Waardenburg

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In het centrum van Waardenburg.
Waardenburg NH Kerk (1)
Kasteel Waardenburg Waardenburg Castle (4510403357)
Waardenburg - poldermolen in de sneeuw
Waardenburg RM Waalbandijk 12 Dijkmagazijn (2)

Waardenburg syndrome is a rare genetic disorder characterized by at least some degree of sensorineural hearing loss, changes in pigmentation of the hair, skin, and eyes, and often, but not always, a distinctive separation between the inner corners of the eyes, known as dystopia canthorum. The syndrome is named after the Dutch ophthalmologist Petrus Johannes Waardenburg, who first described the condition in detail in the early 20th century.

Classification

Waardenburg syndrome is classified into four main types (I, II, III, and IV), based on genetic causes and clinical manifestations. Each type has its own set of characteristics and associated genetic mutations.

  • Type I is distinguished by the presence of dystopia canthorum and is primarily caused by mutations in the PAX3 gene.
  • Type II lacks dystopia canthorum but shares other features with Type I. It can be caused by mutations in several genes, including MITF, SOX10, and others.
  • Type III (or Klein-Waardenburg syndrome) includes features of Type I along with musculoskeletal abnormalities.
  • Type IV (or Waardenburg-Shah syndrome) combines the auditory-pigmentary features with Hirschsprung disease, a condition affecting the colon due to the absence of nerve cells in the intestinal wall.

Symptoms

The symptoms of Waardenburg syndrome can vary widely among individuals, even within the same family. Common symptoms include:

  • Heterochromia (differently colored eyes or eyes with more than one color)
  • Sensorineural hearing loss
  • White patches of hair or early graying of the hair
  • Distinctive facial features, such as a wide nasal bridge
  • Skin pigmentation changes

Genetics

Waardenburg syndrome is usually inherited in an autosomal dominant pattern, meaning one copy of the altered gene in each cell is sufficient to cause the disorder. However, some cases result from new mutations in the gene and occur in people with no history of the disorder in their family.

Diagnosis

Diagnosis of Waardenburg syndrome is based on a clinical evaluation of the characteristic physical features. Genetic testing can confirm the diagnosis and help determine the type of Waardenburg syndrome.

Treatment

There is no cure for Waardenburg syndrome, but treatments are available to manage the symptoms. For individuals with hearing loss, treatment may include the use of hearing aids or cochlear implants. Counseling and support for psychological and social issues are also important.

Epidemiology

Waardenburg syndrome affects an estimated 1 in 40,000 people worldwide. The prevalence of the different types of Waardenburg syndrome varies, with Type I and II being the most common.

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Contributors: Prab R. Tumpati, MD