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Derakhshan P, Habibi A, Amniati S. General Anesthesia in Schwartz-Jampel Syndrome: A Case Report. Anesth Pain Med 2023; 13:e129305. [PMID: 38021333 PMCID: PMC10664156 DOI: 10.5812/aapm-129305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 02/12/2023] [Accepted: 02/14/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Schwartz-Jampel syndrome (SJS) is a rare autosomal recessive disease characterized by muscle weakness and stiffness, abnormal bone development, short stature, joint contractures, and facial dysmorphisms. Myopathy, anatomical deformities, and malignant hyperthermia are challenging for anesthesiologists. Case Presentation This case report describes one case of SJS. The female patient was scheduled for Blepharoplasty in Rasuol Akram General Hospital. Conclusions These patients may have difficult intubation and be prone to malignant hyperthermia. We managed this patient by applying Rocuronium, propofol, and C-MAC video laryngoscopy.
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Affiliation(s)
- Pooya Derakhshan
- Pain Research Center, Department of Anesthesiology and Pain Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Azadeh Habibi
- Pain Research Center, Department of Anesthesiology and Pain Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Saied Amniati
- Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Yamashita Y, Nakada S, Nakamura K, Sakurai H, Ohno K, Goto T, Mabuchi Y, Akazawa C, Hattori N, Arikawa-Hirasawa E. Evaluation of Human-Induced Pluripotent Stem Cells Derived from a Patient with Schwartz–Jampel Syndrome Revealed Distinct Hyperexcitability in the Skeletal Muscles. Biomedicines 2023; 11:biomedicines11030814. [PMID: 36979792 PMCID: PMC10045278 DOI: 10.3390/biomedicines11030814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 02/21/2023] [Accepted: 03/01/2023] [Indexed: 03/10/2023] Open
Abstract
Schwartz–Jampel syndrome (SJS) is an autosomal recessive disorder caused by loss-of-function mutations in heparan sulfate proteoglycan 2 (HSPG2), which encodes the core basement membrane protein perlecan. Myotonia is a major criterion for the diagnosis of SJS; however, its evaluation is based solely on physical examination and can be challenging in neonates and young children. Furthermore, the pathomechanism underlying SJS-related myotonia is not fully understood, and effective treatments for SJS are limited. Here, we established a cellular model of SJS using patient-derived human-induced pluripotent stem cells. This model exhibited hyper-responsiveness to acetylcholine as a result of abnormalities in the perlecan molecule, which were confirmed via comparison of their calcium imaging with calcium imaging of satellite cells derived from Hspg2−/−-Tg mice, which exhibit myotonic symptoms similar to SJS symptoms. Therefore, our results confirm the utility of creating cellular models for investigating SJS and their application in evaluating myotonia in clinical cases, while also providing a useful tool for the future screening of SJS therapies.
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Affiliation(s)
- Yuri Yamashita
- Aging Biology in Health and Disease, Juntendo University Graduate School of Medicine, Tokyo 113-8421, Japan
- Department of Neurology, Faculty of Medicine, Juntendo University, Tokyo 113-8421, Japan
| | - Satoshi Nakada
- Japanese Center for Research on Women in Sport, Juntendo University Graduate School of Health and Sports Science, Chiba 270-1695, Japan
| | - Kyoko Nakamura
- Department of Physiology, Juntendo University Graduate School of Medicine, Tokyo 113-8421, Japan
| | - Hidetoshi Sakurai
- Center for iPS Cell Research and Application (CiRA), Kyoto University, Kyoto 606-8507, Japan
| | - Kinji Ohno
- Division of Neurogenetics, Center for Neurological Diseases and Cancer, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan
| | - Tomohide Goto
- Department of Neurology, Kanagawa Children’s Medical Center, Yokohama 232-8555, Japan
| | - Yo Mabuchi
- Intractable Disease Research Centre, Juntendo University School of Medicine, Tokyo 113-8421, Japan
| | - Chihiro Akazawa
- Intractable Disease Research Centre, Juntendo University School of Medicine, Tokyo 113-8421, Japan
| | - Nobutaka Hattori
- Department of Neurology, Faculty of Medicine, Juntendo University, Tokyo 113-8421, Japan
| | - Eri Arikawa-Hirasawa
- Aging Biology in Health and Disease, Juntendo University Graduate School of Medicine, Tokyo 113-8421, Japan
- Department of Neurology, Faculty of Medicine, Juntendo University, Tokyo 113-8421, Japan
- Japanese Center for Research on Women in Sport, Juntendo University Graduate School of Health and Sports Science, Chiba 270-1695, Japan
- Correspondence: ; Tel.: +81-3-3813-3111
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Peanchitlertkajorn S, Assawakawintip T, Pibulniyom M, Srisan P, Pungchanchaikul P, Jaroenying R. Successful treatment of a child with Schwartz-Jampel syndrome using rapid maxillary expansion and CPAP. J Clin Sleep Med 2021; 17:601-604. [PMID: 33231165 DOI: 10.5664/jcsm.9028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES We reported an 8-year-old male patient with Schwartz-Jampel syndrome, severe obstructive sleep apnea, constricted maxilla and moderate tonsillar hypertrophy. The syndrome is characterized by myotonia, skeletal dysplasia, and facial dysmorphism. METHODS CPAP was initially prescribed, but he was not able to tolerate due to a high pressure setting. Rapid maxillary expansion alone reduced AHI to 10.4 events/h. RESULTS When combined with CPAP, AHI is further reduced to 2.4 events/h. The patient has a better compliance with CPAP following rapid maxillary expansion therapy as the pressure setting decreased. CONCLUSIONS This is the first report utilizing a combination of rapid maxillary expansion and CPAP therapy to successfully treat severe pediatric OSA.
