Lesch-Nyhan syndrome (patient information)

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

Lesch-Nyhan syndrome

Overview

What are the symptoms?

What are the causes?

Who is at highest risk?

Diagnosis

When to seek urgent medical care?

Treatment options

Where to find medical care for Lesch-Nyhan syndrome?

Prevention

What to expect (Outlook/Prognosis)?

Possible complications

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Overview

Lesch-Nyhan syndrome is an inheritable disorder that affects how the body builds and breaks down purines. Purines are a normal part of human tissue and help make up the body's genetic blueprint. They are also found in many different foods.

What are the symptoms of Lesch-Nyhan syndrome?

The excess uric acid levels cause children to develop gout-like swelling in some of their joints. In some cases, kidney and bladder stones develop because of the high uric acid levels.

Males with Lesch-Nyhan have delayed motor development followed by bizarre, sinuous movements and increased deep tendon reflexes. A striking feature of Lesch-Nyhan syndrome is self-destructive behavior characterized by chewing off fingertips and lips, if not restrained. It is unknown how the enzyme deficiency causes these problems.

What causes Lesch-Nyhan syndrome?

Lesch-Nyhan syndrome is inherited as an X-linked trait. It mostly occurs in boys. Persons with this syndrome are missing or are severely lacking an enzyme called hypoxanthine guanine phosphoribosyltransferase 1 (HGP). The body needs this enzyme to recycle purines. Without it, abnormally high levels of uric acid build up in the body.

The condition affects about 1 in 380,000 people.

When to seek urgent medical care?

Call your health care provider if signs of this illness appear in your child or if there is a history of Lesch-Nyhan syndrome in your family.

Diagnosis

There may be a family history of this condition.

The doctor will perform a physical exam. The exam may show:

  • Overexaggerated reflexes
  • Spasticity

Blood and urine tests may reveal high uric acid levels. A skin biopsy may show decreased levels of the HGP enzyme.

Treatment options

No specific treatment exists for Lesch-Nyhan syndrome. The gout medication, allopurinol, successfully decreases uric acid levels, but does not improve the neurological outcome.

Some symptoms may be relieved with the drugs carbidopa/levodopa, diazepam, phenobarbital, or haloperidol.

Where to find medical care for?

Directions to Hospitals Treating Lesch-Nyhan syndrome

What to expect (Outlook/Prognosis)?

The outcome is likely to be poor. Persons with this syndrome usually require assistance walking and sitting and generally need a wheelchair to get around.

Possible complications

Severe, progressive disability is likely.

Sources

http://www.nlm.nih.gov/medlineplus/ency/article/001655.htm