Jervell and Lange-Nielsen syndrome: Difference between revisions

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An ECG may be helpful in the diagnosis of [disease name]. Findings on an ECG suggestive of/diagnostic of [disease name] include
An ECG may be helpful in the diagnosis of Jervell and Lange-Nielsen syndrome (JLNS). Findings on an ECG suggestive of/diagnostic of Jervell and Lange-Nielsen syndrome (JLNS)


* [Finding 1]
* Prolongation of the QTc interval
* [Finding 2]
* Tachyarrhythmias
* [Finding 3]
* Ventricular tachycardia
*Torsade de pointes ventricular tachycardia
*Ventricular fibrillation


== Imaging Findings ==
== Imaging Findings ==

Revision as of 13:20, 25 November 2019

Jervell and Lange-Nielsen syndrome
ICD-9 426.82
OMIM 220400
DiseasesDB 7249
MeSH D029593

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Synonyms and keywords:Autosomal recessive long QT syndrome (LQTS), cardioauditory syndrome, cardioauditory syndrome of Jervell and Lange-Nielsen, deafness, congenital, and functional heart disease, Jervell and Lange-Nielsen (JLNS), surdocardiac syndrome

Overview

Jervell and Lange-Nielsen syndrome is a rare autosomal recessive condition that leads to sensorineural deafness, abnormal ventricular myocardial repolarization with results in long QT syndrome (LQTS) and other cardiac events. Jervell and Lange-Nielsen syndrome is due to KCNQ1 or KCNE1 gene mutations. The range of symptoms and severity of symptoms in Jervell and Lange-Nielsen syndrome differs from patient to patient.

Historical Perspective

  • Jervell and Lange-Nielsen syndrome (JLNS) was first discovered by Anton Jervell a Norwegian physician and Fred Lange-Nielsen a Norwegian doctor and jazz musician, in 1957.[1][2]

Classification

  • Jervell and Lange-Nielsen syndrome (JLNS) may be classified according into two subtypes:[3][4][5][6]
Type Chromosome Locus Gene Mutation Protein Involved
Jervell and Lange-Nielsen syndrome 1 11p15​.5-p15.4 KCNQ1 Potassium voltage-gated channel subfamily KQT member 1
Jervell and Lange-Nielsen syndrome 2 21q22​.12 KCNE1 Potassium voltage-gated channel subfamily E member 1


Pathophysiology

Physiology

The normal physiology of KCNQ1 and KCNE1 genes can be understood as follows:[7]

Pathogenesis

KCNQ1

KCNE1

Genetics

Causes

Genetic Causes

Differentiating Jervell and Lange-Nielsen syndrome from other Diseases

Epidemiology and Demographics

Incidence

  • The incidence of Jervell and Lange-Nielsen syndrome (JLNS) is approximately 1 per 100,000 individuals in Norway.[29][30][31]
  • The incidence of Jervell and Lange-Nielsen syndrome (JLNS) is approximately 1 per 100,000 individuals in Sweden.
  • It is estimated that Jervell and Lange-Nielsen syndrome (JLNS) affects 166,000 to 625,000 children worldwide.

Prevalence

  • The prevalence of Jervell and Lange-Nielsen syndrome (JLNS) is approximately 1:200,000 individuals in Norway.[1][32]

Age

  • The incidence of Jervell and Lange-Nielsen syndrome (JLNS) increases with age; the median age at diagnosis is 6.8 years.[33][34]
  • The exact time of presentation in Jervell and Lange-Nielsen syndrome (JLNS) is highly variable.

Gender

  • Jervell and Lange-Nielsen syndrome (JLNS) affects men and women equally. But the severity of cardiac events is much more common in men.[35]

Risk Factors

Screening

Natural History, Complications and Prognosis

Natural History

Complications

Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Common Symptoms

Common symptoms of Jervell and Lange-Nielsen syndrome (JLNS) include:

Physical Examination

HEENT

  • All patients with Jervell and Lange-Nielsen syndrome (JLNS) are positive for profound bilateral congenital sensorineural deafness.[43][44]
Hearing Loss Severity Hearing Threshold
Mild hearing loss 26-40 Decibels
Moderate hearing loss 41-55 Decibels
Moderately severe hearing loss 56-70 Decibels
Severe hearing loss 71-90 Decibels
Profound hearing loss 90 Decibels

Heart

Laboratory Findings

Laboratory findings consistent with the diagnosis of Jervell and Lange-Nielsen syndrome (JLNS) include:[48][49]

  • Anemia: patients with Jervell and Lange-Nielsen syndrome (JLNS) are more prone to develop anemia especially iron deficiency anemia
  • Hypergastrinemia is due to the potassium channels defect
  • Increased gastrin levels due to gastric hyperplasia

Electrocardiogram

ECG in Jervell and Lange-Nielsen syndrome shows markedly prolonged corrected QT interval (QTc). Case courtesy by Jae Suk Baek et al[50]

There are no ECG findings associated with [disease name].

OR

An ECG may be helpful in the diagnosis of Jervell and Lange-Nielsen syndrome (JLNS). Findings on an ECG suggestive of/diagnostic of Jervell and Lange-Nielsen syndrome (JLNS)

  • Prolongation of the QTc interval
  • Tachyarrhythmias
  • Ventricular tachycardia
  • Torsade de pointes ventricular tachycardia
  • Ventricular fibrillation

Imaging Findings

There are no other imaging findings associated with [disease name].

