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Prader-Willi syndrome

What is Prader-Willi syndrome?

Prader-Willi syndrome is a complex genetic condition that affects many parts of the body. In infancy, this condition is characterized by weak muscle tone (hypotonia), feeding difficulties, poor growth, and delayed development. Beginning in childhood, affected individuals develop an insatiable appetite and chronic overeating (hyperphagia). As a result, most experience rapid weight gain leading to obesity. People with Prader-Willi syndrome typically have mental retardation or learning disabilities and behavioral problems. Many people with this disorder also have distinctive facial features and short stature. The genitals in both males and females are underdeveloped, and most affected individuals are unable to conceive children (infertile). Additionally, some people with Prader-Willi syndrome have unusually fair skin and light-colored hair.

How common is Prader-Willi syndrome?

Prader-Willi syndrome affects an estimated 1 in 10,000 to 25,000 people.

What are the genetic changes related to Prader-Willi syndrome?

Prader-Willi syndrome is related to chromosome 15.

The OCA2 gene is associated with Prader-Willi syndrome.

Prader-Willi syndrome is caused by the loss of active genes in a specific region of chromosome 15. People normally inherit one copy of this chromosome from each parent. Some genes are active only on the copy that is inherited from a person's father (the paternal copy). This parent-specific gene activation is called genomic imprinting. Prader-Willi syndrome occurs when the region of the paternal chromosome 15 containing these genes is missing.

Researchers are working to identify genes on chromosome 15 that are responsible for the characteristic features of Prader-Willi syndrome. They have not definitively connected many genes with specific signs and symptoms. Researchers have determined, however, that a deletion of the OCA2 gene on chromosome 15 is associated with unusually fair skin and light-colored hair in some affected individuals. The protein produced from this gene helps determine the coloring (pigmentation) of the skin, hair, and eyes.

Most cases of Prader-Willi syndrome (about 70 percent) occur when a segment of the paternal chromosome 15 is deleted in each cell. In another 25 percent of cases, a person with Prader-Willi syndrome has two copies of chromosome 15 inherited from his or her mother (maternal copies) instead of one copy from each parent. This phenomenon is called maternal uniparental disomy. Rarely, Prader-Willi syndrome can also be caused by a chromosomal rearrangement called a translocation, or by a mutation or other defect that abnormally inactivates genes on the paternal chromosome 15. Each of these genetic changes results in a loss of gene function in a critical region of chromosome 15.

Can Prader-Willi syndrome be inherited?

Most cases of Prader-Willi syndrome are not inherited, particularly those caused by a deletion in the paternal chromosome 15 or by maternal uniparental disomy. These genetic changes occur as random events during the formation of reproductive cells or in early fetal development. Affected people typically have no history of the disorder in their family.

Rarely, a genetic change responsible for Prader-Willi syndrome can be inherited. For example, it is possible for a genetic defect that abnormally inactivates genes on the paternal chromosome 15 to be passed from one generation to the next.

Prader-Willi Syndrome on Wikipedia

'''Prader-Willi syndrome''' is a genetic disorder in which seven genes (or some subset thereof) on chromosome 15 are missing or unexpressed (chromosome 15q partial deletion). It was identified in 1956 by Andrea Prader, Heinrich Willi, Alexis Labhart, and Guido Fanconi of Switzerland. Prader-Willi syndrome (PWS) is characterized by severe hypotonia and feeding difficulties in early infancy, followed in later infancy or early childhood by excessive eating and gradual development of morbid obesity, unless externally controlled. All patients have some degree of mental retardation and distinctive behavioral problems. Hypogonadism is present in both males and females. Short stature is common.

Diagnosis/testing

Accurate consensus clinical diagnostic criteria exist, but the mainstay of diagnosis is genetic testing, specifically DNA-based methylation testing to detect the absence of the paternally contributed Prader-Willi syndrome/Angelman syndrome (PWS/AS) region on chromosome 15q11.2-q13. Such testing detects over 99% of patients. Methylation-specific testing is important to confirm the diagnosis of PWS in all individuals, but especially those who are too young to manifest sufficient features to make the diagnosis on clinical grounds or in those individuals who have atypical findings.

Genetics

PWS is caused by absence of the paternally derived PWS/AS region of chromosome 15 by one of several genetic mechanisms, including uniparental disomy, imprinting mutations, chromosome translocations, and gene deletions. The genes responsible for Prader-Willi syndrome are expressed only on the paternal chromosome. (Interestingly, a deletion on the maternal chromosome causes Angelman syndrome.) This is the first known instance of imprinting in humans. The risk to the sibling of an affected child of having PWS depends upon the genetic mechanism which caused the disorder. The risk to siblings is <1% ...   [ Read More ]


External Resources

Prader-Willi Alliance of New York - Represents the interests of individuals in New York State with Prader-Willi syndrome, their families, and the professionals who provide services to the Prader-Willi population.

Prader-Willi Syndrome Association of Victoria (Australia) - Includes details about the organization, a diagnosis/infant guide, a general guide, members stories and links.

Williams Syndrome and Prader-Willi Syndrome - Diagnostic assessment, selected treatment services and opportunities to participate in research from the Yale University Child Study Center.

Prader-Willi Syndrome Association (USA) - Characteristics include hypotonia, insatiable appetite, obesity if food intake is uncontrolled, hypogonadism and incomplete sexual development, developmental delays, variable degrees of mental retardation or functional retardation, short stature (adult), small hands and feet, mild dysmorphology, and behavior problems which can be severe.

Ontario Prader-Willi Syndrome Association - OPWSA provides support and information to all those interested in finding out about this syndrome. A special emphasis on Canadian content.

Prader-Willi Syndrome - Suite101 - A forum to provide a support base for PWS without having to join one of the national or international associations, and to make people more aware of PWS.

The Prader-Willi Syndrome Association (UK) - Information and resources about this chromosomal disorder.

Gretton Homes - Information about the organization that offers residential care for people with Prader-Willi Syndrome.

The New Jersey Chapter of the Prader-Willi Syndrome Association - Includes news, important dates, fund raising, maps and links.

Prader-Willi Syndrome Association of South Africa - Informative regarding PWS, its symptoms, causes, prevention and treatment.


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