Papillorenal syndrome risk factors: Difference between revisions

Jump to navigation Jump to search
Shivam Singla (talk | contribs)
Shivam Singla (talk | contribs)
No edit summary
 
(14 intermediate revisions by the same user not shown)
Line 1: Line 1:
{{CMG}} {{AE}} {{Shivam Singla}}
==Overview==
==Overview==
==Risk factors==
''When it happens as a function of a genetic syndrome or chromosomal problem, it may cluster in households according to the inheritance pattern for that condition. Environmental factors that impact early development, such as the '''exposure to alcohol and particular drugs during pregnancy''', might increase the risk of coloboma.''
__NOTOC__
__NOTOC__
{{Papillorenal syndrome}}
{{Papillorenal syndrome}}
The [[pathophysiology]] and the [[risk factors]] responsible for the development of [[Renal-coloboma syndrome]] is mainly [[genetic]] and related to the expression of [[PAX 2]] [[gene]]. So the [[genetic]] [[inheritance]] is the main [[risk factor]] or the important determinant in the causation of [[Renal-coloboma syndrome]]. This [[genetic]] syndrome keeps on clustering in the future generations.


''he bottom line is, it arises from abnormal development of the eye during the 3rd trimester of pregnancy, when the eye is forming. The flaw takes place when the optic fissure does not close completely. Its area depends on which part of the optic fissure fails to close.''
The [[environmental]] [[risk factors]] that impact the [[pregnancy]] like [[alcohol]] and some [[drugs]] may also contribute to the development of [[Renal-coloboma syndrome]]. In conclusion, [[RCS]] leads to the abnormal development of organs like [[kidney]] and [[eyes]] during the [[pregnancy period]]. The abnormal development of [[eyes]] usually happens in the third trimester during that time the [[eyes]] are formed. The abnormalities usually occur due to the impairment in the closure of the [[optic disc]]. It usually depends on which specific part or areas of [[optic fissure]] fails to close.


''Keyhole pupil might occur spontaneously or it might be acquired. Persons with isolated coloboma can still pass the condition onto their children.''
==Risk factors==
 
The [[pathophysiology]] and the risk factors responsible for the development of [[Renal-coloboma syndrome]] is mainly [[genetic]] and related to the expression of [[PAX2]]<ref name="pmid11297491">{{cite journal |vauthors=Parsa CF, Silva ED, Sundin OH, Goldberg MF, De Jong MR, Sunness JS, Zeimer R, Hunter DG |title=Redefining papillorenal syndrome: an underdiagnosed cause of ocular and renal morbidity |journal=Ophthalmology |volume=108 |issue=4 |pages=738–49 |date=April 2001 |pmid=11297491 |doi=10.1016/s0161-6420(00)00661-8 |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> [[gene]]. So the [[genetic inheritance]] is the main [[risk factor]] and this [[genetic syndrome]] keeps on clustering in the future generations. The [[environmental]] [[risk factors]] that impact the [[pregnancy]] like [[alcohol]] and some [[drugs]] may contribute to the development of [[Renal-coloboma syndrome]]. In conclusion, RCS leads to the abnormal development of [[organs]] like [[kidney]] and [[eyes]] during the [[pregnancy]] period. The abnormal development of [[eyes]] usually happens in the [[third trimester]] during that time the [[eyes]] are formed. The abnormalities usually happen when there is a failure of [[optic disc]] closure. It usually depends on which specific part or areas of optic fissure fails to close.
''When it happens as a function of a genetic syndrome or chromosomal problem, it may cluster in households according to the inheritance pattern for that condition.''
 
''Environmental factors that impact early development, such as the exposure to alcohol and particular drugs during pregnancy, might increase the risk of coloboma.''
 
''Prenatal diagnosis or pre-implantation genetic testing is possible if a clearly pathogenic PAX2 mutation has been identified in a family.''
 
===''Genetic counseling''===
''RCS is inherited in an autosomal dominant pattern, though this is complicated by de novo cases, variable expression, incomplete clinical penetrance, and maternal and paternal gonosomal mosaicism.''
 
 
Mar. 18, 2020
 
A coloboma is believed to be genetic and can be passed along in families.
 
Sometimes a coloboma is part of a genetic syndrome. For instance, cat eye syndrome, a rare disorder named after the distinctive shape of an iris coloboma, is caused by a specific genetic mutation and occurs along with other physical abnormalities.


