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PEARSON SYNDROME

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Pearson syndrome is a mitochondrial disease characterized by sideroblastic anemia and exocrine pancreas dysfunction. Other clinical features are failure to thrive, pancreatic fibrosis with insulin-dependent diabetes and exocrine pancreatic deficiency, muscle and neurologic impairment, and, frequently, early death. It is usually fatal in infancy. The few patients who survive into adulthood often develop symptoms of Kearns-Sayre syndrome.

It is caused by a deletion in mitochondrial DNA. Pearson syndrome is very rare, less than hundred cases have been reported in medical literature worldwide.

The syndrome was first described by Pearson in 1979,[1] the deletions causing it were discovered a decade later.[2]

Background

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Pearson Syndrome is a very rare mitochondrial disorder that is characterized by health conditions such as sideroblastic anemia, liver disease, and exocrine pancreas deficiency[3]

History

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Pearson Syndrome was initially characterized in 1979 as a fatal disorder that affects infants. It has now been identified as a rare condition that affects multiple systems. The symptoms of Pearson Syndrome are mitochondrial cytopathy with anemia, neutropenia, and thrombocytopenia[4]

Mitochondrial Disease

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Pearson Syndrome is classified as a mitochondrial disease because it consists of several overlapping syndromes that are caused by mutations of mitochondrial DNA. Specifically, Pearson Syndrome is a combination of syndromes that involves the bone marrow and the exocrine pancreas[5]

Pearson Marrow-Pancreas Syndrome

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Pearson Marrow Pancreas Syndrome (PMPS) is a condition that presents itself with severe reticulocyto-penic anemia[6] With the pancreas not functioning properly, this leads to high levels of fats in the liver. PMPS can also lead ro diabetes and scarring of the pancreas[7]

Pathophysiology

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Defining Features of Pearson Syndrome

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1. Blood= With Pearson Syndrome, the bone marrow fails to produce white blood cells called neutrophils. The syndrome also leads to anemia, low platelet count, and aplastic anemia[8]

  •  
    Neutrophils

2. Pancreas= Pearson Syndrome causes the exocrine pancreas to not function properly because of scarring and atrophy[9] Individuals with this condition have difficulty absorbing nutrients from their diet which leads to malabsorption. infants with this condition generally do not grow or gain weight[10]

Genetics

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  •  
    Mitochondria


Pearson Syndrome is a mitochondrial disease caused by a deletion in mitochondrial DNA (mtDNA)[11]. An mtDNA is genetic material contained in the cellular organelle called the mitochondria. Depending on the tissue type, each cell contains hundreds to thousands of mitochondria. There are 2-10 mtDNA molecules in each mitochondrium [12]. With mitochondrial disorders caused by defects in the mtDNA, the severity of the disease depends on the number of mutant mtDNA molecules present in the cells.

Pearson syndrome consists of mtDNA deletions that differs in size and location compared to other mtDNA disorders such as chronic progressive opthalmoplegia (CPEO) and Kearns-Sayre syndrome (KSS). The deletions in these molecules are usually spontaneous and normally include one or more tRNA genes [13]. Pearson syndrome is transmitted by maternal inheritance. The father of an individual with Pearson Syndrome is not at risk for carrying the mtDNA mutation. The mother carries the trait, but does not have the mtDNA deletion in her tissues. Even though prenatal testing for Pearson Syndrome is theoretically possible, analyzing and interpreting the results would be extremely difficult [14].

With the use of molecular genetic testing, the deletions of mitochondrial DNA with Pearson syndrome ranges in size from 1.1 to 10 kilobases. A common mtDNA deletion associated with Pearson Syndrome is the deletion of 4977 bp. This deletion has been labeled as m.8470_13446del4977 [15]. Diagnosing Pearson Syndrome utilizes leukocyte DNA with the Southern Blot analysis. This type of mitochondrial DNA deletion are normally more abundant and easily isolated in the blood than in any other tissue type [16].


