Papillorenal syndrome risk factors: Difference between revisions

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''The pathophysiology and the risk factors for 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 and this genetic syndrome keeps on clustering in the future generations. The environmental risk factors that impacts the pregnancy like alcohol and some drugs may contribute to the development of Renal-coloboma syndrome. In conclusion it arises from 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 in failure of optic disc closure. It usually depends on which specific part or areas of optic fissure fails to close.''
 
==Risk factors==
==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.''
''The pathophysiology and the risk factors for 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 and this genetic syndrome keeps on clustering in the future generations. The environmental risk factors that impacts the pregnancy like alcohol and some drugs may contribute to the development of Renal-coloboma syndrome. In conclusion it arises from 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 in failure of optic disc closure. It usually depends on which specific part or areas of optic fissure fails to close.''


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''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.''
Coloboma 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 are passed from one generation to another.
 
''Keyhole pupil might occur spontaneously or it might be acquired. Persons with isolated coloboma can still pass the condition onto their children.''
 
''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''===
''Prenatal care and diagnostic evaluation is possible for the cases where there is high index of suspicion or if there is 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.''
''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.''


The eyes in the fetus develops 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 eye affected.


Mar. 18, 2020
Lens coloboma- The missing part is the lens piece


A coloboma is believed to be genetic and can be passed along in families.
Eyelid coloboma- The missing tissue here is part of upper or lower eyelids.


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


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.
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.


A coloboma describes conditions where normal tissue in or around the eye is missing at birth.


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.


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:


* '''Eyelid coloboma.''' A piece of the upper or lower eyelid is missing.
h.
* '''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.





Revision as of 00:40, 6 September 2020

Overview

The pathophysiology and the risk factors for 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 and this genetic syndrome keeps on clustering in the future generations. The environmental risk factors that impacts the pregnancy like alcohol and some drugs may contribute to the development of Renal-coloboma syndrome. In conclusion it arises from 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 in failure of optic disc closure. It usually depends on which specific part or areas of optic fissure fails to close.

Risk factors

The pathophysiology and the risk factors for 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 and this genetic syndrome keeps on clustering in the future generations. The environmental risk factors that impacts the pregnancy like alcohol and some drugs may contribute to the development of Renal-coloboma syndrome. In conclusion it arises from 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 in failure of optic disc closure. It usually depends on which specific part or areas of optic fissure fails to close.


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Coloboma 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 are passed from one generation to another.

Prenatal care and diagnostic evaluation is possible for the cases where there is high index of suspicion or if there is 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 develops 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 eye affected.

Lens coloboma- The missing part is the lens piece

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

Optic nerve coloboma- Optic nerve is f=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.



h.


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

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