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Wu J, Pan S, Lin W, Wen J, Lu R, Chen G. The identification of a novel mutation (p.I223fs) in WRN associated with Werner syndrome. Endocrine 2024; 84:92-96. [PMID: 37856055 DOI: 10.1007/s12020-023-03565-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 10/04/2023] [Indexed: 10/20/2023]
Abstract
PURPOSE Werner syndrome (WS) is a rare autosomal recessive genetic disease caused by mutations in the WRN gene, and it is characterized by multiple manifestations corresponding to early-onset aging. This study reports the case of a WS patient with a novel WRN mutation. PATIENT AND METHODS A 36-year-old male patient with WS was evaluated after approval from the local ethics committee. The clinical and biochemical findings of the patient were described. Peripheral blood sample was collected to extract genomic DNA for WRN gene exome sequencing. The three-dimensional (3D) protein structural prediction analysis was performed via the AlphaFold 2.2 program and PyMol software. RESULTS We report the case of a clinically diagnosed WS patient with consanguineous parents who presented with complex manifestations including early-onset diabetes mellitus, binocular cataracts, cerebral infarction, cerebral atherosclerosis, hypertension, dyslipidemia, hypothyroidism, and suspected meningioma, accompanied by short stature, gray hair, rough skin with subcutaneous fat atrophy, a high-pitched voice, palmoplantar keratoderma, bilateral flat feet, and an indolent deep ulceration on the foot. Exome sequencing identified a novel homozygous frameshift mutation in the WRN gene, c.666-669 del TATT, p.I223fs. The 3D structure prediction showed that premature termination and significant structural changes could occur in the mutant WRN protein. CONCLUSION We identified a novel homozygous frameshift mutation, p.I223fs, in WRN in a Chinese patient with WS, expanding the spectrum of mutations in WS.
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Affiliation(s)
- Jushuang Wu
- Fujian Academy of Medical Sciences, Fuzhou, 350001, Fujian, China
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, 350001, Fujian, China
| | - Shuyao Pan
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, 350001, Fujian, China
| | - Wei Lin
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, 350001, Fujian, China
- Department of Endocrinology, Fujian Provincial Hospital, Fuzhou, 350001, Fujian, China
| | - Junping Wen
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, 350001, Fujian, China
- Department of Endocrinology, Fujian Provincial Hospital, Fuzhou, 350001, Fujian, China
| | - Rongmei Lu
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, 350001, Fujian, China.
- Department of Endocrinology, Fujian Provincial Hospital, Fuzhou, 350001, Fujian, China.
| | - Gang Chen
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, 350001, Fujian, China.
- Department of Endocrinology, Fujian Provincial Hospital, Fuzhou, 350001, Fujian, China.
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Nishino A, Adachi A, Koshizaka M, Maezawa Y, Yokote K, Sawada Y. Case of Werner syndrome complicated with Sjögren's syndrome and Hashimoto's thyroiditis presenting sclerosing panniculitis-like symptoms. Geriatr Gerontol Int 2024; 24:173-174. [PMID: 38009428 DOI: 10.1111/ggi.14747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 10/18/2023] [Accepted: 11/10/2023] [Indexed: 11/28/2023]
Affiliation(s)
- Atsuna Nishino
- Department of Dermatology, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan
| | - Akimasa Adachi
- Department of Dermatology, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan
| | - Masaya Koshizaka
- Department of Endocrinology, Hematology and Gerontology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Yoshiro Maezawa
- Department of Endocrinology, Hematology and Gerontology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Kotaro Yokote
- Department of Endocrinology, Hematology and Gerontology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Yasuyuki Sawada
- Department of Dermatology, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan
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Sugawara E, Shibata Y, Katsumata K. Werner syndrome associated with poorly differentiated thyroid carcinoma and systemic sclerosis-like skin manifestations: A case report. Mod Rheumatol Case Rep 2023; 8:95-100. [PMID: 37417454 DOI: 10.1093/mrcr/rxad039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 06/27/2023] [Accepted: 07/04/2023] [Indexed: 07/08/2023]
Abstract
Werner syndrome (WS) is an autosomal recessive disorder characterised by premature ageing. WS patients often experience scleroderma-like manifestation including skin sclerosis and skin ulcer, making it difficult to differentiate WS from systemic sclerosis (SSc). Moreover, there is a high incidence of malignancy and arteriosclerosis-related disease in WS patients. We herein describe a 36-year-old woman with WS who had poorly differentiated thyroid carcinoma, one of the rare phenotypes of thyroid tumour. This case suggested the importance to distinguish WS from SSc and early diagnosis of malignancy.
