Kearnssayre syndrome kss is a rare mitochondrial genetic disorder with multisystem involvement. We report a case of a 14yearold boy diagnosed and treated as myasthenia gravis for 4 years who was eventually diagnosed with kss. Progressive paralysis of certain eye muscles chronic progressive external ophthalmoplegia, or cpeo. Jul 05, 2019 kearns sayre syndrome kss is characterized by the onset of ophthalmoparesis and pigmentary retinopathy before age 20 years. The kearns sayre syndrome is an uncommon neuromuscular condition that affects those below 20 years of age. Dec 17, 2014 treatment for kearns sayre syndrome is generally symptomatic and supportive. It is the result of abnormalities in the dna of mitochondria small rodlike structures found in every cell of the body that produce the. Kearns sayre syndrome is a rare disorder often caused by mitochondrial dna rearrangement.
Kearns sayre syndrome kss is a rare multisystemic disorder. Aims we aimed to define patient and disease characteristics in. Kearns 1965 reported 9 unrelated patients with ophthalmoplegia, pigmentary degeneration of the retina, and cardiomyopathy as leading features. Kearnssayre syndrome kss is a rare neuromuscular disorder with onset usually before the age of 20 years. The original characterisation as presented by kearns in 1958 comprised three core findings. The features of kearns sayre syndrome usually appear before age 20, and the condition is diagnosed by a few characteristic signs and symptoms. A free powerpoint ppt presentation displayed as a flash slide show on. Evidence for cardioembolic stroke in a case of kearns. Treatment for kearnssayre syndrome is generally symptomatic and supportive. Kearnssayre syndrome kss is a rare mitochondrial cytopathy associated with the phenotypic triad of progressive external ophthalmoplegia, atypical pigmentary degeneration of the retina, and complete heart block. Skeletal muscle biopsy revealed presence of raggedred. Kearns sayre syndrome kss, also known as oculocraniosomatic neuromuscular disease, is a rare mitochondrial myopathy that is characterized by chronic progressive external ophthalmoplegia cpeo, retinitis pigmentosa, and cardiac conduction abnormalities. Rare neuromuscular disorder only 226 cases reported in literature effects mitochondria.
The condition is generally characterized by a progressive paralysis of the eye muscles, discoloration of the retina, and cardiomyopathy. This is the first case to be linked to a nuclear gene defect. It is the result of abnormalities in the dna of mitochondria small rodlike structures found in every cell of the body that produce the energy that drives cellular functions. Apr 28, 2011 one patient had kearns sayre syndrome kss, which is usually a sporadic disorder. His veins run cold when he realizes whos been haunting the homestead all along duration. Pronunciation of kearns sayre syndrome with 2 audio pronunciations, 1 meaning, 10. Ppt mitochondrial diseases powerpoint presentation. Multicolour scanning laser photographs figure 2a, b showed retinal pigment. Kearns sayre syndrome kss is a rare mitochondrial cytopathy associated with the phenotypic triad of progressive external ophthalmoplegia, atypical pigmentary degeneration of the retina, and complete heart block.
Clinical presentation the patient often presents with progressive external ophthalmoplegia 1. Kearnssayre syndrome information page national institute. Kearnssayer syndrome definition of kearnssayer syndrome. Other features include sensorineural deafness, impaired intellectual function, short stature, and endocrine and renal abnormalities. Chronic progressive external ophthalmoplegia cpeo kearns sayre syndrome. This disease is mostly characterized by three primary findings. Jan 29, 2019 a 19yearold man presented 6 months postimplantation of permanent pacemaker for complete heart block with bilateral nonfatigable symmetric ptosis, diminished levator superioris function, and symmetric ophthalmoplegia figure 1. Objective to report the rrm2b mutation frequency in adults with multiple mtdna deletions and examine rnr assembly in a patient with kearnssayre syndrome kss caused by two novel rrm2b mutations. This is a chronic condition that is extremely rare in occurrence but has the potential to destruct vision and other body mechanisms. Kearns sayre syndrome kss belongs to the group of neuromuscular disorders known as mitochondrial encephalomyopathies. Nerad emphasizes that there are two primary forms of ptosis.
