Wikipedia - Stickler Syndrome
General explanation
Stickler
syndrome (hereditary progressive arthro-ophthalmopathy) is a group of genetic
disorders affecting connective tissue, specifically collagen. Stickler syndrome
is a subtype of collagenopathy, types II and XI. Stickler syndrome is
characterized by distinctive facial abnormalities, ocular problems, hearing
loss, and joint problems. It was first studied and characterized by Gunnar B.
Stickler in 1965.
Symptoms
Individuals with Stickler syndrome experience a
range of signs and symptoms. Some people have no signs and symptoms; others
have some or all of the features described below. In addition, each feature of
this syndrome may vary from subtle to severe.
A characteristic feature of Stickler syndrome is
a somewhat flattened facial appearance. This is caused by underdeveloped bones
in the middle of the face, including the cheekbones and the bridge of the nose.
A particular group of physical features, called the Pierre Robin
sequence, is common in children with Stickler syndrome.
Robin sequence includes a U-shaped or sometimes V-shaped cleft palate (an opening in the roof of the mouth) with a tongue that is too large for the
space formed by the small lower jaw. Children with a cleft palate are also
prone to ear infections and occasionally swallowing difficulties. Many people with Stickler
syndrome are very nearsighted (described as having high myopia) because of the shape of the
eye. People with eye involvement are prone to increased pressure within the eye
(ocular hypertension) which could lead to glaucoma and tearing or detachment of
the light-sensitive retina of the eye (retinal detachment). Cataract may also present as an ocular complication associated with Stickler's
Syndrome. The jelly-like substance within the eye (the vitreous humour) has a distinctive appearance in the types of Stickler syndrome
associated with the COL2A1 and COL11A1 genes. As a result regular
appointments to a specialist ophthalmologist are advised. The type of Stickler
syndrome associated with the COL11A2 gene does not affect the
eye.People with this syndrome have problems that affect things other than the
eyes and ears. Arthritis, abnormality to ends of long bones, vertebrae
abnormality, curvature of the spine, scoliosis, joint pain, and double
jointedness are all problems that can occur in the bones and joints. Physical
characteristics of people with Stickler can include flat cheeks, flat nasal
bridge, small upper jaw, pronounced upper lip groove, small lower jaw, and
palate abnormalities, these tend to lessen with age and normal growth and
palate abnormalities can be treated with routine surgery.
Another sign of Stickler syndrome is mild to
severe hearing loss that, for some people, may be progressive (see hearing loss with craniofacial syndromes). The joints of affected children and young adults may be very flexible
(hypermobile). Arthritis often appears at an early age and worsens as a person gets older.
Learning difficulties, not intelligence, can also occur because of hearing and
sight impairments if the school is not informed and the student is not assisted
within the learning environment. Stickler syndrome is thought to be associated
with an increased incidence of mitral valve prolapse of the heart, although no
definitive research supports this.
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