OR

[Imaging modality] may be helpful in the diagnosis of [disease name]. Findings on an [imaging modality] suggestive of/diagnostic of [disease name] include:

  • [Finding 1]
  • [Finding 2]
  • [Finding 3]

Treatment

Template:WikiDoc Sources

References

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  2. Schwartz, Peter J.; Spazzolini, Carla; Crotti, Lia; Bathen, Jørn; Amlie, Jan P.; Timothy, Katherine; Shkolnikova, Maria; Berul, Charles I.; Bitner-Glindzicz, Maria; Toivonen, Lauri; Horie, Minoru; Schulze-Bahr, Eric; Denjoy, Isabelle (2006). "The Jervell and Lange-Nielsen Syndrome". Circulation. 113 (6): 783–790. doi:10.1161/CIRCULATIONAHA.105.592899. ISSN 0009-7322.
  3. Tyson J, Tranebjaerg L, McEntagart M, Larsen LA, Christiansen M, Whiteford ML; et al. (2000). "Mutational spectrum in the cardioauditory syndrome of Jervell and Lange-Nielsen". Hum Genet. 107 (5): 499–503. doi:10.1007/s004390000402. PMID 11140949.
  4. Schwartz PJ, Spazzolini C, Crotti L, Bathen J, Amlie JP, Timothy K; et al. (2006). "The Jervell and Lange-Nielsen syndrome: natural history, molecular basis, and clinical outcome". Circulation. 113 (6): 783–90. doi:10.1161/CIRCULATIONAHA.105.592899. PMID 16461811.
  5. Tranebjaerg L, Bathen J, Tyson J, Bitner-Glindzicz M (1999). "Jervell and Lange-Nielsen syndrome: a Norwegian perspective". Am J Med Genet. 89 (3): 137–46. PMID 10704188.
  6. ACMG (2002) Genetics Evaluation Guidelines for the Etiologic Diagnosis of Congenital Hearing Loss. Genetic Evaluation of Congenital Hearing Loss Expert Panel. ACMG statement. Genet Med 4 (3):162-71. DOI:10.1097/00125817-200205000-00011 PMID: 12180152
  7. Adam MP, Ardinger HH, Pagon RA, Wallace SE, Bean LJH, Stephens K; et al. (1993). "GeneReviews®". PMID 20301579.
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  9. Wang Z, Li H, Moss AJ, Robinson J, Zareba W, Knilans T; et al. (2002). "Compound heterozygous mutations in KvLQT1 cause Jervell and Lange-Nielsen syndrome". Mol Genet Metab. 75 (4): 308–16. doi:10.1016/S1096-7192(02)00007-0. PMID 12051962.
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  31. Winbo A, Stattin EL, Nordin C, Diamant UB, Persson J, Jensen SM; et al. (2014). "Phenotype, origin and estimated prevalence of a common long QT syndrome mutation: a clinical, genealogical and molecular genetics study including Swedish R518X/KCNQ1 families". BMC Cardiovasc Disord. 14: 22. doi:10.1186/1471-2261-14-22. PMC 3942207. PMID 24552659.
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  40. Neyroud N, Tesson F, Denjoy I, Leibovici M, Donger C, Barhanin J; et al. (1997). "A novel mutation in the potassium channel gene KVLQT1 causes the Jervell and Lange-Nielsen cardioauditory syndrome". Nat Genet. 15 (2): 186–9. doi:10.1038/ng0297-186. PMID 9020846.
  41. Adam MP, Ardinger HH, Pagon RA, Wallace SE, Bean LJH, Stephens K; et al. (1993). "GeneReviews®". PMID 20301579.
  42. Winbo A, Rydberg A (2015). "Vestibular dysfunction is a clinical feature of the Jervell and Lange-Nielsen Syndrome". Scand Cardiovasc J. 49 (1): 7–13. doi:10.3109/14017431.2014.988172. PMID 25471708.
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  45. Winbo A, Stattin EL, Diamant UB, Persson J, Jensen SM, Rydberg A (2012). "Prevalence, mutation spectrum, and cardiac phenotype of the Jervell and Lange-Nielsen syndrome in Sweden". Europace. 14 (12): 1799–806. doi:10.1093/europace/eus111. PMID 22539601.
  46. Winbo A, Stattin EL, Nordin C, Diamant UB, Persson J, Jensen SM; et al. (2014). "Phenotype, origin and estimated prevalence of a common long QT syndrome mutation: a clinical, genealogical and molecular genetics study including Swedish R518X/KCNQ1 families". BMC Cardiovasc Disord. 14: 22. doi:10.1186/1471-2261-14-22. PMC 3942207. PMID 24552659.
  47. Neyroud N, Tesson F, Denjoy I, Leibovici M, Donger C, Barhanin J; et al. (1997). "A novel mutation in the potassium channel gene KVLQT1 causes the Jervell and Lange-Nielsen cardioauditory syndrome". Nat Genet. 15 (2): 186–9. doi:10.1038/ng0297-186. PMID 9020846.
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  50. "Jervell and Lange-Nielsen Syndrome: Novel Compound Heterozygous Mutations in the KCNQ1 in a Korean Family".

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