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Affiliation(s)
| | | | - Mevadee Pibulniyom
- Panyananthaphikkhu Chonprathan Medical Center, Srinakharinwirot University, Nonthaburi, Thailand
| | - Panida Srisan
- Division of Pulmonary and Critical Care, Department of Pediatrics, Queen Sirikit National Institute of Child Health, Bangkok, Thailand
| | | | - Rasintra Jaroenying
- Division of Pediatric Pulmonary and Critical Care, Department of Pediatrics, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand
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Ding J, Xu Y, Yuan B, Li D. Management of blepharospasm and blepharophimosis associated with Schwartz-Jampel syndrome. J AAPOS 2021; 25:54-56. [PMID: 33601038 DOI: 10.1016/j.jaapos.2020.10.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 09/21/2020] [Accepted: 10/11/2020] [Indexed: 11/26/2022]
Abstract
We report the case of a 5-year-old boy with progressive bilateral blepharospasm and blepharophimosis secondary to Schwartz-Jampel syndrome type 1A. Molecular findings confirmed two novel heterozygous mutations in the HSPG2 gene. After the patient did not respond to a single injection of botulinum toxin, he underwent levator resection combined with orbicularis myectomy of bilateral upper and lower eyelids, with satisfactory aesthetic and functional outcomes.
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Affiliation(s)
- Jingwen Ding
- Department of Ophthalmology, Beijing Tongren Hospital, and Beijing Ophthalmology & Visual Science Key Lab, Capital Medical University, Beijing, China
| | - Yan Xu
- Department of Ophthalmology, Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Bowei Yuan
- Department of Ophthalmology, Beijing Tongren Hospital, and Beijing Ophthalmology & Visual Science Key Lab, Capital Medical University, Beijing, China
| | - Dongmei Li
- Department of Ophthalmology, Beijing Tongren Hospital, and Beijing Ophthalmology & Visual Science Key Lab, Capital Medical University, Beijing, China.
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Nondystrophic Myotonic Disorders. Neuromuscul Disord 2018. [DOI: 10.1007/978-981-10-5361-0_27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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de Oliveira Camacho FC, Lopes Amaral TM, de Barros Mourão JI. A successful anesthetic approach in a patient with Schwartz-Jampel syndrome. Saudi J Anaesth 2018; 12:128-130. [PMID: 29416471 PMCID: PMC5789473 DOI: 10.4103/sja.sja_393_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Schwartz–Jampel syndrome (SJS) is a rare genetic condition that is characterized by several musculoskeletal abnormalities, such as myotonia, joint contractures, and facial dysmorphisms. Patients with this syndrome can present an anesthetic challenge, due to an increased risk of developing malignant hyperthermia (MH) and the possibility of encountering a difficult airway. Several precautions must be taken when general anesthesia is required, such as the avoidance of potential triggers for MH, continuous core temperature, and end-tidal CO2 monitoring, assuring that dantrolene is readily available. It is also fundamental to prepare for a possible difficult airway, guaranteeing that difficult airway devices are available. We describe the anesthetic management of a 14-year-old boy diagnosed with SJS who was scheduled for multiple dental extractions and was successfully anesthetized with our approach.