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Affiliation(s)
- Eri Sugawara
- Department of Rheumatology, Tonan Hospital, Sapporo, Japan
| | - Yuhei Shibata
- Department of Rheumatology, Tonan Hospital, Sapporo, Japan
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Santos MM, Baerga CG, Lamsal S, Engel C, Ozdemir S. Breast cancer in a Hispanic patient with Werner syndrome. J Radiol Case Rep 2023; 17:21-31. [PMID: 38343885 PMCID: PMC10852053 DOI: 10.3941/jrcr.v17i8.5168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024] Open
Abstract
Werner Syndrome is a rare autosomal recessive condition characterized by premature aging and increased risk of malignancies due to gene mutations associated with DNA stability. We present the first case report of a 29-year-old Hispanic female with WS diagnosed with breast cancer. Diagnostic mammography and ultrasound, breast MRI and PET examinations revealed two lesions biopsy proven as invasive ductal carcinoma. The patient underwent neoadjuvant chemotherapy and radical mastectomy. Recurrence occurred 10 months postoperatively with molecular analysis demonstrating TP53 mutations. The multifactorial assessment of breast cancer in this case study is crucial towards optimizing screening, diagnosis and management of this disease in patients with WS.
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Affiliation(s)
| | | | - Sanjay Lamsal
- Department of Diagnostic Radiology, University of Florida Jacksonville, FL 32209, USA
| | - Corey Engel
- Department of Diagnostic Radiology, University of Florida Jacksonville, FL 32209, USA
| | - Savas Ozdemir
- Department of Diagnostic Radiology, University of Florida Jacksonville, FL 32209, USA
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Sumiyoshi R, Morita H, Kusadokoro S, Fujii K, Kawaura H, Aoki M, Nagano H. A Patient with Werner's Syndrome Who Underwent Aortic Valve Replacement through Minimally Invasive Cardiac Surgery. Ann Thorac Cardiovasc Surg 2023; 29:210-213. [PMID: 35264497 PMCID: PMC10466116 DOI: 10.5761/atcs.cr.21-00214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 01/29/2022] [Indexed: 11/16/2022] Open
Abstract
Werner's syndrome (WS) is a genetic disorder presenting with premature senility. In the present study, we performed minimally invasive cardiac surgery (MICS)-aortic valve replacement (AVR) on a patient with Werner's syndrome who presented with aortic stenosis. The patient, a 49-year-old Japanese man, was brought to the emergency room with dyspnea during exercise. On echocardiography, severe aortic stenosis was found and surgery was planned. He had poorly controlled diabetes mellitus and underwent MICS-AVR to avoid the risk of sternal osteomyelitis, which resulted in a good outcome. The aortic valve had sclerotic changes and a genetic disease was suspected based on the onset of aortic stenosis at a young age, characteristic appearance, and various signs of aging. Genetic testing led to the diagnosis of WS.
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Affiliation(s)
- Riki Sumiyoshi
- Department of Cardiovascular Surgery, Saitama Red Cross Hospital, Saitama, Saitama, Japan
| | - Hideki Morita
- Department of Cardiovascular Surgery, Saitama Red Cross Hospital, Saitama, Saitama, Japan
| | - Sho Kusadokoro
- Department of Cardiovascular Surgery, Saitama Red Cross Hospital, Saitama, Saitama, Japan
| | - Kento Fujii
- Department of Cardiovascular Surgery, Saitama Red Cross Hospital, Saitama, Saitama, Japan
| | - Hiroyuki Kawaura
- Department of Cardiovascular Surgery, Saitama Red Cross Hospital, Saitama, Saitama, Japan
| | - Masakazu Aoki
- Department of Cardiovascular Surgery, Saitama Red Cross Hospital, Saitama, Saitama, Japan
| | - Hiroshi Nagano
- Department of Cardiovascular Surgery, Saitama Red Cross Hospital, Saitama, Saitama, Japan
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Maeda Y, Koshizaka M, Shoji M, Kaneko H, Kato H, Maezawa Y, Kawashima J, Yoshinaga K, Ishikawa M, Sekiguchi A, Motegi SI, Nakagami H, Yamada Y, Tsukamoto S, Taniguchi A, Sugimoto K, Takami Y, Shoda Y, Hashimoto K, Yoshimura T, Kogure A, Suzuki D, Okubo N, Yoshida T, Watanabe K, Kuzuya M, Takemoto M, Oshima J, Yokote K. Renal dysfunction, malignant neoplasms, atherosclerotic cardiovascular diseases, and sarcopenia as key outcomes observed in a three-year follow-up study using the Werner Syndrome Registry. Aging (Albany NY) 2023; 15:3273-3294. [PMID: 37130431 PMCID: PMC10449280 DOI: 10.18632/aging.204681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 04/15/2023] [Indexed: 05/04/2023]
