Werner's syndrome

A typical patient with this uncommon premature aging syndrome was followed over a period of four and a half years until his death. He presented the characteristic clinical features, as well as the complications, of Werner's syndrome. About one hundred forty cases of this recessively inherited syndrome have been reported. Most patients become recognizable in their thirties by their short stature, typical facies, premature graying, hair loss, cataracts, atrophy of skin and subcutaneous tissue, and acral sclerosis. Advanced peripheral vascular disease occurs early; angina, skin cancer, diabetes mellitus, and internal malignancy are common. Most patients die before the age of fifty years either from complications of anteriosclerotic vascular disease or malignancy.

[The Werner syndrome]

Werner's syndrome, also known as "progeria adultorum", manifests itself in young adults. They appear older than their chronological age. Characteristically, there is atrophy in the distal extremities and the face. There is progressive scleropoikiloderma and hyperkeratosis on the foot soles. In the face, there is frequently a "bird-like" expression. Other characteristics are premature graying and early loss of hair, juvenile cataracts, hypogonadism, diabetic symptoms, arteriosclerosis, osteoporosis, small stature with characteristic features, muscle atrophy and cardiac abnormalities. The disease is inherited in an autosomal recessive way. Pathogenesis is unclear. In the following paper, we are reporting the case of a 29 year old saleswoman, who complained of cramps in the calves, and presented the typical symptoms of Werner's syndrome.

Cellular aging in Werner's syndrome: a unique phenotype?

Werner's syndrome is commonly regarded as a model for the study of premature aging. There are, however, a variety of clinical and pathologic anatomical features that clearly distinguish it from aging in normal individuals. In this paper we report on in vitro cytogenetic and cell fusion studies that indicate cultured fibroblast-like cells derived from Werner patients differ from cells of normal donors. Despite these discordances with "natural" aging, however, Werner's syndrome, like several other "segmental progeroid syndromes," may prove useful for the investigation of selected aspects of the aging process and of age-related diseases.

Studies on age-related diseases in cultured skin fibroblasts

In order to trace the origins of age-dependent diseases to the cellular level, we studied cultured human fibroblasts from subjects with 3 discrete inherited disorders and normal controls of various ages. Skin fibroblasts from subjects with progeria and Werner syndrome had a moderate to severe reduction in growth capacity, whereas cells from subjects with diabetes mellitus had a more subtle growth impairment. There was a decreased response of progeric fibroblasts to insulin-like hormones, and in normal cells the response decreased as a function of the passage level and donor age. Tissue factor, a procoagulant, was more abundant in progeric and Werner fibroblasts. An understanding of fibroblast aging in vitro may help us explain various concomitant phenomena of organismic aging such as diabetes mellitus, cell dropout, impaired hormone responsiveness, and increased atherothrombosis.

Aortic medial calcification in progeria-like syndrome

Aortic medial calcification was investigated in rats in which the progeria-like syndrome (PLS) was evoked by administering dihydrotachysterol. In 35 experimental rats and 15 controls, calcification was studied morphologically by light and electron microscopy, and by enzyme histochemistry. Body weight, food intake and serum calcium levels were also determined. Calcification occurred along and on the elastic lamellae in association with the accumulation of ground substance. In the smooth-muscle cells surrounding the calcified foci, the activities of various lysosomal enzymes increased concomitantly with a tendency toward transformation of smooth-muscle cells to a modified form. From these observations, the role of ground-substance formation by smooth-muscle cells is postulated, and participation in the catabolism of ground substance by the lysosomal enzymes of these cells is suggested. It appears the increased activity of adenosine monophosphatase should be linked to the calcification. The etiology of weight loss, skin manifestations and aortic calcification in PLS rats seems to be different from that in human progeric diseases. Therefore, the PLS rat should not be readily accepted as an animal model for the study of progeric diseases.

Postmortem study of a case of Werner's syndrome

The postmortem study of a classic case of Werner's syndrome is presented. The subject was a Japanese man who died at the age of 39. Major findings included general microsplanchnia, extreme atrophy of the testes and skin, calcified aortic atherosclerosis, an increase of basophils in the pituitary, aspiration pneumonia, chronic pyelonephritis and a meningioma in the occipital area of the brain. Histologically, no osteoporosis was evident in the lumbar spine and iliac bone. The findings suggest that in Werner's syndrome the dominant pathologic factor may be found in connective tissue other than bone.

Werner's syndrome: autopsy report of one case, with a review of pathologic findings reported in the literature

The autopsy findings in a 29-year-old male with Werner's syndrome are presented, with a review of similar data on 17 autopsy cases reported in the literature. The pathologic findings in this new case were scleroderma-like skin atrophy, arteriosclerosis, and atrophy of the endocrine glands (including the genital organs). In the reported cases of Werner's syndrome, as in the present example, the authors were unable to identify any responsible organ or system. However, they suggest that connective tissue, widely distributed throughout the entire body, may play an important role. The possible abnormal metabolism of connective tissue in Werner's syndrome deserves further study.

The Werner syndrome

The symptoms of Werner’s Syndrome are reported by means of 2 cases. The importance of an endocrinological and ophthalmological examination of patients with ‘systemic sclerosis’ is demonstrated.