RT Journal Article
T1 Clinical manifestations in female carriers of mucopolysaccharidosis type II: a spanish cross-sectional study
A1 Guillén Navarro, Encarnación
A1 Domingo Jiménez, María Rosario
A1 Alcalde Martín, Carlos
A1 Cancho Candela, Ramón
A1 Couce Pico, María Luz
A1 Galán Gómez, Enrique
A1 Alonso Luengo, Olga
K1 Hunter syndrome
K1 Mucopolysaccharidosis type II
K1 Carriers
K1 Heterozygotes
K1 X- inactivation
K1 Iduronate 2-sulfatase
K1 Glycosaminoglycans
AB Background: Mucopolysaccharidosis type II (MPS II) is an inherited X-linked disease associated with a deficiency in the enzyme iduronate 2-sulfatase due to iduronate 2-sulfatase gene (IDS) mutations. Recent studies in MPS II carriers did not find clinical involvement, but these were mainly performed by anamnesis and patients’ self-reported description of signs and symptoms. So although it is rare in heterozygous carriers, investigations in other types of inherited X-linked disorders suggest that some clinical manifestations may be a possibility. The aim of this study was to evaluate the clinical pattern in female carriers of MPS II and to determine whether clinical symptoms were associated with the X-chromosome inactivation (XCI) pattern and age.Methods: Female carriers of MPS II were genetically identified by molecular analysis of IDS. The clinical evaluation protocol included pedigree analysis, a comprehensive anamnesis, complete physical examination, ophthalmological evaluation, brain-evoked auditory response, electrocardiogram, echocardiogram, pulmonary function tests, abdominal sonogram, skeletal survey, neurophysiological studies, blood cell counts and biochemistry, urine glycosaminoglycan (GAGs) quantification, karyotype and pattern of XCI.Results: Ten women were included in the study. The mean age of the participants was 40.2 ± 13.1 years. Six carriers presented a skewed XCI pattern, 3 of whom (aged 38, 42 and 52 years) had increased levels of GAGs in the urine and showed typical MPS II clinical manifestations, such as skeletal anomalies, liver abnormalities, carpal tunnel syndrome, recurrent ear infection, hypoacusia and more frequent severe odontological problems without coarse facial features.Conclusions: This is the first study performing a comprehensive evaluation of heterozygous MPS II carriers. Our results provide evidence of possible progressive, age-dependent, mild clinical manifestations in MPS II female carriers with a skewed XCI pattern, most likely affecting the normal allele. Further comparative studies with systematized clinical examinations in larger age-stratified populations of MPS II female carriers are required.
PB BioMed Central
YR 2013
FD 2013
LK http://hdl.handle.net/10347/21601
UL http://hdl.handle.net/10347/21601
LA eng
NO Guillén-Navarro, E., Domingo-Jiménez, M.R., Alcalde-Martín, C. et al. Clinical manifestations in female carriers of mucopolysaccharidosis type II: a spanish cross-sectional study. "Orphanet J Rare Dis" 8, 92 (2013)
DS Minerva
RD 28 abr 2026