Abstract
Werner syndrome is an adult-onset progeria syndrome that results in various complications. This study aimed to clarify the profile and secular variation of the disease. Fifty-one patients were enrolled and registered in the Werner Syndrome Registry. Their data were collected annually following registration. A cross-sectional analysis at registration and a longitudinal analysis between the baseline and each subsequent year was performed. Pearson's chi-squared and Wilcoxon signed-rank tests were used. Malignant neoplasms were observed from the fifth decade of life (mean onset: 49.7 years) and were observed in approximately 30% of patients during the 3-year survey period. Regarding renal function, the mean estimated glomerular filtration rate calculated from serum creatinine (eGFRcre) and eGFRcys, which were calculated from cystatin C in the first year, were 98.3 and 83.2 mL/min/1.73 m2, respectively, and differed depending on the index used. In longitudinal analysis, the average eGFRcre for the first and fourth years was 74.8 and 63.4 mL/min/1.73 m2, showing a rapid decline. Secular changes in Werner syndrome in multiple patients were identified. The prevalence of malignant neoplasms is high, and renal function may decline rapidly. It is, therefore, necessary to carry out active and detailed examinations and pay attention to the type and dose of the drugs used.
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Affiliation(s)
- Yukari Maeda
- Department of Endocrinology, Hematology, and Gerontology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Masaya Koshizaka
- Department of Endocrinology, Hematology, and Gerontology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Mayumi Shoji
- Department of Endocrinology, Hematology, and Gerontology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Hiyori Kaneko
- Department of Endocrinology, Hematology, and Gerontology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Hisaya Kato
- Department of Endocrinology, Hematology, and Gerontology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Yoshiro Maezawa
- Department of Endocrinology, Hematology, and Gerontology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Junji Kawashima
- Department of Metabolic Medicine, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Kayo Yoshinaga
- Department of Metabolic Medicine, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Mai Ishikawa
- Department of Dermatology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Akiko Sekiguchi
- Department of Dermatology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Sei-Ichiro Motegi
- Department of Dermatology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Hironori Nakagami
- Department of Health Development and Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yoshihiko Yamada
- Department of Medicine, Division of Diabetes, Metabolism and Endocrinology, Atami Hospital, International University of Health and Welfare, Atami, Japan
| | - Shinji Tsukamoto
- Department of Orthopaedic Surgery, Nara Medical University, Nara, Japan
| | - Akira Taniguchi
- Department of Orthopaedic Surgery, Nara Medical University, Nara, Japan
| | - Ken Sugimoto
- General Geriatric Medicine, Kawasaki Medical School, Okayama, Japan
| | - Yoichi Takami
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yukiko Shoda
- Department of Dermatology, Sumitomo Hospital, Osaka, Japan
| | - Kunihiko Hashimoto
- Department of Endocrinology and Metabolic Medicine, Nippon Life Hospital, Osaka, Japan
| | - Toru Yoshimura
- Diabetes and Endocrinology, Saga-Ken Medical Centre Koseikan, Saga, Japan
| | - Asako Kogure
- Department of Dermatology, Showa General Hospital, Tokyo, Japan
| | - Daisuke Suzuki
- Department of Dermatology, Showa General Hospital, Tokyo, Japan
| | - Naoki Okubo
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Takashi Yoshida
- Department of Orthopaedic Surgery, North Medical Center, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Kazuhisa Watanabe
- Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | | | - Minoru Takemoto