A 19yearold man presented 6 months postimplantation of permanent pacemaker for complete heart block with bilateral nonfatigable symmetric ptosis, diminished levator superioris function, and symmetric ophthalmoplegia figure 1. The patient, on further examination, showed ophthalmoplegia, bilateral ptosis figure 2 and pigmentary retinopathy figure 3. Kearnssayre syndrome by tommy antony mitochondrial dna circular dna encodes for several rnas and proteins mitochondria produces energy for the body what is kearnssayre syndrome mitochondrial encephalomyopathies sporadic mutations heteroplasmy occurs diagnosis eye muscle paralysis pigment accumulation heart disease testing symptoms usually occur. An 11yearold girl with moderate ptosis and chronic progressive ophthalmoplegia figure 1 was referred for retinal evaluation in view of nyctalopia. Kearnssayre syndrome genetic and rare diseases information. Ppt mitochondrial diseases powerpoint presentation free. Kearnssayre syndrome kss is characterized by the onset of. The key triad of features includes progressive external ophthalmoplegia, pigmentary retinal dystrophy and onset before 20 years of age. Kearnssayre syndrome symptoms, treatment, causes, prognosis. Oct 20, 2008 kearns sayre syndrome kearns sayre syndrome is when the mitochondria in dna becomes abnormal, and does not do its proper fucntions. It is a disease with a wide continuum of phenotypes ranging from mild forms of ptosis to multisystemic disorders resulting in early death. Cardiac involvement is reported in approximately 50% of cases. Management options include placement of cardiac pacemakers in individuals with cardiac conduction blocks, eyelid slings for severe ptosis, cochlear implants and hearing aids for neurosensory hearing loss, hormone replacement for endocrinopathies, dilation of the upper.
Complete heart blocks and ventricular tachycardia are implicated as mechanisms of sudden. Around 50% of patients develop conductive abnormalities that can ultimately lead to a complete atrioventricular block or bradycardiarelated polymorphic ventricular tachycardia. Kearnssayre syndrome kss, also known as oculocraniosomatic disorder, is a rare multisystem mitochondrial disorder. Kearns sayre syndrome kss a syndrome caused by major rearrangements of, and often large deletions from, the mitochondrial dna. Kearns sayre syndrome charles shepherd bio 3 background rare neuromuscular disorder only 226 cases reported in literature effects mitochondria large duplications or deletions in mitochondrial dna bp results in under or over production of mitochondrial gene products cases 4977bp deletion randomly effects people only isolated reports. An important clinical symptomatic feature is the presence of droopy eyelids ptosis in one or both eyes. Kearns sayre syndrome kss, also known as oculocraniosomatic disorder, is a rare multisystem mitochondrial disorder. Kearnssayre syndrome is a condition that affects many parts of the body, especially the eyes. Sayre, an ophthalmologist, who published their findings in two patients. Kearns sayre syndrome is a condition that affects many parts of the body, especially the eyes. Kearnssayre syndrome kearnssayre syndrome is when the mitochondria in dna becomes abnormal, and does not do its proper fucntions. Kearnssayre syndrome is caused by defects in mitochondria, which.
Background cerebral infarction is a known complication in patients with mitochondrial encephalomyopathies melas, merrf, kearnssayre syndrome, but the etiology in the different types remains uncertain case description a 33yearold woman who had suffered from ophthalmoplegia, bilateral ptosis, ataxia, retinitis pigmentosa, and epilepsy since childhood. Ataxia diabetes deafness myopathy heart block hearing loss short stature heart disease kearnssayre syndrome this shows droopy eyelids treatment kearnssayre syndrome symptoms, treatment, causes, prognosis. We describe the images of a 27yearold man presenting with recurrent syncope due to complete heart block figure 1. In patients with this triad, other neurological deficits may occur with associated abnormalities of the electrocardiogram, electroencephalogram, audiogram, and an elevation of protein. A rare case of kearnssayre syndrome in a 17yearold.
Kearnssayre syndrome definition of kearnssayre syndrome. The syndrome is defined by the obligatory triad of onset before the age of 20 years, progressive. Pdf kearnssayre syndrome presenting as isolated growth failure. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. We also provide important insight into how rrm2b mutations cause disease by demonstrating impaired rnr assembly using blue native gel electrophoresis. Kearnssayre syndrome kss is a rare neuromuscular disorder.
The kearnssayre syndrome is an uncommon neuromuscular condition that affects those below 20 years of age. Kearns sayre syndrome nord national organization for rare. Ataxia diabetes deafness myopathy heart block hearing loss short stature heart disease kearns sayre syndrome this shows droopy eyelids treatment kearns sayre syndrome symptoms, treatment, causes, prognosis. Kearnssayre syndrome presenting as isolated growth failure. People with kearns sayre syndrome have progressive external ophthalmoplegia, which is weakness or paralysis. Kearnssayre syndrome charles shepherd bio 3 background rare neuromuscular disorder only 226 cases reported in literature effects mitochondria large duplications or deletions in mitochondrial dna bp results in under or over production of mitochondrial gene products cases 4977bp deletion randomly effects people only isolated reports.
