Morquio's syndrome: Difference between revisions

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   MeshID        = D009085 |
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==Overview==
==Overview==
'''Morquio syndrome''' (referred to as '''[[mucopolysaccharidosis]] IV''' or '''Morquio''')  is a [[mucopolysaccharide]] storage disease (see also [[lysosomal storage disorder]]), usually inherited. It is a relatively rare [[dwarfism]] with serious consequences. When the body cannot process certain types of mucopolysaccharides, they build up or are eliminated, causing various symptoms.  
'''Morquio syndrome''' (referred to as '''[[mucopolysaccharidosis]] IV''' or '''Morquio''')  is a [[mucopolysaccharide]] storage disease (see also [[lysosomal storage disorder]]), usually inherited. Morquio is a relatively rare metabolic disorder in which the body cannot process certain types or mucopolysaccharides. When the body cannot process certain types of mucopolysaccharides, they build up or are eliminated, causing various symptoms. It is usually an inherited disease.
 
==Historical Perspective==
 
==Classification==
===Presentation===
The disease is caused by an abnormal accumulation of [[mucopolysaccharide]]s - in this case, [[keratan sulfate]] - in the body. Keratan sulfate is excreted in urine.
 
The symptoms vary from patient to patient, and may include hearing loss, cataracts, skeletal dysplasia, spinal instability, and minor respiratory issues, among others.  


==Types==
===Types===
Two forms are recognized, type A and type B.  
Two forms are recognized, type A and type B.  
* Morquio type A is a deficiency of the enzyme [[N-acetylgalactosamine-6-sulfate sulfatase]].  
* Morquio type A is a deficiency of the enzyme [[N-acetylgalactosamine-6-sulfate sulfatase]].  
* Morquio type B is the deficiency of the enzyme [[beta-galactosidase]].  
* Morquio type B is the deficiency of the enzyme [[beta-galactosidase]].  


==Presentation==
==Pathophysiology==
The disease is caused by an abnormal accumulation of [[mucopolysaccharide]]s - in this case, [[keratan sulfate]] - in the body. Keratan sulfate is excreted in urine.
 
==Causes==
 
==Differentiating {{PAGENAME}} from Other Diseases==
 
==Epidemiology and Demographics==
 
==Risk Factors==
 
==Screening==


The symptoms vary from patient to patient, and may include hearing loss, cataracts, skeletal dysplasia, spinal instability, and minor respiratory issues, among others.
==Natural History, Complications, and Prognosis==


==History==
==History and Symptoms==
===History===
The condition was first described, simultaneously and independently, in 1929, by Luis Morquio in Montevideo, Uruguay, and by James Frederick Brailsford in Birmingham, England. They both recognized the occurrence of corneal clouding, aortic valve disease, and urinary excretion of keratan sulfate. Morquio observed the disorder in 4 siblings in a family of Swedish extraction and reported his observations in French.
The condition was first described, simultaneously and independently, in 1929, by Luis Morquio in Montevideo, Uruguay, and by James Frederick Brailsford in Birmingham, England. They both recognized the occurrence of corneal clouding, aortic valve disease, and urinary excretion of keratan sulfate. Morquio observed the disorder in 4 siblings in a family of Swedish extraction and reported his observations in French.


==Symptoms==
===Symptoms===
The following symptoms are associated with Morquio syndrome:
The following symptoms are associated with Morquio syndrome:
*Abnormal heart development
*Abnormal heart development
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*Compression of spinal cord
*Compression of spinal cord


==Laboratory diagnosis==
===Complications===
 
===Prognosis===
 
==Diagnosis==
===Diagnostic Criteria===
 
===Laboratory diagnosis===
As most mucopolysaccharidoses, Morquio syndrome exhibits alterations in [[white blood cells]] that are diagnostic, and might allow for screening procedures and cost-effective differential diagnosis in the future. These anomalies can be best studied with [[Wright stain]], the routine dye employed in hematology laboratory. [[Neutrophils]] in Morquio's syndrome exhibit persistence of the azurophilia in its granules, which is explained by the deficient enzyme's inability to clear them from mucopolysaccharides used as a tags in the cells vesicular sorting system. Approximately 70 percent of the neutrophils exhibit this subtle alteration. Differential diagnosis must be made with mucopolisaccharidoses I,II,III,VI and VII.  
As most mucopolysaccharidoses, Morquio syndrome exhibits alterations in [[white blood cells]] that are diagnostic, and might allow for screening procedures and cost-effective differential diagnosis in the future. These anomalies can be best studied with [[Wright stain]], the routine dye employed in hematology laboratory. [[Neutrophils]] in Morquio's syndrome exhibit persistence of the azurophilia in its granules, which is explained by the deficient enzyme's inability to clear them from mucopolysaccharides used as a tags in the cells vesicular sorting system. Approximately 70 percent of the neutrophils exhibit this subtle alteration. Differential diagnosis must be made with mucopolisaccharidoses I,II,III,VI and VII.  


Nonetheless, after this screening procedure has been carried on, quantitative enzyme determination assays must be conducted to verify the diagnosis, should any replacement treatment is available.
Nonetheless, after this screening procedure has been carried on, quantitative enzyme determination assays must be conducted to verify the diagnosis, should any replacement treatment is available.


