Department of Pediatrics, Lilavati Hospital and Research Center, Mumbai, India.
Indian J Pediatr. 2012 May;79(5):650-4. doi: 10.1007/s12098-011-0618-3. Epub 2012 Jan 10.
Kearns-Sayre Syndrome is form of rare mitochondrial cytopathy, first described by Thomas P. Kearns and George Pomeroy Sayre in 1958 and is characterized by progressive external opthalmoplegia, cardiac conduction block, pigmentary retinal degeneration, variable number of red ragged fibers on muscle biopsy. It presents before the child reaches the age of twenty. Kearns-Sayre syndrome may affect many organ systems and additional features may include myopathy, dystonia, bulbar symptoms in the form of dysarthria and nasal regurgitation and bilateral facial weakness. Endocrine abnormalities (e.g., diabetes, growth retardation/short stature, and hypoparathyroidism), bilateral sensorineural deafness, dementia, cataracts, and proximal renal tubular acidosis, skeletal muscle weakness (proximal more than distal) and exercise intolerance are additional features. Kearns Sayre Syndrome occurs as a result of large-scale single deletions (or rearrangements) of mitochondrial DNA (mtDNA), which is usually not inherited but occurs spontaneously, probably at the germ-cell level or very early in embryonic development. No disease-modifying therapy is available for Kearns-Sayre syndrome (KSS). Management is supportive vigilance for detection of associated problems. In the future, potential treatment in patients with Kearns-Sayre syndrome may attempt to inhibit mutant mtDNA replication or encourage replication of wild-type mtDNA.
肌阵挛性癫痫伴破碎红纤维病是一种罕见的线粒体细胞病,由托马斯·P·卡恩斯(Thomas P. Kearns)和乔治·波默罗伊·赛雷(George Pomeroy Sayre)于 1958 年首次描述,其特征是进行性眼外肌麻痹、心脏传导阻滞、色素性视网膜变性、肌肉活检时可见数量不定的破碎红纤维。该病在儿童 20 岁之前发病。肌阵挛性癫痫伴破碎红纤维病可能影响多个器官系统,其他特征可能包括肌病、肌张力障碍、构音障碍和鼻音反流等球部症状以及双侧面部无力。内分泌异常(如糖尿病、生长迟缓/身材矮小和甲状旁腺功能减退症)、双侧感觉神经性耳聋、痴呆、白内障和近端肾小管酸中毒、骨骼肌无力(近端比远端更严重)和运动不耐受也是其特征。肌阵挛性癫痫伴破碎红纤维病是由于线粒体 DNA(mtDNA)的大规模单缺失(或重排)引起的,这种缺失通常不是遗传的,而是自发发生的,可能发生在生殖细胞水平或胚胎发育早期。目前尚无针对肌阵挛性癫痫伴破碎红纤维病的治疗方法。治疗主要是支持性监测,以发现相关问题。在未来,肌阵挛性癫痫伴破碎红纤维病患者的潜在治疗方法可能试图抑制突变型 mtDNA 的复制或鼓励野生型 mtDNA 的复制。