- Department of Medicine, Division of Diabetes, Metabolism and Endocrinology, International University of Health and Welfare, Narita, Japan
| | - Junko Oshima
- Department of Endocrinology, Hematology, and Gerontology, Chiba University Graduate School of Medicine, Chiba, Japan
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA 98195, USA
| | - Koutaro Yokote
- Department of Endocrinology, Hematology, and Gerontology, Chiba University Graduate School of Medicine, Chiba, Japan
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7
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Okyar B, Akben S, Torun B, Çetin GY. A rare syndrome mimicking scleroderma: Werner syndrome. Mod Rheumatol Case Rep 2023; 7:315-319. [PMID: 36208300 DOI: 10.1093/mrcr/rxac077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 09/04/2022] [Accepted: 09/17/2022] [Indexed: 06/16/2023]
Abstract
Werner syndrome (WS), also known as adult progeria, is a premature ageing syndrome that can manifest itself with grey hair, hair loss, diabetes mellitus, hyperlipidaemia, hypertension, skin disorders, ocular cataracts, myocardial infarction, osteoporosis, and stroke, especially after puberty. Physical examination findings similar to systemic sclerosis may be seen. Therefore, it may mimic this disease as misleading. A 43-year-old female patient was admitted to our clinic with a pre-diagnosis of systemic sclerosis complaint of skin hardening up to the ankle. In the first physical examination, there were wrinkles and thinning of the lip, suggesting systemic sclerosis in the facial appearance. On her capillaroscopy, there was tortuosity and an old focus of microhemorrhage. She had a history of diabetes mellitus and chronic osteomyelitis. When all symptoms, clinical findings, and antibody results were combined, it was thought that the patient might have WS. WS was diagnosed with homozygous c.2221 C>P p.R741*(rs763089663) positive in genetic analysis. It is known that WS creates a predisposition to malignancies, and most patients die secondary to malignancies. Therefore, early diagnosis becomes essential. Early diagnosis is of vital importance both to prevent complications and to delay treatment. In particular, systemic sclerosis-like findings of this syndrome may cause delays in diagnosis. For this reason, small clues suggesting WS in the clinic should be well known and well defined.
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Affiliation(s)
- Burak Okyar
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Kahramanmaraş Sütçü İmam University, Kahramanmaraş,Turkey
| | - Seçkin Akben
- Department of Internal Medicine, Faculty of Medicine, Kahramanmaraş Sütçü İmam University, Kahramanmaraş, Turkey
| | - Bekir Torun
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Kahramanmaraş Sütçü İmam University, Kahramanmaraş,Turkey
| | - Gözde Yıldırım Çetin
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Kahramanmaraş Sütçü İmam University, Kahramanmaraş,Turkey
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Topak OZ, Yildiz T, Ozdel O. A Werner Syndrome with Psychiatric Symptoms: Case Report. Psychiatr Danub 2022; 34:100-101. [PMID: 35467620 DOI: 10.24869/psyd.2022.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- Osman Zulkif Topak
- Pamukkale University, Department of Psychiatry, Kınıklı Campus Pamukkale, Denizli, Turkey,
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Peng H, Wang J, Liu Y, Yang H, Li L, Ma Y, Zhuo H, Jiang H. Case Report: A novel WRN mutation in Werner syndrome patient with diabetic foot disease and myelodysplastic syndrome. Front Endocrinol (Lausanne) 2022; 13:918979. [PMID: 35909544 PMCID: PMC9334726 DOI: 10.3389/fendo.2022.918979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 06/27/2022] [Indexed: 11/25/2022] Open
Abstract
Werner syndrome is an autosomal recessive rare disease caused by a WRN gene mutation, which is rarely reported in the Chinese population. We report the clinical and genetic data of a Chinese patient with Werner syndrome. The proband was a 40-year-old male patient who presented with diabetic foot ulcers, accompanied by short stature, cataracts, hypogonadism, and hair thinning, and myelodysplastic syndrome (MDS) occurred after 18 months. Genetic sequencing showed there were compound heterozygous mutations as c.3384-1G>C and c.3744dupA in the WRN gene. The c.3744dupA mutation is a novel pathogenic variation for Werner syndrome.