Kearnssayre syndrome is a rare disorder often caused by mitochondrial dna rearrangement. Kearnssayre syndrome by tommy antony mitochondrial dna circular dna encodes for several rnas and proteins mitochondria produces energy for the body what is kearnssayre syndrome mitochondrial encephalomyopathies sporadic mutations heteroplasmy occurs diagnosis eye muscle paralysis pigment accumulation heart disease testing symptoms usually occur before age 20 other symptoms include. Kearnssayre syndrome kss is a form of rare neuromuscular disorder that commonly begins affecting people before they reach the age of twenty. Kearns sayre syndrome kss is a rare neuromuscular disorder with onset usually before the age of 20 years. Coinheritance of long qt syndrome and kearnssayre syndrome. Kearnssayre syndrome kss, oculocraniosomatic disorder or oculocranionsomatic neuromuscular disorder with ragged red fibers, is a mitochondrial myopathy with a typical onset before 20 years of age. Marked heterogeneity and various types of inheritance have been observed. Kearnssayre syndrome kss belongs to the group of neuromuscular disorders known as mitochondrial encephalomyopathies. The condition features paralysis of the eyemoving muscles with double vision. Skeletal muscle biopsy revealed presence of raggedred fibers, consistent with kearns sayre syndrome. Kearnssayre syndrome kss, also known as oculocraniosomatic neuromuscular disease, is a rare mitochondrial myopathy that is characterized by chronic progressive external ophthalmoplegia cpeo, retinitis pigmentosa, and cardiac conduction abnormalities. The importance of rnr dysfunction in adult mitochondrial disease is unclear. Kearns sayre syndrome kss is part of the subclass of mitochondrial diseases known as mitochondrial myopathy.
Make a greatlooking ppt presentation quickly and affordably with our. Slitlamp examination revealed a normal anterior segment. The syndrome results from an abnormality in the dna of mitochondria, which are small structures found in each cell of a persons body and produce energy that drives their cellular functions. Chronic progressive external ophthalmoplegia and myopathy. Identical large scale rearrangement of mitochondrial dna causes. Evidence for cardioembolic stroke in a case of kearnssayre.
Background rare neuromuscular disorder only 226 cases reported in literature effects mitochondria large duplications or deletions in mitochondrial dna bp results in under or over production of mitochondrial gene products cases 4977bp deletion randomly effects people only isolated reports of any kind or. Chronic progressive external ophthalmoplegia cpeo kearns sayre syndrome dr. Ppt kearnssayre syndrome powerpoint presentation, free. Kearnssayre syndrome kearnssayre syndrome is generally inherited but not always, it can be caused due to mutations in the bodys cells that occur after conception. Mar 03, 2016 kearnssayre syndrome kss is a rare mitochondrial myopathy characterized by external ophthalmoplegia, pigmentary retinopathy, cerebellar ataxia and heart block. This means that kearnssayre syndrome, or a subtype of kearnssayre syndrome, affects less than 200,000 people in the us population. People with kearnssayre syndrome have progressive external ophthalmoplegia, which is weakness or paralysis of the eye muscles that impairs eye movement and. Kearns sayre syndrome kss is a rare mitochondrial genetic disorder with multisystem involvement. Ataxia diabetes loss of eye movement mild skeletalmuscle weakness heart block hearing loss loss of coordination impaired cognitive function and rarely seizures kearn sayre syndrome kearn sayre syndrome is a condition that affects many. Less consistent features were weakness of facial, pharyngeal, trunk and extremity muscles, deafness, small. A mother with kearnssayre syndrome and her son with a similar, although milder, clinical presentation, carried an identical, large scale heteroplasmic. People with kearnssayre syndrome have progressive external ophthalmoplegia, which is weakness or paralysis of the eye muscles that.
Two studies have provided congruent information on the prevalence of largescale mitochondrial deletions in the adult population. Recently, she has been experiencing nausea and headaches and extreme lethargy, making her arms and legs feel like they have weights on them. Congenital ptosis is manifested at birth and is associated with poor levator function and absent upper lid crease. The features of kearnssayre syndrome usually appear before age 20, and the condition is diagnosed by a few characteristic signs and symptoms. Kearnssayre syndrome ppt video online download slideplayer. Pronunciation of kearns sayre syndrome with 2 audio pronunciations, 1 meaning, 10 translations and more for kearns sayre syndrome. Circular dna encodes for several rnas and proteins mitochondria produces energy for the. Classical triad of kearnssayre syndrome bmj case reports.
