eMedicine Specialties > Neurology > Pediatric Neurology
Lesch-Nyhan Syndrome: Follow-up
Updated: Dec 15, 2008
Follow-up
Further Inpatient Care
- Inpatient admissions should be limited to those absolutely necessary for medical interventions, since moving these patients into an unfamiliar environment will exacerbate behavioral problems such as self-injury.
- Restraints should be applied at all times to prevent self-injury; this includes nighttime sleeping periods and also during transfer for any tests. This disease is one of a few rare conditions that are exempted from the usual regulations of the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) against continuous and long-term patient restraints.
Deterrence/Prevention
- Since few reliable treatments are available for the condition, genetic counseling is critical for prevention. Mothers and sisters of patients should be tested to determine if they are carriers.
- Prenatal testing should be offered to all pregnant women known to be carriers. Because of the rare potential for gonadal mosaicism, prenatal testing should also be offered to mothers who have previously given birth to an affected individual, even if she does not appear to be a carrier.
Prognosis
- With optimal medical care, affected individuals typically live into their third or even fourth decade of life.
- Many die from aspiration pneumonia or complications from chronic nephrolithiasis and renal failure; however, a significant proportion of patients die suddenly and unexpectedly from unknown causes.
More on Lesch-Nyhan Syndrome |
| Overview: Lesch-Nyhan Syndrome |
| Differential Diagnoses & Workup: Lesch-Nyhan Syndrome |
| Treatment & Medication: Lesch-Nyhan Syndrome |
Follow-up: Lesch-Nyhan Syndrome |
| Multimedia: Lesch-Nyhan Syndrome |
| References |
| « Previous Page | Next Page » |
References
Alford RL, Redman JB, O'Brien WE, et al. Lesch-Nyhan syndrome: carrier and prenatal diagnosis. Prenat Diagn. Apr 1995;15(4):329-38. [Medline].
Jinnah HA, Friedmann T. Lesch-Nyhan disease and its variants. In: Scriver CR, Sly WS, Childs B, Beaudet AL, et al, eds. The Molecular and Metabolic Bases of Inherited Disease. 6th ed. New York, NY: McGraw-Hill; 2000:Chapter 107.
Jinnah HA, De Gregorio L, Harris JC, et al. The spectrum of inherited mutations causing HPRT deficiency: 75 new cases and a review of 196 previously reported cases. Mutat Res. Oct 2000;463(3):309-26. [Medline].
Jinnah HA, Visser JE, Harris JC, et al. Delineation of the motor disorder of Lesch-Nyhan disease. Brain. May 2006;129(Pt 5):1201-17. [Medline].
Lesch M, Nyhan WL. A familial disorder of uric acid metabolism and central nervous system function. Am J Med. Apr 1964;36:561-70. [Medline].
Nyhan WL, Vuong LU, Broock R. Prenatal diagnosis of Lesch-Nyhan disease. Prenat Diagn. Oct 2003;23(10):807-9. [Medline].
Visser JE, Bar PR, Jinnah HA. Lesch-Nyhan disease and the basal ganglia. Brain Res Brain Res Rev. Apr 2000;32(2-3):449-75. [Medline].
Further Reading
Keywords
HPRT deficiency, hypoxanthine-guanine phosphoribosyl transferase, Kelley-Seegmiller syndrome, Lesch-Nyhan disease, overproduction of uric acid, neurologic disability, behavioral problems, hyperuricemia, nephrolithiasis with renal failure, gouty arthritis, tophi, dystonia, choreoathetosis, ballismus, spasticity, hyperreflexia, cognitive dysfunction, aggressive behaviors, impulsive behaviors, self-injurious behavior
Follow-up: Lesch-Nyhan Syndrome