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Fardeau C, Alafaleq M, Dhaenens CM, Dollfus H, Koné-Paut I, Grunewald O, Morel JB, Titah C, Saadoun D, Lazeran PO, Meunier I. ROSAH syndrome mimicking chronic uveitis. Clin Genet 2023; 103:453-458. [PMID: 36543582 DOI: 10.1111/cge.14286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 12/12/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022]
Abstract
To suggest a unique missense variant candidate based on long-term ophthalmological changes and associated systemic signs described in five patients from two unrelated families affected by an autosomal dominant multi-systemic disorder including Retinal dystrophy, Optic nerve oedema, Splenomegaly, Anhidrosis and migraine Headaches, called ROSAH syndrome, related to a unique missense variant in ALPK1 gene. Observational longitudinal follow-up study of unrelated families. Clinical analysis of ophthalmological and systemic examinations was performed, followed by genetic analysis, including targeted Next Generation Sequencing (NGS) and Whole-Genome Sequencing (WGS). The ophthalmological phenotype showed extensive optic nerve swelling associated with early macular oedema and vascular leakage. The main associated systemic manifestations were recurrent fever, splenomegaly, anhidrosis, mild cytopenia, anicocytosis and hypersegmented polynuclear cells. WGS, shortened in the second family by the gene candidate suggestion, revealed in all patients the heterozygous missense variant c.710C>T; p.(Thr237Met) in ALPK1. The primary morbidity in ROSAH syndrome in this cohort appeared ophthalmological. Comprehensive, detailed phenotype changes aided by the advancement in genetic testing could allow an early genetic diagnosis of ROSAH syndrome and targeted treatment. The unique missense variant may be suggested as a target of gene correction therapy.
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Affiliation(s)
- Christine Fardeau
- Department of Ophthalmology, Reference Center for Rare Diseases, La Pitié-Salpêtrière Hospital, Paris-Sorbonne University, Paris, France
| | - Munirah Alafaleq
- Department of Ophthalmology, Reference Center for Rare Diseases, La Pitié-Salpêtrière Hospital, Paris-Sorbonne University, Paris, France
- Ophthalmology Department, Imam Abdulrahman Bin Faisal University, King Fahad Hospital of the University, Dammam, Saudi Arabia
| | - Claire-Marie Dhaenens
- University Lille, Inserm, CHU Lille, U1172-LilNCog-Lille Neuroscience & Cognition, Lille, France
| | - Hélène Dollfus
- Institut de Génétique médicale d'Alsace, CARGO Reference Center for Rare Diseases in Genetic Ophthalmology, University Hospital of Strasbourg, Strasbourg, France
| | - Isabelle Koné-Paut
- Paediatric Rheumatology Department and CEREMAIA, Bicetre Hospital, APHP, University of Paris Sud Saclay, Bures-sur-Yvette, France
| | - Olivier Grunewald
- University Lille, Inserm, CHU Lille, U1172-LilNCog-Lille Neuroscience & Cognition, Lille, France
| | - Jean-Baptiste Morel
- Department of Ophthalmology, Reference Center for Rare Diseases, La Pitié-Salpêtrière Hospital, Paris-Sorbonne University, Paris, France
| | - Cherif Titah
- Department of Ophthalmology, Hôpital Fondation Rothschild, Paris, France
| | - David Saadoun
- Department of Internal Medicine and Clinical Immunology, Reference Centre for Systemic Auto-Immune Diseases, La Pitié-Salpêtrière Hospital, Paris-Sorbonne University, Paris, France
| | | | - Isabelle Meunier
- Department of Ophthalmology, Reference Centre for Genetic Sensory Diseases, Hôpital Gui de Chauliac, Montpellier University, Montpellier, France
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Culea C, Tăbăcaru B, Stanca TH. Bilateral papillary oedema - case report. Rom J Ophthalmol 2018; 62:166-174. [PMID: 30206562 PMCID: PMC6117519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE We report one case of malignant high blood pressure with no systemic signs but with ocular complaints. METHODS The paper presents the case of a 31-year-old male who complained of sudden loss of visual acuity in both eyes. The ophthalmological examination revealed bilateral papillary oedema. General and cardiological examinations revealed he was suffering from malignant high blood pressure. RESULTS The pathogenic treatment resulted in resolution of signs and symptoms with favourable ophthalmological evolution and almost entirely functional recovery. Clinical, paraclinical and imagistic data suggested the diagnosis of pheochromocytoma. CONCLUSION This case highlighted ocular complications of high blood pressure. The paper summarizes the differential diagnosis and management of high blood pressure and reviews the most common causes of secondary hypertension in young patients.