==X-ray==


===Complications===
Complications that may develop include:
* Heart failure
* Difficulty with vision
* Walking problems related to abnormal curvature of the spine
* Abnormal neck bones can cause spinal cord damage that can cause severe disease including paralysis if not caught early -- spinal fusion can prevent this
* Problems with urination
===Physical Examination===
===Laboratory Findings===
===X-ray===
* Radiographic features include oval-shaped vertebral bodies with anterior beaking, unossified femoral heads with proximal femoral valgus deformities, and broad, flat ilia.
* Radiographic features include oval-shaped vertebral bodies with anterior beaking, unossified femoral heads with proximal femoral valgus deformities, and broad, flat ilia.
* By 2 to 3 years of age, universal platyspondyly with central beaking is almost pathognomonic.
* By 2 to 3 years of age, universal platyspondyly with central beaking is almost pathognomonic.
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==Complications==
Complications that may develop include:
* Heart failure
* Difficulty with vision
* Walking problems related to abnormal curvature of the spine
* Abnormal neck bones can cause spinal cord damage that can cause severe disease including paralysis if not caught early -- spinal fusion can prevent this
* Problems with urination


==References==
===Imaging Findings===
{{reflist|2}}
 
===Other Diagnostic Studies===
 
==Treatment==
===Medical Therapy===
 
===Surgery===
 
===Prevention===


==External links==
==External links==
*[http://www.mpssociety.org/ National MPS Society]
*[http://www.mpssociety.org/ National MPS Society]
* www.morquio.com
* www.morquio.com
==References==
{{reflist|2}}


{{Endocrine, nutritional and metabolic pathology }}
{{Endocrine, nutritional and metabolic pathology }}


 
[[Category:Endocrinology]]
 
[[Category:Lysosomal storage diseases]]


[[pl:Zespół Morquio]]
[[pl:Zespół Morquio]]
[[fi:Morquion oireyhtymä]]
[[fi:Morquion oireyhtymä]]
[[Category:Inborn errors of metabolism]]
 
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Latest revision as of 18:12, 1 August 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief:

Morquio's syndrome
ICD-10 E76.2
ICD-9 277.5
OMIM 253000 253010
DiseasesDB 30807 Template:DiseasesDB2
MedlinePlus 001206
eMedicine ped/1477 
MeSH D009085

Overview

Morquio syndrome (referred to as mucopolysaccharidosis IV or Morquio) is a mucopolysaccharide storage disease (see also lysosomal storage disorder), usually inherited. Morquio is a relatively rare metabolic disorder in which the body cannot process certain types or mucopolysaccharides. When the body cannot process certain types of mucopolysaccharides, they build up or are eliminated, causing various symptoms. It is usually an inherited disease.

Historical Perspective

Classification

Presentation

The disease is caused by an abnormal accumulation of mucopolysaccharides - in this case, keratan sulfate - in the body. Keratan sulfate is excreted in urine.

The symptoms vary from patient to patient, and may include hearing loss, cataracts, skeletal dysplasia, spinal instability, and minor respiratory issues, among others.

Types

Two forms are recognized, type A and type B.

Pathophysiology

Causes

Differentiating Morquio's syndrome from Other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications, and Prognosis

History and Symptoms

History

The condition was first described, simultaneously and independently, in 1929, by Luis Morquio in Montevideo, Uruguay, and by James Frederick Brailsford in Birmingham, England. They both recognized the occurrence of corneal clouding, aortic valve disease, and urinary excretion of keratan sulfate. Morquio observed the disorder in 4 siblings in a family of Swedish extraction and reported his observations in French.

Symptoms

The following symptoms are associated with Morquio syndrome:

  • Abnormal heart development
  • Abnormal skeletal development
  • Hypermobile joints
  • Large fingers
  • Knock-knees
  • Widely spaced teeth
  • Coarse facial features
  • Large head
  • Star shaped chest (ribs flared)
  • Compression of spinal cord

Complications

Prognosis

Diagnosis

Diagnostic Criteria

Laboratory diagnosis

As most mucopolysaccharidoses, Morquio syndrome exhibits alterations in white blood cells that are diagnostic, and might allow for screening procedures and cost-effective differential diagnosis in the future. These anomalies can be best studied with Wright stain, the routine dye employed in hematology laboratory. Neutrophils in Morquio's syndrome exhibit persistence of the azurophilia in its granules, which is explained by the deficient enzyme's inability to clear them from mucopolysaccharides used as a tags in the cells vesicular sorting system. Approximately 70 percent of the neutrophils exhibit this subtle alteration. Differential diagnosis must be made with mucopolisaccharidoses I,II,III,VI and VII.

Nonetheless, after this screening procedure has been carried on, quantitative enzyme determination assays must be conducted to verify the diagnosis, should any replacement treatment is available.


Complications

Complications that may develop include:

  • Heart failure
  • Difficulty with vision
  • Walking problems related to abnormal curvature of the spine
  • Abnormal neck bones can cause spinal cord damage that can cause severe disease including paralysis if not caught early -- spinal fusion can prevent this
  • Problems with urination

Physical Examination

Laboratory Findings

X-ray

  • Radiographic features include oval-shaped vertebral bodies with anterior beaking, unossified femoral heads with proximal femoral valgus deformities, and broad, flat ilia.
  • By 2 to 3 years of age, universal platyspondyly with central beaking is almost pathognomonic.
  • The long tubular bones are thickened and shortened as well.


Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Prevention

External links

References

Template:Endocrine, nutritional and metabolic pathology fi:Morquion oireyhtymä


Template:WikiDoc Sources