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Righi D, Porco L, Di Mambro C, Gnazzo M, Baban A, Paglia S, Silvetti MS, Novelli A, Tozzi AE, Drago F. Autosomal Recessive Long QT Syndrome: Clinical Aspects and Therapy. Pediatr Cardiol 2023; 44:1736-1740. [PMID: 37597120 DOI: 10.1007/s00246-023-03266-y] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 08/04/2023] [Indexed: 08/21/2023]
Abstract
The autosomal recessive (AR) form of Long QT Syndrome (LQTS) is described both associated with deafness known as Jervell and Lange-Nielsen (JLN) syndrome, and without deafness (WD). The aim of the study is to report the characteristics of AR LQTS patients and the efficacy of the therapy. Data of all children with AR LQTS referred to the Bambino Gesù Children's Hospital IRCCS from September 2012 to September 2021were included. Three (30%) patients had compound heterozygosity and 7 (70%) had homozygous variants of the KCNQ1 gene, the latter showing deafness. Four patients (40%) presented aborted sudden cardiac death (aSCD): three with previous episodes of syncope (75%), the other without previous symptoms (16.6% of asymptomatic patients). An episode of aSCD occurred in 2/3 (66.7%) of WD and heterozygous patients, while in 2/7 (28%) JLN and homozygous patients and in 2/2 patients with QTC > 600 ms. All patients were treated with Nadolol. In 5 Mexiletine was added, shortening QTc and obtaining the disappearance of the T-wave alternance (TWA) in 3/3. Episodes of aSCD seem to be more frequent in LQTS patients with compound heterozygous variants and WD than in those with JLN and homozygous variants. Episodes of aSCD also appear more frequent in children with syncope or with QTc value > 600 ms, even on beta-blocker therapy, than in patients without syncope or with Qtc < 600 ms. However, our descriptive results should be confirmed by larger studies. Moreover, Mexiletine addition reduced QTc value and eliminated TWA.
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Affiliation(s)
- Daniela Righi
- Cardiac Arrhythmias Complex Unit, Department of Pediatric Cardiology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
| | - Luigina Porco
- Cardiac Arrhythmias Complex Unit, Department of Pediatric Cardiology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Corrado Di Mambro
- Cardiac Arrhythmias Complex Unit, Department of Pediatric Cardiology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Maria Gnazzo
- Laboratory of Medical Genetics, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Anwar Baban
- Cardiac Arrhythmias Complex Unit, Department of Pediatric Cardiology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Simone Paglia
- Cardiac Arrhythmias Complex Unit, Department of Pediatric Cardiology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Massimo Stefano Silvetti
- Cardiac Arrhythmias Complex Unit, Department of Pediatric Cardiology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Antonio Novelli
- Laboratory of Medical Genetics, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Alberto Eugenio Tozzi
- Predictive and Preventive Medicine Research Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Fabrizio Drago
- Cardiac Arrhythmias Complex Unit, Department of Pediatric Cardiology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
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Bhattacharya D, Namboodiri N, Sreelekshmi MP, Prabhu MA, Sreevilasam Pushpangadhan A, Menon S, Dharan BS, Valaparambil A. Left cardiac sympathetic denervation in children with Jervell Lange-Nielsen syndrome and drug refractory torsades - A case series. Pacing Clin Electrophysiol 2023; 46:1197-1202. [PMID: 37728293 DOI: 10.1111/pace.14827] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 08/30/2023] [Accepted: 09/05/2023] [Indexed: 09/21/2023]
Abstract
INTRODUCTION Long QT syndrome is an inherited malignant channelopathy which leads to life-threatening arrhythmia, with multiple genotypes. Jervell and Lange-Nielsen syndrome (JLNS) is an autosomal recessive subtype of this disease, characterized by congenital sensorineural deafness and a high incidence of sudden cardiac death (SCD). METHODOLOGY We prospectively followed up six children who underwent left cardiac sympathetic denervation (LCSD) for JLNS in view of high-risk features despite being on maximally tolerated doses of oral propranolol. RESULTS Mean age at diagnosis was 2.75 ± 0.39 years, with a significant delay between onset of symptoms and diagnosis (mean 7.2 ± 3.5 months). All had sensorineural hearing loss, conforming to the JLNS phenotype. Mean QTc interval was 603 ± 93 ms, with T wave alternans (TWA) seen in all cases. All were started on propranolol and subsequently subjected to LCSD, and 3 underwent AAI permanent pacemaker implantation. Over a mean follow-up of 20 months, there was a significant reduction in QTc (603 ± 93 ms to 501 ± 33 ms, p = .04), which was persistent on follow-up (525 ± 41 ms) and only two out of six had persistent T wave alternans on ECG (p < .01). None of these children had presyncope, syncope, seizures, torsades de pointes, cardiac arrest or death on follow up following LCSD. CONCLUSION Jervell Lange-Nielsen syndrome is a subtype of LQTS with high-risk features. LCSD, an effective therapeutic option for those having symptoms despite being on propranolol, results in significant reduction of QTc interval and amelioration of symptoms.
