Filson Meghan J, Davis Dakota C, Yother Claire
Medicine, Edward Via College of Osteopathic Medicine, Auburn, USA.
Medicine, Alabama College of Osteopathic Medicine, Dothan, USA.
Cureus. 2023 Aug 22;15(8):e43934. doi: 10.7759/cureus.43934. eCollection 2023 Aug.
is a genetically inherited condition characterized by congenital sensorineural hearing loss and progressive vision loss secondary to retinitis pigmentosa. Patients may also display vestibular areflexia and balance issues secondary to inner ear damage. Usher Syndrome is the most commonly diagnosed syndrome within the blind-deaf community, and it accounts for a significant portion of the hearing and visual deficit cases among patients younger than 65 years of age. Due to the reported prevalence of Usher Syndrome in the United States, it appears there is chronic underdiagnosis in clinical settings throughout the country. A possible explanation for this is the visual deficits of Usher syndrome do not appear until later in life and thus inappropriately lower the index of suspicion for this diagnosis in young children with hearing deficits. This case study highlights a healthy newborn who failed the universal newborn hearing screening (UNHS) bilaterally and a follow-up hearing screening in a pediatrician's office. Auditory brainstem response (ABR) later confirmed bilateral severe-to-profound sensorineural hearing loss. Upon genetic testing, an abnormality in the Unconventional Myosin VII-A (MYO7) gene was discovered and consistent with Usher syndrome Type 1B (USH1B). Usher Syndrome should be considered on the differential for patients with congenital hearing loss. Genetic counseling should be used if no other cause of sensorineural hearing loss is identified. Due to the progressive nature of this condition and the physical and developmental deficits that will transpire without treatment, a genetic panel for hearing loss should be prioritized to determine the presence of genetic mutations suggesting Usher syndrome.
是一种遗传性疾病,其特征为先天性感音神经性听力损失,以及继发于色素性视网膜炎的进行性视力丧失。患者还可能出现继发于内耳损伤的前庭反射消失和平衡问题。Usher综合征是在聋哑人群体中最常被诊断出的综合征,在65岁以下患者的听力和视力缺陷病例中占很大比例。由于美国报道的Usher综合征患病率,该国临床环境中似乎存在长期诊断不足的情况。对此的一个可能解释是,Usher综合征的视力缺陷直到晚年才出现,因此不恰当地降低了对有听力缺陷幼儿进行该诊断的怀疑指数。本病例研究重点介绍了一名健康新生儿,其双侧新生儿听力普遍筛查(UNHS)未通过,在儿科医生办公室进行的后续听力筛查也未通过。听觉脑干反应(ABR)后来证实双侧严重至极重度感音神经性听力损失。基因检测发现非传统肌球蛋白VII - A(MYO7)基因异常,与1B型Usher综合征(USH1B)一致。对于先天性听力损失患者,鉴别诊断时应考虑Usher综合征。如果未发现其他感音神经性听力损失原因,应进行遗传咨询。由于这种疾病的进行性本质以及未经治疗将会出现的身体和发育缺陷,应优先进行听力损失基因检测,以确定是否存在提示Usher综合征的基因突变。