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Ozge G, Uysal Y, Melih Ceylan O, Erdurman FC. Surgical management of 2 cases with Schwartz-Jampel syndrome. Can J Ophthalmol 2015; 50:e110-2. [PMID: 26651316 DOI: 10.1016/j.jcjo.2015.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2014] [Revised: 07/29/2015] [Accepted: 08/24/2015] [Indexed: 10/22/2022]
Affiliation(s)
- Gokhan Ozge
- Gulhane Military Medical Academy and Faculty of Medicine, Ankara.
| | - Yusuf Uysal
- Gulhane Military Medical Academy and Faculty of Medicine, Ankara
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Multidisciplinary approach to the treatment of a patient with chondrodystrophic myotonia (Schwartz-Jampel vel Aberfeld syndrome): case report and literature review. Ann Plast Surg 2012; 67:315-9. [PMID: 21263291 DOI: 10.1097/sap.0b013e3181fac1ec] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Chondrodystrophic myotonia, Schwartz-Jampel syndrome, is a rare congenital disorder, which results from disturbance in a perlecan protein synthesis. Most affected are the muscles, acting in generalized myotonia, leading to joint contractures, weird-looking mask-like face appearance, and causing vision disturbances. Also, impaired bones and cartilages result in skeletal anomalies and dental disorders. Allergic reactions to numerous drugs occur in affected individuals. Surgical treatment is risky, due to a low tolerance of anesthetics and high risk of malignant hyperthermia. In this article, a case of 17-year-old girl with Schwartz-Jampel syndrome is presented. The patient with typical syndrome debilitations underwent long diagnostic scheme and multiple treatments in order to restore acceptable appearance and function. All procedures were performed with cautious anesthesiologists' supervision. Modern diagnostic tools can improve the diagnosis rate while multidisciplinary evaluation and advanced treatment techniques can reveal symptoms, minimizing the hazard of anesthesia and improving the quality of life.
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Abstract
PURPOSE OF REVIEW The purpose of this review is to outline those systemic disorders with associated cataracts to help in the evaluation and diagnosis of the patient with pediatric cataract who has systemic abnormalities. RECENT FINDINGS With the profound advancement in genetics, both making and confirming a diagnosis in rare syndromic disorders have become even more possible. By diagnosing a syndromic cataract, the patient and family members are afforded the opportunity to obtain a better understanding of their disorder as well as develop expectations as to the course of their child's disorder. SUMMARY The intent of this article is to act as a resource for helping to determine the cause of cataracts based on the lens appearance, age of onset and systemic findings. Children with cataracts, especially when bilateral, require a comprehensive history and ophthalmic examination with physician awareness toward other organ system involvement. A basic assessment of facial, skeletal, genitourinary, gastrointestinal and integumentary abnormalities is beneficial. In this review, there are numerous tables that are to act as a resource in developing a differential diagnosis and guide further systemic and genetic evaluation.
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A case of Schwartz-Jampel syndrome with cleft palate. Int J Pediatr Otorhinolaryngol 2009; 73:1601-3. [PMID: 19733405 DOI: 10.1016/j.ijporl.2009.08.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2009] [Revised: 08/07/2009] [Accepted: 08/10/2009] [Indexed: 11/21/2022]
Abstract
Schwartz-Jampel syndrome is a rare inherited autosomal recessive disorder characterized by generalized myotonia, joint contractures, skeletal abnormalities and facial dysmorphism. The gene defect involves the 1p34-p36.1 region of chromosome 1. Also, one of the candidate genes for orofacial clefting is the 1p36 region. Cleft palate is the most common congenital anomaly in the head and neck. Despite both diseases share a genetic defect in chromosome 1p36 region, the association of both conditions has not yet been investigated. Feeding problems due to the presence of the cleft may add to the growth retardation that is already present in those patients, so palatoplasty is mandatory. We described a case of Schwartz-Jampel syndrome with cleft palate.
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Stiff person syndrome: presentation of a case with repetitive complex discharges in electromiograms. Neurologist 2009; 15:227-9. [PMID: 19590385 DOI: 10.1097/nrl.0b013e3181935a29] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Stiff person syndrome is characterized by rigidity of axial and proximal limb muscles, associated with muscle spasms, triggered by unexpected acoustic or somesthetic stimuli. It usually has an autoimmune basis, in which the blood contains antiglutamate decarboxylase antibodies, and is associated with different types of autoimmune diseases. The electromyogram provides evidences of continuous muscular activity. CASE REPORT A 41-year-old woman with a history of diabetes mellitus type I, Hashimoto thyroiditis, vitiligo, and pernicious anemia developed symptoms compatible with stiff person syndrome. In the electromyogram, in addition to continuous muscular activity, there was evidence of complex repetitive activity in the form of doublets and triplets. CONCLUSIONS Given the absence of clinical or electrophysiological neuropathic affectation, the presence of doublets and triplets in our patient could be due to a subclinical functional alteration of alpha motoneurons. They could produce the complex repetitive discharges when released from the inhibition mediated by GABAergic neurons.
