Gardner's syndrome

(Redirected from Gardner syndrome)
Jump to: navigation, search
Gardner's syndrome
Gardner1.jpg
OMIM 175100
DiseasesDB 5094
MedlinePlus 000266
eMedicine med/2712  derm/163
MeSH D005736

WikiDoc Resources for Gardner's syndrome

Articles

Most recent articles on Gardner's syndrome

Most cited articles on Gardner's syndrome

Review articles on Gardner's syndrome

Articles on Gardner's syndrome in N Eng J Med, Lancet, BMJ

Media

Powerpoint slides on Gardner's syndrome

Images of Gardner's syndrome

Photos of Gardner's syndrome

Podcasts & MP3s on Gardner's syndrome

Videos on Gardner's syndrome

Evidence Based Medicine

Cochrane Collaboration on Gardner's syndrome

Bandolier on Gardner's syndrome

TRIP on Gardner's syndrome

Clinical Trials

Ongoing Trials on Gardner's syndrome at Clinical Trials.gov

Trial results on Gardner's syndrome

Clinical Trials on Gardner's syndrome at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Gardner's syndrome

NICE Guidance on Gardner's syndrome

NHS PRODIGY Guidance

FDA on Gardner's syndrome

CDC on Gardner's syndrome

Books

Books on Gardner's syndrome

News

Gardner's syndrome in the news

Be alerted to news on Gardner's syndrome

News trends on Gardner's syndrome

Commentary

Blogs on Gardner's syndrome

Definitions

Definitions of Gardner's syndrome

Patient Resources / Community

Patient resources on Gardner's syndrome

Discussion groups on Gardner's syndrome

Patient Handouts on Gardner's syndrome

Directions to Hospitals Treating Gardner's syndrome

Risk calculators and risk factors for Gardner's syndrome

Healthcare Provider Resources

Symptoms of Gardner's syndrome

Causes & Risk Factors for Gardner's syndrome

Diagnostic studies for Gardner's syndrome

Treatment of Gardner's syndrome

Continuing Medical Education (CME)

CME Programs on Gardner's syndrome

International

Gardner's syndrome en Espanol

Gardner's syndrome en Francais

Business

Gardner's syndrome in the Marketplace

Patents on Gardner's syndrome

Experimental / Informatics

List of terms related to Gardner's syndrome


Gardner's syndrome is a genetic disorder characterized by the presence of multiple polyps in the colon together with tumors outside the colon. The extracolonic tumors may include osteomas of the skull, thyroid cancer, epidermoid cysts, fibromas and sebaceous cysts. The countless polyps in the colon predispose to the development of colon cancer.

Inheritance

Gardner's syndrome has an autosomal dominant pattern of inheritance.

Gardner's syndrome is inherited in an autosomal dominant manner. Typically, one parent has Gardner's syndrome. Each of their children, male and female alike, are at 50% risk of inheriting the gene for Gardner's syndrome and manifesting it.

Diagnosis

Gardner's syndrome can be identified based on oral findings, including multiple impacted and supernumerary teeth, multiple jaw osteomas which give a "cotton-wool" appearance to the jaws, as well as multiple odontomas, congenital hypertrophy of the retinal pigment epithelium (CHRPE), in addition to multiple adenomatous polyps of the colon.

Eponym

The syndrome is named for Eldon J. Gardner (1909-1989), a college teacher of genetics, who first described it in 1951.[1] Gardner had been introduced to a large Utah family with the syndrome by a premedical student in his course in genetics.

Genetics

Gardner's syndrome is now known to be caused by mutation in the APC gene located in chromosome 5q21 (band q21 on chromosome 5). This is the same gene as is mutant in familial adenomatous polyposis (FAP), a more common disease that also predisposes to colon cancer.

New genetic and molecular information has caused some genetic disorders to be split into multiple entities while other genetic disorders merge into one condition. After existing for most of the second half of the 20th century, Gardner's syndrome has vanished as a separate entity. It has been merged into familial adenomatous polyposis (FAP) and is now considered simply a phenotypic variant of FAP.

