal-Coloboma Syndrome (RCS). This condition usually consisting of renal anomalies plus optic nerve dysplasia. It is transmitted to future generations in an Autosomal dominant fashion. First clearly described by Weaver al in 1988. In two brothers having ESRD with coloboma in the eyes. In 1995, the association of dominant mutations in PAX2 gene with RCS was made. It was studied in a two-generation family having renal dysplasia, coloboma of the optic nerve, and also the presence of vesicoureteral reflux. There are different opinions regarding the name of this condition between the observers. Papillorenal syndrome is a combination of renal and ocular anomalies. Eccles and Schimmenti, 1999; Negrisolo et al., 2011 summarized Less common findings associated with expression of PAX2 gene in numerous tissues with disease include hearing loss, CNS anomalies, joint problems, ligament laxity, soft skin.

Historical Perspective

Papillorenal syndrome for which another term used most commonly is Renal-coloboma syndrome(RCS). This condition usually consisting of renal anomalies plus optic nerve dysplasia. It is transmitted to generations in an Autosomal dominant fashion[1].

Weaver al in 1988 First clearly described papillorenal syndrome. In two brothers having ESRD with coloboma in the eyes.

In 1995, the association of dominant mutations in PAX2 gene with RCS was made. It was studied in a two-generation family having renal dysplasia, coloboma of the optic nerve, and also the presence of vesicoureteral reflux. There are different opinions regarding the name of this condition between the observers.

Rieger in 1977 first reported a family in whom the male died because of chronic kidney disease and bilateral optic disc anomalies. His son on examination also showed eye changes involving macula and retina but on the kidney workup was normal but on the other hand, his daughter was having normal vision with no eye abnormalities suggested from renal failure. This is a variable expression not uncommon in Autosomal dominant syndrome.

Karcher in 1979 described a combined case of father and son from a family showing some eye anomalies and renal disease as well. The eye anomalies found in his son was named morning glory optic disc anomaly. There was a high uncertainty that whether morning glory includes colobomatous defects or its just the abnormal regression of mesodermal embryonic disc structures. Bron et al in 1989 described the same disorder under the term Papillorenal syndrome.

Schimmenti et al. & Sanyanusin et al. in 1995 four individuals ( One father and 3 sons) of having coloboma of the optic nerve, kidney anomalies, and also the presence of vesicoureteral reflux. The father on workup was found to be having normal with respect to the renal function. Although Eye examination showed the presence of myopia a coloboma in the eyes bilaterally. But all 3 sons were having kidneys and eyes affected to a variable extent.

Parsa in 1998 concluded that this is most likely a condition of the dysplastic disc rather than being called coloboma, so the papillorenal syndrome was the most appropriate term designated.

Amiel et al. in 2000 described a family of 3 members with striking ocular phenotypic variability. One of them was having renal hypoplasia along with eye manifestation while the other 2 were having renal anomalies ( Unilateral cystic renal hypoplasia) with optic disc anomalies bilaterally.

According to PubMed search performed in November 2010, The RCS is more common with 131 citations identified when the people searched for the term 'Renal-coloboma syndrome' as compared to only 18 citations that have been identified when people used the search term as 'Papillorenal syndrome'. The difference in results and the observation is mainly due to the differences in the explanation or description of phenotypic changes in the eye. For many ophthalmologists, the eye findings are mainly due to the failure of the optic fissure to close during eye development and should be called coloboma. For others, eye manifestation should be regarded as Dysplasia.

Eccles and Schimmenti, 1999; Negrisolo et al., 2011[2] summarized Less common findings associated with expression of the PAX2 gene in numerous tissues with the disease include hearing loss, CNS anomalies, joint problems, ligament laxity, soft skin.

Schimmenti in 2011- Summarized The ocular and renal anomalies result in a wide range of manifestations. They commonly result in decreased visual activity along with retinal detachment, renal insufficiency, proteinuria, hypertension, which can rapidly go on to develop end-stage renal disease.

Negrisolo et al., 2011; latropoulos at al., 2012.- This disorder has shown a wide variety of familial variability with a variable presentation in different family members. The patients under the category of CAKUT that are 'congenital anomalies of the kidney and urinary tract' present with renal features without remarkable ocular changes, the same is the case with some patients having PAX2 mutations[3][4]. In these patients the ocular manifestations may be hard to detect without the use of advanced screening techniques or it can be normal.

References

  1. "OMIM Entry - # 120330 - PAPILLORENAL SYNDROME; PAPRS".
  2. Deng H, Zhang Y, Xiao H, Yao Y, Liu X, Su B, Zhang H, Xu K, Wang S, Wang F, Ding J (June 2019). "Diverse phenotypes in children with PAX2-related disorder". Mol Genet Genomic Med. 7 (6): e701. doi:10.1002/mgg3.701. PMC 6565600 Check |pmc= value (help). PMID 31060108.
  3. Schimmenti LA (December 2011). "Renal coloboma syndrome". Eur. J. Hum. Genet. 19 (12): 1207–12. doi:10.1038/ejhg.2011.102. PMC 3230355. PMID 21654726.

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