Prader-Willi syndrome
Prader-Willi syndrome (PWS) is a genetic disorder caused by a deletion on chromosome 15, which results in a range of developmental, cognitive, and physical challenges. It affects approximately 1 in 20,000 to 30,000 births, impacting individuals of all genders and races. Key characteristics include low birth weight, diminished muscle tone, short stature, and small hands and feet. As children grow, they may develop an insatiable appetite leading to obesity and associated health complications. Behavioral issues are also common, including compulsive eating and psychiatric disorders. Treatments focus on managing symptoms through dietary restrictions, regular exercise, hormone therapy, and educational support. Early intervention and a supportive environment are crucial for helping individuals with PWS lead fulfilling lives. Research continues to explore the genetic and hormonal aspects of the syndrome, with the aim of improving treatment options and understanding the condition more comprehensively.
Prader-Willi syndrome
ANATOMY OR SYSTEM AFFECTED: Bones, brain, endocrine system, genitals, glands, heart, musculoskeletal system, psychic-emotional system, teeth
DEFINITION: A disorder caused by a deletion in chromosome 15, characterized by developmental and cognitive delays, overeating resulting in obesity, and behavioral difficulties
CAUSES: Spontaneous genetic deletion, possibly with environmental trigger
SYMPTOMS: Low birth weight, decreased muscle tone, small genitalia, undescended testicles, small hands and feet, short stature, poor motor development, mental retardation (ranging from mild to severe), insatiable need to eat, behavioral disorders, psychiatric disorders
DURATION: Lifelong
TREATMENTS: Alleviation of symptoms; may include dietary restrictions and regular exercise to avoid obesity, growth hormone, special education (speech, behavioral, and psychiatric therapy)
Causes and Symptoms
Prader-Willi syndrome is caused by a spontaneous deletion involving chromosome 15. Although this disease is genetic in nature, most parents of children with Prader-Willi syndrome have normal chromosomes. Some research indicates an association between the disease and fathers employed at the time of conception in fields associated with hydrocarbons, such as lumbermen, chemists, or mechanics. That connection might implicate an environmental trigger in some cases.
![Pws. Prader-Willi syndrome phenotype, at 15 years of age . Note absence of typical PWS facial features and presence of mild truncal obesity. By Schüle B et al [CC-BY-2.0 (http://creativecommons.org/licenses/by/2.0)], via Wikimedia Commons 86194498-28822.jpg](https://imageserver.ebscohost.com/img/embimages/ers/sp/embedded/86194498-28822.jpg?ephost1=dGJyMNHX8kSepq84xNvgOLCmsE2epq5Srqa4SK6WxWXS)
Prader-Willi syndrome occurs in one in 20,000–30,000 births and affects both genders and all races. Newborns with the disease appear floppy, with low muscle tone. They often had a low birth weight, and males may have undescended testicles. Small genitalia are common, as are small hands and feet. These babies feed poorly and display poor motor development. Intellectual disability is common, ranging from mild to severe.
Between the ages of two and four, children with Prader-Willi syndrome develop an insatiable need to eat. They will do anything to get food and will eat without control. Obesity and other related health problems are major concerns for these patients. Many patients also suffer from behavioral disorders related to excessive eating, compulsive or repetitive behaviors, tantrums, and psychiatric disorders including depression and, in extreme cases, psychoses.
Treatment and Therapy
Primary treatment for Prader-Willi syndrome centers on the many health concerns related to obesity, in addition to meeting the educational, social, and emotional needs of patients as they grow and mature. Studies indicate an abnormally high level of the hormone ghrelin in these patients. It is the only appetite-stimulating hormone produced in the stomach and was touted in the early twenty-first century as a possible breakthrough in treatment.
Dietary restrictions, including types of food and portion control, are critical with these patients. Since they are unable to control their cravings for food, cooperation among family, school personnel, and community members is essential. Regular exercise is also recommended. Because patients with Prader-Willi syndrome are often small in stature, growth hormones are often used to facilitate growth and decrease the percentage of body fat, thus helping improve both strength and agility in patients. Special education services, including speech, behavioral assistance, and psychological or psychiatric services, are also important components of treatment.
Perspective and Prospects
Prader-Willi syndrome was first defined as a syndrome by Andrea Prader, Alexis Labhart, and Heinrich Willi in 1956. Prader and Willi refined the syndrome in 1963. Since the mid-twentieth century, researchers have focused on the influences of hormones and genetics in the development and treatment of this disease. Treatments evolved based on increased knowledge of how genes and hormones influence human biology and behavior.
Bibliography
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Dykens, Elisabeth M, Elizabeth Roof, and Hailee Hunt-Hawkins. "The Prader-Willi Syndrome Profile: Validation of a New Measure of Behavioral and Emotional Problems in Prader-Willi Syndrome." Orphanet Journal of Rare Diseases, vol. 19, no. 83, 23 Feb. 2024, doi.org/10.1186/s13023-024-03045-9. Accessed 7 Apr. 2024.
Gutierrez, Maria A. Fermin, and Magda D. Mendez. "Prader-Willi Syndrome." StatPearls, 31 Jan. 2023, www.ncbi.nlm.nih.gov/books/NBK553161/. Accessed 7 Apr. 2024.
Jones, Kenneth Lyons. “Prader-Willi Syndrome.” In Smith’s Recognizable Patterns of Human Malformation. 6th ed. Philadelphia: Saunders/Elsevier, 2006. Print.
"Prader-Willi Syndrome." Genetics Home Reference. Natl. Lib. of Medicine, 3 May 2016. Web. 5 May. 2016.
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