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Affiliation(s)
- Deepanjan Bhattacharya
- Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | - Narayanan Namboodiri
- Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | | | - Mukund A Prabhu
- Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | | | - Sabarinath Menon
- Department of Cardiovascular and Thoracic Surgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | - Baiju S Dharan
- Department of Cardiovascular and Thoracic Surgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | - Ajitkumar Valaparambil
- Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
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Zhao N, Yu Z, Cai Z, Chen W, He X, Huo Z, Lin X. Novel combinations of variations in KCNQ1 were associated with patients with long QT syndrome or Jervell and Lange-Nielsen syndrome. BMC Cardiovasc Disord 2023; 23:399. [PMID: 37568094 PMCID: PMC10422715 DOI: 10.1186/s12872-023-03417-2] [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: 04/24/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023] Open
Abstract
OBJECTIVES Long QT syndrome (LQTS) is one of the primary causes of sudden cardiac death (SCD) in youth. Studies have identified mutations in ion channel genes as key players in the pathogenesis of LQTS. However, the specific etiology in individual families remains unknown. METHODS Three unrelated Chinese pedigrees diagnosed with LQTS or Jervell and Lange-Nielsen syndrome (JLNS) were recruited clinically. Whole exome sequencing (WES) was performed and further validated by multiplex ligation-dependent probe amplification (MLPA) and Sanger sequencing. RESULTS All of the probands in our study experienced syncope episodes and featured typically prolonged QTc-intervals. Two probands also presented with congenital hearing loss and iron-deficiency anemia and thus were diagnosed with JLNS. A total of five different variants in KCNQ1, encoding a subunit of the voltage-gated potassium channel, were identified in 3 probands. The heterozygous variants, KCNQ1 c.749T > C was responsible for LQTS in Case 1, transmitting in an autosomal dominant pattern. Two patterns of compound heterozygous variants were responsible for JLNS, including a large deletion causing loss of the exon 16 and missense variant c.1663 C > T in Case 2, and splicing variant c.605-2 A > G and frame-shift variant c.1265del in Case 3. To our knowledge, the compound heterozygous mutations containing a large deletion and missense variant were first reported in patients with JLNS. CONCLUSION Our study expanded the LQTS genetic spectrum, thus favoring disease screening and diagnosis, personalized treatment, and genetic consultation.
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Affiliation(s)
- Nongnong Zhao
- Department of Cardiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310009, Zhejiang, China
- Yuyao People's Hospital of Zhejiang Province, Yuyao, Ningbo, 315400, Zhejiang, China
| | - Zhengyang Yu
- Department of Cardiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310009, Zhejiang, China
| | - Zhejun Cai
- Department of Cardiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310009, Zhejiang, China
| | - Wenai Chen
- Department of Cardiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310009, Zhejiang, China
| | - Xiaopeng He
- Department of Cardiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310009, Zhejiang, China
| | - Zhaoxia Huo
- Experimental Teaching Center, School of Basic Medical Sciences, Zhejiang University, 866 Yuhangtang Road, Hangzhou, 310058, Zhejiang, China.
| | - Xiaoping Lin
- Department of Cardiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310009, Zhejiang, China.
