eMedicine Specialties > Pediatrics: Genetics and Metabolic Disease > Metabolic Diseases
Mucopolysaccharidosis Type VII: Differential Diagnoses & Workup
Updated: Dec 5, 2008
- Overview
- Differential Diagnoses & Workup
- Treatment & Medication
- Follow-up
Differential Diagnoses
Mucopolysaccharidosis Type IH
Mucopolysaccharidosis Type II
Other Problems to Be Considered
Mucolipidoses
Oligosaccharidosis
Workup
Laboratory Studies
Disease-specific tests
- Granulocytes studies reveal the presence of coarse metachromatic inclusions in patients with mucopolysaccharidosis type VII (MPS VII).
- Mucopolysacchariduria or increased levels of urinary glycosaminoglycan (either chondroitin sulfate (CS) alone or dermatan sulfate (DS), heparan sulfate (HS), and CS combined) is observed.
- Diagnosis is confirmed by demonstration of beta-D-glucuronidase deficiency in cultured leucocytes or fibroblasts. Pseudodeficient alleles make mild forms more difficult to identify and make prenatal diagnosis difficult.
- Molecular analysis of the GUSB gene may be performed.
Prenatal diagnosis
- Prenatal diagnosis for the enzyme deficiency may also be offered to parents with an affected child using the following methods:
- Enzyme assay of amniotic fluid
- Molecular analysis amniotic cells and chorionic villi cells
Imaging Studies
- The skeletal features of the disorder become evident in the first few years of life. In many patients, radiographic studies may reveal J -shaped turcica and odontoid hypoplasia, dysostosis multiplex, dislocated hips, platyspondyly (flattening of the vertebral bodies), and thoracolumbar kyphoscoliosis.
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Differential Diagnoses & Workup: Mucopolysaccharidosis Type VII |
| Treatment & Medication: Mucopolysaccharidosis Type VII |
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References
Nelson J. Incidence of the mucopolysaccharidoses in Northern Ireland. Hum Genet. Dec 1997;101(3):355-8. [Medline].
Wallace SP, Prutting CA, Gerber SE. Degeneration of speech, language, and hearing in a patient with mucopolysaccharidosis VII. Int J Pediatr Otorhinolaryngol. Jun 1990;19(2):97-107. [Medline].
Sly WS, Vogler C. Gene therapy for lysosomal storage disease: a no-brainer? Transplants of fibroblasts secreting high levels of beta-glucuronidase decrease lesions in the brains of mice with Sly syndrome, a lysosomal storage disease. Nat Med. Jul 1997;3(7):719-20. [Medline].
Vellodi A, Young EP, Cooper A, et al. Bone marrow transplantation for mucopolysaccharidosis type I: experience of two British centres. Arch Dis Child. Feb 1997;76(2):92-9. [Medline].
Emory AE, Rimoin DL, Connor JM, Pyeritz RE, eds. Emery and Rimoin's Principles and Practice of Medical Genetics. 3rd ed. Pearson Professional; 1996:2077-8.
McKusick VA. Gene 253220. In: Mendelian Inheritance in Man: A Catalog of Human Genes and Genetic Disorders. Vol 3. Johns Hopkins University Press; 1998.
Meikle PJ, Hopwood JJ, Clague AE, Carey WF. Prevalence of lysosomal storage disorders. JAMA. Jan 20 1999;281(3):249-54. [Medline].
Neufeld E, Muenzer J. The Mucopolysaccharidoses. In: Scriver C, Beaudet A, Sly W, Valle D, eds. The Metabolic and Molecular Bases of Inherited Disease. New York, NY: McGraw Hill; 2001:3421-52.
Peters C, Shapiro EG, Anderson J, et al. Hurler syndrome: II. Outcome of HLA-genotypically identical sibling and HLA-haploidentical related donor bone marrow transplantation in fifty-four children. The Storage Disease Collaborative Study Group. Blood. Apr 1 1998;91(7):2601-8. [Medline].
Wasant P, Wattanaweeradej S, Raksadawan N, Kolodny EH. Lysosomal storage disorders in Thailand: the Siriraj experience. Southeast Asian J Trop Med Public Health. 1995;26 Suppl 1:54-8. [Medline].
Whitley CB, Belani KG, Chang PN, Summers CG, Blazar BR, Tsai MY. Long-term outcome of Hurler syndrome following bone marrow transplantation. Am J Med Genet. Apr 15 1993;46(2):209-18. [Medline].
Nampoothiri S, Kappanayil M, Hiran KR, Sunitha V. Sly Disease Mucopolysaccharidosis Type VII. Indian Pediatr. Oct 2008;45(10):859-61. [Medline].
Further Reading
Keywords
mucopolysaccharidosis type VII, MPS VII, Sly syndrome, beta-glucuronidase deficiency, Hunter syndrome, hydrops fetalis, upper respiratory tract infections, macrocephaly, hepatomegaly, hepatosplenomegaly, inguinal hernia, umbilical hernia, growth retardation, neonatal cholestasis, ascites, short stature, dwarfism, hearing loss, hirsutism, chronic inflammatory lung disease
Differential Diagnoses & Workup: Mucopolysaccharidosis Type VII