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Ju Z, Wells MC, Heater SJ, Walter RB. Multiple tissue gene expression analyses in Japanese medaka (Oryzias latipes) exposed to hypoxia. Comp Biochem Physiol C Toxicol Pharmacol 2007; 145:134-44. [PMID: 16916623 DOI: 10.1016/j.cbpc.2006.06.012] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2005] [Revised: 06/18/2006] [Accepted: 06/19/2006] [Indexed: 12/22/2022]
Abstract
Due in part to human population growth watersheds and coastal estuaries have been receiving increasing run-off of nutrients and genotoxins. As a consequence, the occurrences of nutrient-driven hypoxia in coastal waters appear to be increasing. Thus, understanding the molecular genetic response to hypoxia by model aquatic organisms is of interest both from environmental and physiological viewpoints. The major objectives of this study are to determine genome-wide gene expression profiles and to better understand how hypoxia influences global gene expression in medaka (Oryzias latipes), a well utilized aquatic model species. Herein we detail our development of a microarray containing 8046 medaka unigenes and describe our experimental results for measuring gene expression changes in the brain, gill, and liver of hypoxia exposed fish. Using conservative selection criteria, we determined that 501 genes in the brain, 442 in the gill, and 715 in the liver were differentially expressed in medaka exposed to hypoxia. These differentially expressed genes fell into a number of biological gene ontology groups related to general metabolism, catabolism, RNA and protein metabolism, etc. Two biological pathways, ubiquitin-proteasome and phosphatidylinositol signaling, were significantly dysregulated in medaka upon hypoxia exposure. Comparative genomics between medaka and human identified several human orthologies associated with known diseases.
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Affiliation(s)
- Zhenlin Ju
- Molecular Biosciences Research Group, Department of Chemistry and Biochemistry, 419 Centennial Hall, Texas State University, San Marcos, TX 78666-4616, USA.
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Melrose J, Roughley P, Knox S, Smith S, Lord M, Whitelock J. The structure, location, and function of perlecan, a prominent pericellular proteoglycan of fetal, postnatal, and mature hyaline cartilages. J Biol Chem 2006; 281:36905-14. [PMID: 16984910 DOI: 10.1074/jbc.m608462200] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
The aim of this study was to immunolocalize perlecan in human fetal, postnatal, and mature hyaline cartilages and to determine information on the structure and function of chondrocyte perlecan. Perlecan is a prominent component of human fetal (12-14 week) finger, toe, knee, and elbow cartilages; it was localized diffusely in the interterritorial extracellular matrix, densely in the pericellular matrix around chondrocytes, and to small blood vessels in the joint capsules and perichondrium. Aggrecan had a more intense distribution in the marginal regions of the joint rudiments and in para-articular structures. Perlecan also had a strong pericellular localization pattern in postnatal (2-7 month) and mature (55-64 year) femoral cartilages, whereas aggrecan had a prominent extracellular matrix distribution in these tissues. Western blotting identified multiple perlecan core protein species in extracts of the postnatal and mature cartilages, some of which were substituted with heparan sulfate and/or chondroitin sulfate and some were devoid of glycosaminoglycan substitution. Some perlecan core proteins were smaller than intact perlecan, suggesting that proteolytic processing or alternative splicing had occurred. Surface plasmon resonance and quartz crystal microbalance with dissipation experiments demonstrated that chondrocyte perlecan bound fibroblast growth factor (FGF)-1 and -9 less efficiently than endothelial cell perlecan. The latter perlecan supported the proliferation of Baf-32 cells transfected with FGFR3c equally well with FGF-1 and -9, whereas chondrocyte perlecan only supported Baf-32 cell proliferation with FGF-9. The function of perlecan therefore may not be universal but may vary with its cellular origin and presumably its structure.
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Affiliation(s)
- James Melrose
- The Raymond Purves Research Laboratories, Institute of Bone and Joint , University of Sydney at the Royal North Shore Hospital of Sydney, St. Leonards, New South Wales 2065, Australia.
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Díaz-Serrano KV, Brandão CB, Brandão RB, Watanabe PCA, Regalo SCH. Dental findings and muscular-skeletal features in Schwartz-Jampel syndrome: case report of two affected siblings. SPECIAL CARE IN DENTISTRY 2006; 26:225-9. [PMID: 17249445 DOI: 10.1111/j.1754-4505.2006.tb01443.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Schwartz-Jampel syndrome (SJS) is a rare, inherited disorder defined by myotonia, skeletal malformations, muscular stiffness, and growth retardation. The clinical signs and symptoms of SJS are seen in the maxillofacial region. The combination of skeletal and muscular abnormalities predisposes affected individuals to a number of primary and secondary orodental manifestations. Although several studies have discussed the clinical features of SJS from a medical perspective, few reports have addressed the oral findings or dental treatment in children and adolescents with the disorder. This article reviews the dental manifestations and impairments of Schwartz-Jampel syndrome. The case histories of two siblings diagnosed with this disorder are described as well as their dental care.
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Affiliation(s)
- Kranya Victoria Díaz-Serrano
- Department of Pediatric Clinics, Preventive and Social Dentistry, Faculty of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil.
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