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Arana-Rueda E, Pezzotti MR, Pedrote A, Marcos-Fuentes L, Frutos-López M, Castellano A. New KCNQ1 c.604+1G>C variant associated with Jervell-Lange Nielsen syndrome in homozygosity and compound heterozygosity. Rev Esp Cardiol (Engl Ed) 2022; 75:529-531. [PMID: 35144896 DOI: 10.1016/j.rec.2021.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 11/25/2021] [Indexed: 06/14/2023]
Affiliation(s)
- Eduardo Arana-Rueda
- Unidad de Arritmias, Servicio de Cardiología, Hospital Universitario Virgen del Rocío, Sevilla, Spain; Instituto de Biomedicina de Sevilla (IBiS), HUVR/CSIC/Departamento de Fisiología Médica y Biofísica, Universidad de Sevilla, Sevilla, Spain.
| | - Maria-Rosa Pezzotti
- Instituto de Biomedicina de Sevilla (IBiS), HUVR/CSIC/Departamento de Fisiología Médica y Biofísica, Universidad de Sevilla, Sevilla, Spain
| | - Alonso Pedrote
- Unidad de Arritmias, Servicio de Cardiología, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Laura Marcos-Fuentes
- Servicio de Cardiología Pediátrica, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Manuel Frutos-López
- Unidad de Arritmias, Servicio de Cardiología, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Antonio Castellano
- Instituto de Biomedicina de Sevilla (IBiS), HUVR/CSIC/Departamento de Fisiología Médica y Biofísica, Universidad de Sevilla, Sevilla, Spain.
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Wójcik T, Kobusiak-Prokopowicz M, Ściborski K, Mysiak A. [Myocardial infarction without coronary arteries stenoses in a patient with Jervell and Lange-Nielsen syndrome--diagnostic dilemmas]. Kardiol Pol 2011; 69:830-833. [PMID: 21850631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
According to the rules of differential diagnostics an acute coronary syndrome (ACS) often constitutes an initial diagnosis while a subsequent patient's follow-up with troponin determination results in further verification of the diagnosis. A 55 year-old female with congenital hearing loss, poorly controlled hypertension, type 2 diabetes treated with oral medications, and hypothyreosis was admitted to the Department of Cardiology with 6 h long severe chest pain radiating over her back with concomitant dyspnea. She underwent urgent coronary angiography which showed no epicardial coronary narrowing. Acute heart failure symptoms occurred immediately after coronary angiography in the form of cardiogenic shock. Even though an ACS was diagnosed on the basis of typical biochemical, electrocardiographic and clinical criteria, a further follow-up suggested a possibility of a co-existance of other diseases which occurred to be a Jervell and Lange-Nielsen syndrome.
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Affiliation(s)
- Tomasz Wójcik
- Katedra i Klinika Kardiologii, Akademia Medyczna, Wrocław.
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Biernacka EK. [Letter to the editor. Myocardial infarction without coronary arteries stenoses in a patient with Jervell and Lange-Nielsen syndrome--diagnostic dilemmas]. Kardiol Pol 2011; 69:1320; author reply 1320. [PMID: 22219124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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Baek JS, Bae EJ, Lee SY, Park SS, Kim SY, Jung KN, Noh CI. Jervell and Lange-Nielsen syndrome: novel compound heterozygous mutations in the KCNQ1 in a Korean family. J Korean Med Sci 2010; 25:1522-5. [PMID: 20890437 PMCID: PMC2946666 DOI: 10.3346/jkms.2010.25.10.1522] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2009] [Accepted: 12/30/2009] [Indexed: 11/20/2022] Open
Abstract
The Jervell and Lange-Nielsen syndrome (JLNS) is an autosomal recessive syndrome characterized by congenital deafness and cardiac phenotype (QT prolongation, ventricular arrhythmias, and sudden death). JLNS has been shown to occur due to homozygous mutation in KCNQ1 or KCNE1. There have been a few clinical case reports on JLNS in Korea; however, these were not confirmed by a genetic study. We identified compound heterozygous mutations in KCNQ1 in a 5-yr-old child with JLNS, who visited the hospital due to recurrent syncope and seizures and had congenital sensorineural deafness. His electrocardiogram revealed a markedly prolonged corrected QT interval with T wave alternans. The sequence analysis of the proband revealed the presence of novel compound heterozygous deletion/splicing error mutations (c.828-830 delCTC, p.S277del/c.921G>A, p.V307V). Each mutation in KCNQ1 was identified on the maternal and paternal side. With β-blocker therapy the patient has remained symptom-free for three and a half years.