Source national institutes of health nih ophanet, a consortium of european partners, currently defines a condition rare when it affects 1 person per 2,000. Kearnssayre syndrome handbook of pediatric anesthesia. Funduscopy revealed bilateral pigmentary retinopathy figure 2. Kearnssayre syndrome symptoms, diagnosis, treatments and. Kearnssayre syndrome kss is a rare mitochondrial genetic disorder with multisystem. Download figure open in new tab download powerpoint. Management options include placement of cardiac pacemakers in individuals with cardiac conduction blocks, eyelid slings for severe ptosis, cochlear implants and hearing aids for neurosensory hearing loss, hormone replacement for endocrinopathies, dilation of the upper esophageal sphincter to alleviate cricopharyngeal. Kearnssayre syndrome kss is a rare mitochondrial myopathy characterized by external ophthalmoplegia, pigmentary retinopathy, cerebellar ataxia and heart block. Abnormal accumulation of colored pigmented material on the retina atypical retinitis pigmentosa, leading to chronic inflammation and progressive. Genedx 207 perry parkway gaithersburg, md 20877 toll free. Chronic progressive external ophthalmoplegia cpeo kearns.
A free powerpoint ppt presentation displayed as a flash slide show on id. For kearns sayre syndrome kss, there is to our knowledge only one other case report associated with cerebral infarction. Kss is a more severe syndromic variant of chronic progressive external ophthalmoplegia abbreviated cpeo, a syndrome that is characterized by isolated involvement. Other frequently associated clinical features include cerebellar ataxia, cardiac conduction block, raised cerebrospinal fluid csf protein content, and proximal myopathy. It has characteristic syndromal features, which include.
Kss is a more severe syndromic variant of chronic progressive external ophthalmoplegia abbreviated cpeo, a syndrome that is characterized by isolated involvement of the muscles controlling movement of the eyelid levator palpebrae. Kearns sayre syndrome peroxisomal disorders refsum disease, adrenoleukodystrophy lysosomal storage diseases krabbe s disease, metachromatic leukodystophy. Aims we aimed to define patient and disease characteristics in a large group of. Cpeo affects the muscles that control eyelid movement and eye movement. Pigmentary retinopathy in kearnssayre syndrome bmj case. Kearnssayre syndrome kss is a rare multisystemic disorder. Kearns sayre syndrome kss is a rare mitochondrial myopathy caused by deletion of mitochondrial dna. Kearns sayre syndrome kss is a neuromuscular disorder defined by the triad of onset before age 20 years, pigmentary retinopathy a saltandpepper pigmentation in the retina that can affect vision, but often leaves it intact, and progressive external ophthalmoplegia peo. Background kearnssayre syndrome kss is a rare mitochondrial cytopathy, first described at mayo clinic in 1958. Kearnssayre syndrome kss is a rare mitochondrial myopathy caused by deletion of mitochondrial dna.
Ataxia diabetes loss of eye movement mild skeletalmuscle weakness heart block hearing loss loss of coordination impaired cognitive function and rarely seizures kearnsayre syndrome kearnsayre syndrome is. Mim 530000 is a mitochondrial syndrome, in most cases caused by large scale mitochondrial dna deletions or mitochondrial dna depletion maceluch and niedziela 2007. Jul 05, 2019 kearns sayre syndrome is a rare disorder. The combination of ophthalmoplegia and retinal degeneration was first described by the two american ophthalmologists r. Kearnssayre syndrome kss is characterized by the onset of ophthalmoparesis and pigmentary retinopathy before age 20 years. To research the causes of kearnssayre syndrome, consider researching the causes of these these diseases that may be similar, or associated with kearnssayre syndrome. Florence hines is a 40yearold elementary school teacher and mother of five children. It is a progressive disorder, and the prognosis for patients with the condition is poor.
One patient had kearnssayre syndrome kss, which is usually a sporadic disorder. The syndrome of a slowly progressive external ophthalmoplegia, pigment retinopathy, and disorder of cardiac conduction was described by kearns and sayre in 1958. Multicolour scanning laser photographs figure 2a, b showed retinal pigment granularity in ou that was. Kearns sayre syndrome nord national organization for. Mar 27, 2019 kearns sayre syndrome kss is a rare neuromuscular disorder with onset usually before the age of 20 years. Kearnssayre syndrome kernz sar, mim530000 a form of chronic progressive external ophthalmoplegia with associated cardiac conduction defects, short stature, and hearing loss. A neuromuscular disorder characterized by three primary findings. Kearnssayre syndrome peroxisomal disorders refsum disease, adrenoleukodystrophy lysosomal storage diseases krabbe s disease, metachromatic leukodystophy. Dec 17, 2014 kearns sayre syndrome kss is a neuromuscular disorder defined by the triad of onset before age 20 years, pigmentary retinopathy a saltandpepper pigmentation in the retina that can affect vision, but often leaves it intact, and progressive external ophthalmoplegia peo. The most commonly reported mitochondrial dna deletion is 4977 bp in size spanning nucleotides 8469 and 447. Kearnssayre syndrome kss is a mitochondrial myopathy with a typical onset before 20 years of age.