However, not all babies born with a coloboma have a family history of this condition or a particular syndrome, suggesting that the disorder can appear by chance.
[[Coloboma]]<ref name="pmid26571382">{{cite journal |vauthors=Okumura T, Furuichi K, Higashide T, Sakurai M, Hashimoto S, Shinozaki Y, Hara A, Iwata Y, Sakai N, Sugiyama K, Kaneko S, Wada T |title=Association of PAX2 and Other Gene Mutations with the Clinical Manifestations of Renal Coloboma Syndrome |journal=PLoS ONE |volume=10 |issue=11 |pages=e0142843 |date=2015 |pmid=26571382 |pmc=4646464 |doi=10.1371/journal.pone.0142843 |url=}}</ref> or keyhole [[pupil]] might occurs all of sudden at its own during the pregnancy or it may be acquired. Some cases reported that even isolated coloboma is passed from one generation to another.


Prenatal care and diagnostic evaluation are possible for the cases where there is a high index of suspicion or if there is a clear cut family history of [[PAX2|PAX2 gen]]<nowiki/>e mutation running in the family. This [[Renal-coloboma syndrome]] usually presents in [[autosomal dominant]] pattern with variations and complications due to other associated genetic manipulations like variable expression, [[Mosaicism|genetic mosaicism]] and/or [[incomplete penetrance]].


The eyes in the fetus develop during the first 3 months. Choroidal fissure forms the eye. This usually closes by the seventh week of pregnancy and failure of closure of this results in the development of [[coloboma]]. Usually affects one eye but at point seen affecting both eyes as well. There are different types of coloboma based on the structural and functional tissue of the eye affected.


A coloboma describes conditions where normal tissue in or around the eye is missing at birth.
'''Lens coloboma'''- The missing part is the [[Lens|lens piece]]


Coloboma comes from the Greek word that means "curtailed." The eye develops quickly during a fetus' first three months of growth. A gap, known as the choroidal fissure, appears at the bottom of the stalks that eventually forms the eye. This fissure generally closes by the seventh week of pregnancy. If it does not close, a coloboma or space forms.
'''Eyelid coloboma'''- The missing tissue here is part of the upper or lower eyelids.


A coloboma can affect one or both eyes. If both eyes are involved, it can affect them the same way or differently. There are different types of coloboma, depending on the part of the eye affected:
'''Optic nerve coloboma'''- [[Optic nerve|Optic nerv]]<nowiki/>e is affected that results in the impairment of vision.


* '''Eyelid coloboma.''' A piece of the upper or lower eyelid is missing.
'''Uveal coloboma'''- If the coloboma affects the iris then it is given a special name called [[Cat-eye syndrome|Cat-eye appearance]].
* '''Lens coloboma.''' A piece of the lens is missing.
* '''Macular coloboma.''' In this coloboma, the macula fails to develop normally.
* '''Optic nerve coloboma.''' In this coloboma, the optic nerve is hollowed out, reducing vision.
* '''Uveal coloboma.''' The uvea is the middle layer of the eye. This coloboma can affect the iris, the colored part of the eye, giving it a distinct keyhole or cat-eye appearance.
* '''Chorio-retinal coloboma.''' In this coloboma, part of the retina is missing.


'''Chorio-retinal coloboma'''- [[Retina]] is the missing part in this case.


The wide association between urinary tract malformations and dysplastic kidneys, known as CAKUT (Congenital Anomalies of the Kidney and Urinary Tract), could be caused by a single disorder of the embryonic development of the kidney and urinary tract. These complex patterns of development are under genetic control. A positive family history strongly suggests a genetic origin of these conditions. Linkage studies show an extreme genetic heterogenicity and an important phenotypic and clinical variability of the same mutation. Some urinary tract malformations have been investigated in the context of clinical syndromes. The renal-coloboma syndrome is an autosomal dominant human disease, secondary to mutation of the PAX2 transcription factor, characterized by optic nerve coloboma, renal anomalies and vesicoureteral reflux. However, most of the urinary tract anomalies can occur in isolation. Studies have shown the association of hereditary hydronephrosis with HLA antigens on chromosome 6 and the association of VUR with the mutations in a locus of chromosome 1. The higher frequency and severity of some uropathies in the male gender may be explained by a linkage-disequilibrium phenomenon or a X-linked transmission pattern. For example, the mutations in the AGTR2 gene on chromosome X were observed in animal models but not yet confirmed in human subjects. Finally, the ACE gene polymorphism is associated with a higher incidence of congenital hypo-dysplastic kidneys and represents a significant risk factor for the development of progressive
'''Macular coloboma'''- The development of macula is abnormal in this case.