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Affiliation(s)
- Jae Suk Baek
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea
| | - Eun Jung Bae
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea
| | - Sang Yun Lee
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea
| | - Sung Sup Park
- Department of Laboratory Medicine, Seoul National University Hospital, Seoul, Korea
| | - So Yeon Kim
- Department of Laboratory Medicine, Seoul National University Hospital, Seoul, Korea
| | - Kyu Nam Jung
- Department of Laboratory Medicine, Seoul National University Hospital, Seoul, Korea
| | - Chung Il Noh
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea
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Acet H, Duygu H, Başoğlu M, Ergene AO. [Two sisters with Jervell-Lange- Nielsen syndrome]. Turk Kardiyol Dern Ars 2010; 38:446. [PMID: 21200130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Affiliation(s)
- Halit Acet
- İzmir Atatürk Eğitim ve Araştırma Hastanesi, Kardiyoloji Kliniği, Turkey
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Lundin C, Platonov P, Kristoffersson U. [Hereditary risk of sudden cardiac death--genetic investigation of the family]. Lakartidningen 2009; 106:1089-1093. [PMID: 19492675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
MESH Headings
- Adult
- Arrhythmias, Cardiac/diagnosis
- Arrhythmias, Cardiac/genetics
- Arrhythmogenic Right Ventricular Dysplasia/diagnosis
- Arrhythmogenic Right Ventricular Dysplasia/genetics
- Brugada Syndrome/diagnosis
- Brugada Syndrome/genetics
- Cardiomyopathy, Hypertrophic, Familial/diagnosis
- Cardiomyopathy, Hypertrophic, Familial/genetics
- Child
- Death, Sudden, Cardiac/etiology
- Death, Sudden, Cardiac/prevention & control
- Genetic Predisposition to Disease/genetics
- Genetic Testing
- Humans
- Jervell-Lange Nielsen Syndrome/diagnosis
- Jervell-Lange Nielsen Syndrome/genetics
- Long QT Syndrome/diagnosis
- Long QT Syndrome/genetics
- Tachycardia, Ventricular/diagnosis
- Tachycardia, Ventricular/genetics
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Shanbag P. Jervell-Lange Nielsen syndrome in a family with the long QT syndrome (LQTS). Indian J Pediatr 2007; 74:90; author reply 90. [PMID: 17264466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
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Abstract
OBJECTIVES The aim of this study was to review the different types of genetic deafness. METHODS We describe syndromic and isolated sensorineural deafness and transmission deafness. RESULTS Genetic sensorineural syndromic deafness represents 30% of cases of genetic deafness. A frequent cause is Pendred syndrome, which associates congenital sensorineural deafness with goitre and malformations of the inner ear which can be identified on computed tomography scan. Isolated deafness which is responsible for 70% of cases of genetic deafness is then outlined. Among the different types of isolated deafness, 80% are autosomal recessive disorders. A frequent form of autosomal recessive deafness is due to mutations in the connexin 26 gene. Lastly, we detail transmission deafness dominated by aplasia. Major aplasia is characterized by a malformation of the external ear associated with malformations of the middle ear whereas, minor aplasia corresponds to a malformation of the middle ear, sometimes associated with minor external ear malformations. CONCLUSION For each type of deafness we propose a systematic assessment.
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Affiliation(s)
- A Marcolla
- Service d'ORL Pédiatrique et d'Audiophonologie, Hôpital Charles Nicolle, 1 rue de Germont 76000 Rouen.