References

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  1. ^ Pearson HA; Lobel JS; Kocoshis SA; et al. (1979). "A new syndrome of refractory sideroblastic anemia with vacuolization of marrow precursors and exocrine pancreatic dysfunction". J. Pediatr. 95 (6): 976–84. doi:10.1016/S0022-3476(79)80286-3. PMID 501502. {{cite journal}}: Unknown parameter |author-separator= ignored (help)
  2. ^ Rotig A; Colonna M; Bonnefont JP; et al. (1989). "Mitochondrial DNA deletion in Pearson's marrow/pancreas syndrome". Lancet. 1 (8643): 902–3. doi:10.1016/S0140-6736(89)92897-3. PMID 2564980. {{cite journal}}: Unknown parameter |author-separator= ignored (help)
  3. ^ Agoropoulou, K., Roilides, E., Lazaridou, A., Karatza, E., Farmaki,E., Tsantali, H., Savvopoulou, P. &Tsiouris. (2007). Pearson Syndrome in an infant heterozygous for C282Y allele of HFE gene. Hematology, 12 (6). pgs 549-553
  4. ^ Rogers, Z. (2012). Pearson Syndrome. Medscape Reference. http://emedicine.medscape.com/article/957186
  5. ^ Rogers, Z. (2012). Pearson Syndrome. Medscape Reference. http://emedicine.medscape.com/article/957186
  6. ^ Agoropoulou, K., Roilides, E., Lazaridou, A., Karatza, E., Farmaki,E., Tsantali, H., Savvopoulou, P. &Tsiouris. (2007). Pearson Syndrome in an infant heterozygous for C282Y allele of HFE gene. Hematology, 12 (6). pgs 549-553
  7. ^ Pearson marrow-pancreas syndrome. (2013). http://ghr.nlm.gov/condition/pearson-marrow-pancreas-syndrome
  8. ^ Pearson Syndrome. http://marrowfailure.cancer.gov/PEARSON.html
  9. ^ Rogers, Z. (2012). Pearson Syndrome. Medscape Reference. http://emedicine.medscape.com/article/957186
  10. ^ Pearson marrow-pancreas syndrome. (2013). http://ghr.nlm.gov/condition/pearson-marrow-pancreas-syndrome
  11. ^ Agoropoulu, K., Roilides, E., Lazaridou, A., Karatza, E., Farmaki, E., Tsantali, H., Saccopoulou, P.& Tsioris, J (2007). Pearson Syndrome in an infant heterozygous for C282Y allele of HFE gene. Hematology, 12(6).
  12. ^ Agoropoulu, K., Roilides, E., Lazaridou, A., Karatza, E., Farmaki, E., Tsantali, H., Saccopoulou, P.& Tsioris, J (2007). Pearson Syndrome in an infant heterozygous for C282Y allele of HFE gene. Hematology, 12(6).
  13. ^ Sadikovic, B., Wang, J., El-Hattab, A., Landsverk, M., Douglas, G., Brundage, E., Craigen, W., Schmitt, E., &Wong, L. (2010). Sequence Homology at the Breakpoint and Clinical Phenotype of Mitochondrial DNA Deletion Syndromes. Molecular and Human Genetics, 5(12).
  14. ^ Ouweland, J., Klerk, J., Corput, M., Dirks, R., Raap, A., Scholte, H., Hujmans, J., Hart, L., Bruining, G., & Maassen, J. (2008). Characterization of a novel mitochondrial DNA deletion in a patient with a variant of the Pearson marrow-pancreas syndrome. European Journal of Human Genetics (2000)8, 195-203.
  15. ^ DiMauro, S., & Hirano, M. (2003). Mitochondrial DNA Deletion Syndromes. NCBI Bookshelf.
  16. ^ 4. DiMauro, S., & Hirano, M. (2003). Mitochondrial DNA Deletion Syndromes. NCBI Bookshelf.
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Category:Mitochondrial diseases Category:Rare diseases Category:Syndromes


 

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