WAGR syndrome

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WAGR syndrome is a rare genetic syndrome in which affected children are predisposed to develop Wilms tumor (a tumor of the kidneys), Aniridia (absence of the colored part of the eye, the iris), Genitourinary anomalies, and mental Retardation. The G is sometimes instead given as "gonadoblastoma," since the genitourinary anomalies are tumors of the gonads (testes or ovaries).

1 Synonyms
2 History
3 Pathophysiology
4 Clinical features and diagnosis
5 See also
6 References
7 External links

[edit] Synonyms

WAGR complex, Wilms tumor-aniridia syndrome, aniridia-Wilms tumor syndrome.

[edit] History

WAGR syndrome was first described by Miller et al.^[1]

[edit] Pathophysiology

WAGR syndrome is caused by a mutation on chromosome 11 in the 11p13 region. Specifically, several genes in this area are deleted, including the PAX6 ocular development gene and the Wilms tumor gene (WT1). Abnormalities in WT1 may also cause genitourinary anomalies. Mutations in the PAX6 gene have recently been shown to not only cause ocular abnormalities, but also problems in the brain and pancreas (Glaser et al, 1994; Yasuda, 2002; Mitchell, 2003; Talamillo, 2003).

[edit] Clinical features and diagnosis

Newborn children with WAGR syndrome are soon noted to have aniridia. The clinical suspicion for WAGR may be increased with the presence of other genital anomalies. It must be noted that genitourinary anomalies are not always present, particularly in girls. In older children, clinical diagnosis of the syndrome can be made when aniridia and one of the other features are present. It must be noted that while aniridia is rarely absent in WAGR syndrome, cases have been reported without it (Turleau, 1984; Fischbach, 2005). Other common eye defects include cataracts and ptosis. About 50% of patients develop Wilms tumor.

The child's chromosomes have to be analyzed to confirm the clinical diagnosis

[edit] See also

Denys-Drash syndrome

[edit] References

^ Miller RW, Fraumeni JF Jr, Manning MD (1964). "Association of wilms's tumor with aniridia, hemihypertrophy and other congenital malformations". N Engl J Med 270: 922-7. PMID 14114111

Clericuzio CL (2004). “WAGR syndrome”, Cassidy SB, Allanson JE: Management of Genetic Syndromes, 2nd edition, New York, NY: John Wiley & Sons. ISBN 0-471-30870-6.

Fischbach BV, Trout KL, Lewis J, Luis CA, Sika M (2005). "WAGR syndrome: a clinical review of 54 cases". Pediatrics 116 (4): 984-8. PMID 16199712.

Glaser T, Jepeal L, Edwards JG, Young SR, Favor J, Maas RL (1994). "PAX6 gene dosage effect in a family with congenital cataracts, aniridia, anophthalmia and central nervous system defects". Nat Genet 7 (4): 463-71. PMID 7951315.

Miller RW, Fraumeni JF Jr, Manning MD (1964). "Association of wilms's tumor with aniridia, hemihypertrophy and other congenital malformations". N Engl J Med 270: 922-7. PMID 14114111.

Mitchell TN, Free SL, Williamson KA, Stevens JM, Churchill AJ, Hanson IM, Shorvon SD, Moore AT, van Heyningen V, Sisodiya SM (2003). "Polymicrogyria and absence of pineal gland due to PAX6 mutation". Ann Neurol 53 (5): 658-63. PMID 12731001.

Talamillo A, Quinn JC, Collinson JM, Caric D, Price DJ, West JD, Hill RE (2003). "Pax6 regulates regional development and neuronal migration in the cerebral cortex". Dev Biol 255 (1): 151-63. PMID 12618140.

Turleau C, de Grouchy J, Nihoul-Fekete C, Dufier JL, Chavin-Colin F, Junien C (1984). "Del11p13/nephroblastoma without aniridia". Hum Genet 67 (4): 455-6. PMID 6092262.

Yasuda T, Kajimoto Y, Fujitani Y, Watada H, Yamamoto S, Watarai T, Umayahara Y, Matsuhisa M, Gorogawa S, Kuwayama Y, Tano Y, Yamasaki Y, Hori M (2002). "PAX6 mutation as a genetic factor common to aniridia and glucose intolerance". Diabetes 51 (1): 224-30. PMID 11756345.