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Abstract
A child with Jervell-Lange Nielsen syndrome is presented from Kolkata. Family study showed that the other family members are suffering from long QT syndrome. The child had frequent syncopal attack and very prolonged QT interval requiring left cardiac sympathetic denervation and beta-blocker therapy as patient could not afford implantable defibrillator and cardiac pacing.
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Affiliation(s)
- R K Mondal
- Department of Cardiovascular and Thoracic Surgery, IPGMER & SSKM Hospital, Kolkata, India
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Yuen LK, Lam CW, Fong NC, Tang PM, Shek CC, Chan YW, Chow CB. Jervell-Lange Nielsen syndrome in a Pakistani family. Hong Kong Med J 2004; 10:351-4. [PMID: 15479966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023] Open
Abstract
Congenital long QT syndrome is a rare hereditary disease that is related to the dysfunction of ion channels in cardiac cells. We report on a very rare case of its autosomal recessive form--the Jervell-Lange Nielsen syndrome--in a Pakistani family, which was diagnosed after the incidental finding of bradycardia in a newborn baby girl. We discuss the range of presentations in neonates; the importance of strong suspicion of the syndrome and family screening; the use of the diagnostic criteria and genetic tests; and the different management strategies.
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Affiliation(s)
- L K Yuen
- Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, Laichikok, Hong Kong.
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Abstract
UNLABELLED Syndromes that are associated with hearing loss include Waardenburg, Stickler (STL), Jervell and Lange-Nielsen, Usher (USH), Alport, mitochondrial encephalomyopathy, lactic acidosis, stroke-like episodes, and sensorineural hearing loss (MELAS) and mitochondrial encephalomyopathy, myoclonus epilepsy, ragged-red fibers, and sensorineural hearing loss (MERRF). Waardenburg and STL show an autosomal dominant pattern of inheritance, while Jervell and Lange-Nielsen and USH are autosomal recessive, and Alport is usually X-linked. Mutations in specific genes that are associated with each of these syndromes have been identified, and genetic diagnostic tests are becoming available. The goal of ongoing research is to understand the functions of the proteins encoded by these genes, and develop effective therapies based on knowledge of the underlying causal mutations. LEARNING OUTCOMES The reader will be introduced to basic genetic principles and will understand that (1) the etiology of hearing loss is usually genetic and many patients should be referred to a clinical geneticist; (2) a negative family history does not mean that the hearing loss is not genetic; (3) hearing loss may be part of a syndrome for which early detection and intervention for associated anomalies is necessary; and (4) many different mutations in a large number of genes underlie hearing loss.
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Affiliation(s)
- Bronya J B Keats
- Department of Genetics, Louisiana State University Health Sciences Center, New Orleans 70112-1349, USA.
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Mönnig G, Schulze-Bahr E, Wedekind H, Eckardt L, Kirchhof P, Funke H, Kotthoff S, Vogt J, Assmann G, Breithardt G, Haverkamp W. [Clinical aspects and molecular genetics of the Jervell- and Lange-Nielsen Syndrome]. Z Kardiol 2002; 91:380-8. [PMID: 12132284 DOI: 10.1007/s00392-002-0789-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
In contrast to the Romano-Ward (R-W) syndrome, the Jervell and Lange-Nielsen (J-LN) syndrome is an autosomal recessive inherited disease characterized by QT-prolongation in the electrocardiogram (ECG) and recurrent syncopal attacks which are also typical for the R-W syndrome, but also by congenital deafness. Recently, defect alleles in the genes for KCNQ1 and KCNE1 have been identified in patients with the J-LN syndrome. These genes may be causative for the R-W syndrome as well but in J-LN patients, they are only present in the homozygote or compound heterozygote form. In the present paper, we review the clinical and genetic similarities and differences of the J-LN and the R-W syndrome as well as the diagnostic and therapeutic management of these patients and their family members.
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Affiliation(s)
- G Mönnig
- Medizinische Klinik und Poliklinik C-Kardiologie und Angiologie Universitätsklinikum Münster, Institut für Arterioskleroseforschung Westfälische Wilhelms-Universität Münster Albert-Schweitzer-Strasse 33 48129 Münster, Germany.
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