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Affiliation(s)
- Cristina Culea
- Ophthalmology Clinic, “Agrippa Ionescu” Clinical Emergency Hospital, Bucharest, Romania
| | - Bogdana Tăbăcaru
- Ophthalmology Clinic, “Agrippa Ionescu” Clinical Emergency Hospital, Bucharest, Romania
,Department of Ophthalmology, “Carol Davila” University of Medicine and
Pharmacy, Bucharest, Romania
| | - Tudor Horia Stanca
- Ophthalmology Clinic, “Agrippa Ionescu” Clinical Emergency Hospital, Bucharest, Romania
,Department of Ophthalmology, “Carol Davila” University of Medicine and
Pharmacy, Bucharest, Romania
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Imane M, Asmae M, Toufik R, Rachid S. [ Papillary oedema revealing Arnold Chiari malformation type 1: about a case]. Pan Afr Med J 2016; 24:293. [PMID: 28154648 PMCID: PMC5267851 DOI: 10.11604/pamj.2016.24.293.7415] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2015] [Accepted: 11/14/2015] [Indexed: 11/14/2022] Open
Abstract
La malformation d'Arnold Chiari de type 1 est définie par une hernie des tonsilles cérébelleuses dans le foramen magnum de plus de 5 mm. Les symptômes sont dominés par les céphalées surtout occipitales, les torticolis, et parfois des troubles de déglutition. Sur le plan ophtalmologique les anomalies de convergences, les paralysies oculomotrices et la diplopie sont les principaux signes cliniques retrouvés. Nous rapportons le cas d'un enfant de 9 ans, qui consulte pour une baisse d'acuité visuelle évoluant depuis 6 mois. L'examen ophtalmologique objective une acuité visuelle chiffrée à 4/10ème aux deux yeux. Une motilité oculaire conservée ainsi qu'un nystagmus rotatoire. L'examen du segment antérieur montre une mégalocornée, sans goniodysgénésie, un iridodonesis associé à une atrophie du muscle dilatateur, et une microcorie avec un reflex photo-moteur paresseux. Le tonus oculaire est correct à 14 mmHg. Le fond d'œil, malgré la difficulté de le réaliser, objective la présence d'un œdème papillaire bilatéral stade II. L'examen général retrouve un torticolis, une scoliose et un syndrome tétra-pyramidal. L'imagerie par résonance magnétique a mis en évidence une malformation de CHIARI type I, associée à une hydrocéphalie et une syringomyélie. Une intervention neurochirurgicale reposant sur une dérivation interne du LCR avec décompression ostéodurale cervico occipitale est proposée. L'évolution est favorable avec une régression des signes cliniques. Sur le plan ophtalmologique, on note une régression de l'œdème papillaire, mais l'acuité visuelle est restée stationnaire. La survenue d'un œdème papillaire est rare dans la malformation de Chiari type 1, il n'a été décrit que chez 2% des patients symptomatiques. Sa physiopathologie est encore mal élucidée. L'originalité de notre observation consiste en l'association de malformations cérébelleuses avec des malformations oculaires à type de mégalocornée et de microcorie rendant l'examen ophtalmologique encore plus difficile à réaliser.
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Affiliation(s)
- Mouhoub Imane
- Service d'Ophtalmologie, CHU Mohammed VI, Oujda, Maroc
| | - Maadane Asmae
- Service d'Ophtalmologie, CHU Mohammed VI, Oujda, Maroc
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