==References==
==References==

Latest revision as of 14:42, 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 Microchapters

Home

Patient Information

Overview

Historical Perspective

Pathophysiology

Differentiating Papillorenal syndrome from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

MRI

Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Papillorenal syndrome risk factors On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Papillorenal syndrome risk factors

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Papillorenal syndrome risk factors

CDC on Papillorenal syndrome risk factors

Papillorenal syndrome risk factors in the news

Blogs on Papillorenal syndrome risk factors

Directions to Hospitals Treating Papillorenal syndrome

Risk calculators and risk factors for Papillorenal syndrome risk factors

The pathophysiology and the risk factors responsible for the development of Renal-coloboma syndrome is mainly genetic and related to the expression of PAX 2 gene. So the genetic inheritance is the main risk factor or the important determinant in the causation of Renal-coloboma syndrome. This genetic syndrome keeps on clustering in the future generations.

The environmental risk factors that impact the pregnancy like alcohol and some drugs may also contribute to the development of Renal-coloboma syndrome. In conclusion, RCS leads to the abnormal development of organs like kidney and eyes during the pregnancy period. The abnormal development of eyes usually happens in the third trimester during that time the eyes are formed. The abnormalities usually occur due to the impairment in the closure of the optic disc. It usually depends on which specific part or areas of optic fissure fails to close.

Risk factors

The pathophysiology and the risk factors responsible for the development of Renal-coloboma syndrome is mainly genetic and related to the expression of PAX2[1][2] gene. So the genetic inheritance is the main risk factor and this genetic syndrome keeps on clustering in the future generations. The environmental risk factors that impact the pregnancy like alcohol and some drugs may contribute to the development of Renal-coloboma syndrome. In conclusion, RCS leads to the abnormal development of organs like kidney and eyes during the pregnancy period. The abnormal development of eyes usually happens in the third trimester during that time the eyes are formed. The abnormalities usually happen when there is a failure of optic disc closure. It usually depends on which specific part or areas of optic fissure fails to close.

Coloboma[3] or keyhole pupil might occurs all of sudden at its own during the pregnancy or it may be acquired. Some cases reported that even isolated coloboma is passed from one generation to another.

Prenatal care and diagnostic evaluation are possible for the cases where there is a high index of suspicion or if there is a clear cut family history of PAX2 gene mutation running in the family. This Renal-coloboma syndrome usually presents in autosomal dominant pattern with variations and complications due to other associated genetic manipulations like variable expression, genetic mosaicism and/or incomplete penetrance.

The eyes in the fetus develop during the first 3 months. Choroidal fissure forms the eye. This usually closes by the seventh week of pregnancy and failure of closure of this results in the development of coloboma. Usually affects one eye but at point seen affecting both eyes as well. There are different types of coloboma based on the structural and functional tissue of the eye affected.

Lens coloboma- The missing part is the lens piece

Eyelid coloboma- The missing tissue here is part of the upper or lower eyelids.

Optic nerve coloboma- Optic nerve is affected that results in the impairment of vision.

Uveal coloboma- If the coloboma affects the iris then it is given a special name called Cat-eye appearance.

Chorio-retinal coloboma- Retina is the missing part in this case.

Macular coloboma- The development of macula is abnormal in this case.

References

  1. Parsa CF, Silva ED, Sundin OH, Goldberg MF, De Jong MR, Sunness JS, Zeimer R, Hunter DG (April 2001). "Redefining papillorenal syndrome: an underdiagnosed cause of ocular and renal morbidity". Ophthalmology. 108 (4): 738–49. doi:10.1016/s0161-6420(00)00661-8. PMID 11297491.
  2. 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.
  3. Okumura T, Furuichi K, Higashide T, Sakurai M, Hashimoto S, Shinozaki Y, Hara A, Iwata Y, Sakai N, Sugiyama K, Kaneko S, Wada T (2015). "Association of PAX2 and Other Gene Mutations with the Clinical Manifestations of Renal Coloboma Syndrome". PLoS ONE. 10 (11): e0142843. doi:10.1371/journal.pone.0142843. PMC 4646464. PMID 26571382.

Template:WH Template:WS