DIfferentiating Gardner's syndrome from other diseases

Disease Gene Chromosome Differentiating Features Components of MEN Diagnosis
Parathyroid Pitutary Pancreas
von Hippel-Lindau syndrome Von Hippel–Lindau tumor suppressor 3p25.3
  • Angiomatosis, 
  • Hemangioblastomas,
  • Pheochromocytoma, 
  • Renal cell carcinoma,
  • Pancreatic cysts (pancreatic serous cystadenoma)
  • Endolymphatic sac tumor,
  • Bilateral papillary cystadenomas of the epididymis (men) or broad ligament of the uterus (women)
- - +
  • Clinical diagnosis
  • In hereditary VHL, disease techniques such as Southern blotting and gene sequencing can be used to analyse DNA and identify mutations.
Carney complex  PRKAR1A 17q23-q24
  • Myxomas of the heart
  • Hyperpigmentation of the skin (lentiginosis)
  • Endocrine (ACTH-independent Cushing's syndrome due to primary pigmented nodular adrenocortical disease)
- - -
  • Clinical diagnosis
Neurofibromatosis type 1 RAS 17 - - - Prenatal
  • Chorionic villus sampling or amniocentesis can be used to detect NF-1 in the fetus.

Postnatal Cardinal Clinical Features" are required for positive diagnosis.

  • Six or more café-au-lait spots over 5 mm in greatest diameter in pre-pubertal individuals and over 15 mm in greatest diameter in post-pubertal individuals.
  • Two or more neurofibromas of any type or 1 plexiform neurofibroma
  • Freckling in the axillary (Crowe sign) or inguinal regions
  • Optic glioma
  • Two or more Lisch nodules (pigmented iris hamartomas)
  • A distinctive osseous lesion such as sphenoid dysplasia, or thinning of the long bone cortex with or without pseudarthrosis.
Li-Fraumeni syndrome TP53 17 Early onset of diverse amount of cancers such as - - -

Criteria

  • Sarcoma at a young age (below 45)
  • A first-degree relative diagnosed with any cancer at a young age (below 45)
  • A first or second degree relative with any cancer diagnosed before age 60.
Gardner's syndrome APC  5q21
  • Multiple polyps in the colon 
  • Osteomas of the skull
  • Thyroid cancer,
  • Epidermoid cysts,
  • Fibromas
  • Desmoid tumors
- - -
  • Clinical diagnosis
  • Colonoscopy
Multiple endocrine neoplasia type 2 RET - + - -

Criteria Two or more specific endocrine tumors

Cowden syndrome PTEN -  Hamartomas - - -
  • PTEN mutation probability risk calculator
Acromegaly/gigantism - - - + -
Pituitary adenoma - - - + -
Hyperparathyroidism - - - + - -
  • An elevated concentration of serum calcium with elevated parathyroid hormone level is diagnostic of primary hyperparathyroidism.
  • Most consistent laboratory findings associated with the diagnosis of secondary hyperparathyroidism include elevated serum parathyroid hormone level and low to normal serum calcium.
  • An elevated concentration of serum calcium with elevated parathyroid hormone level in post renal transplant patients is diagnostic of tertiary hyperparathyoidism.
Pheochromocytoma/paraganglioma

VHL RET NF1   SDHB  SDHD

- Characterized by - - -
  • Increased catecholamines and metanephrines in plasma (blood) or through a 24-hour urine collection.
Adrenocortical carcinoma
  • p53
  • Retinoblastoma h19
  • Insulin-like growth factor II (IGF-II)
  • p57kip2
17p, 13q  - - -
  • Increased serum glucose
  • Increased urine cortisol
  • Serum androstenedione and dehydroepiandrosterone
  • Low serum potassium
  • Low plasma renin activity
  • High serum aldosterone.
  • Excess serum estrogen.
Adapted from Toledo SP, Lourenço DM, Toledo RA. A differential diagnosis of inherited endocrine tumors and their tumor counterparts, journal=Clinics (Sao Paulo), volume= 68, issue= 7, 07/24/2013[2]

References

  1. Gardner EJ (1951). "A genetic and clinical study of intestinal polyposis, a predisposing factor for carcinoma of the colon and rectum". Am J Hum Genet. 3: 167–76. PMC 1716321. PMID 14902760.
  2. Toledo SP, Lourenço DM, Toledo RA (2013). "A differential diagnosis of inherited endocrine tumors and their tumor counterparts". Clinics (Sao Paulo). 68 (7): 1039–56. doi:10.6061/clinics/2013(07)24. PMC 3715026. PMID 23917672.

External Links

de:Gardner-Syndrom it:Sindrome di Gardner



Linked-in.jpg