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Affiliation(s)
- Huifang Peng
- Endocrine and Metabolic Disease Center, Medical Key Laboratory of Hereditary Rare Diseases of Henan, Luoyang Sub-Center of National Clinical Research Center for Metabolic Diseases, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China
| | - Jie Wang
- Endocrine and Metabolic Disease Center, Medical Key Laboratory of Hereditary Rare Diseases of Henan, Luoyang Sub-Center of National Clinical Research Center for Metabolic Diseases, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China
| | - Yanyun Liu
- Endocrine and Metabolic Disease Center, Medical Key Laboratory of Hereditary Rare Diseases of Henan, Luoyang Sub-Center of National Clinical Research Center for Metabolic Diseases, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China
| | - Haiping Yang
- Department of Hematology, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China
| | - Liping Li
- Endocrine and Metabolic Disease Center, Medical Key Laboratory of Hereditary Rare Diseases of Henan, Luoyang Sub-Center of National Clinical Research Center for Metabolic Diseases, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China
| | - Yujin Ma
- Endocrine and Metabolic Disease Center, Medical Key Laboratory of Hereditary Rare Diseases of Henan, Luoyang Sub-Center of National Clinical Research Center for Metabolic Diseases, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China
| | - Huiqin Zhuo
- Department of Gastrointestinal Surgery, Zhongshan Hospital of Xiamen University, Xiamen, China
- *Correspondence: Hongwei Jiang, ; Huiqin Zhuo,
| | - Hongwei Jiang
- Endocrine and Metabolic Disease Center, Medical Key Laboratory of Hereditary Rare Diseases of Henan, Luoyang Sub-Center of National Clinical Research Center for Metabolic Diseases, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China
- *Correspondence: Hongwei Jiang, ; Huiqin Zhuo,
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Yamamoto R, Akasaki K, Horita M, Yonezawa M, Asakura H, Kanamori T, Maezawa Y, Koshizaka M, Yokote K, Kurita S. Evaluation of glucose tolerance and effect of dietary management on increased visceral fat in a patient with Werner syndrome. Endocr J 2020; 67:1239-1246. [PMID: 32814719 DOI: 10.1507/endocrj.ej20-0304] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Werner syndrome (WS), a type of progeria, is a hereditary condition caused by a mutation in the WRN gene. A 62-year-old Japanese woman was diagnosed with WS at the age of 32 and has been visiting the hospital for follow-up since the last 30 years. The patient developed diabetes at the age of 46, and at the age of 60, her body mass index increased from 20.1 to 22.7 kg/m2 owing to her unhealthy eating habits; her visceral fat area at the age of 61 was 233 cm2. With dietary control, her body weight, including the visceral fat and subcutaneous fat, decreased at the age of 62, and her insulin secretion, obesity, and fatty liver improved. We conducted the oral glucose challenge test four times, including at the prediabetic stage, to evaluate the insulin-secretion ability. The patient's insulin resistance gradually increased for more than 14 years, and her insulin secretion ability began to decrease 14 years after her diabetes diagnosis. Despite a remarkable decrease in body weight and fat mass with dietary management, the psoas muscle index did not decrease significantly in proportion to the body weight or fat mass. However, muscle mass monitoring is important for preventing the progression of sarcopenia. Hence, gradual reduction of visceral fat and weight by dietary management may be useful in treating diabetes in patients with WS, particularly in those whose visceral fat is significantly increased.
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Affiliation(s)
- Reina Yamamoto
- Department of Endocrinology and Metabolism, National Hospital Organization Kanazawa Medical Center, Ishikawa 920-8650, Japan
| | - Kyota Akasaki
- Department of Endocrinology and Metabolism, National Hospital Organization Kanazawa Medical Center, Ishikawa 920-8650, Japan
| | - Masataka Horita
- Department of Endocrinology and Metabolism, National Hospital Organization Kanazawa Medical Center, Ishikawa 920-8650, Japan
| | - Makoto Yonezawa
- Department of Endocrinology and Metabolism, National Hospital Organization Kanazawa Medical Center, Ishikawa 920-8650, Japan
| | - Hiroki Asakura
- Department of Endocrinology and Metabolism, National Hospital Organization Kanazawa Medical Center, Ishikawa 920-8650, Japan
| | - Takehiro Kanamori
- Department of Endocrinology and Metabolism, National Hospital Organization Kanazawa Medical Center, Ishikawa 920-8650, Japan
| | - Yoshiro Maezawa
- Department of Endocrinology, Hematology and Gerontology, Chiba University Graduate School of Medicine, Chiba 260-8670, Japan
| | - Masaya Koshizaka
- Department of Endocrinology, Hematology and Gerontology, Chiba University Graduate School of Medicine, Chiba 260-8670, Japan
| | - Koutaro Yokote
- Department of Endocrinology, Hematology and Gerontology, Chiba University Graduate School of Medicine, Chiba 260-8670, Japan
| | - Seiichiro Kurita
- Department of Endocrinology and Metabolism, National Hospital Organization Kanazawa Medical Center, Ishikawa 920-8650, Japan
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He G, Yan Z, Sun L, Lv Y, Guo W, Gang X, Wang G. Diabetes mellitus coexisted with progeria: a case report of atypical Werner syndrome with novel LMNA mutations and literature review. Endocr J 2019; 66:961-969. [PMID: 31270292 DOI: 10.1507/endocrj.ej19-0014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Werner syndrome (WS) is a rare, adult-onset progeroid syndrome. Classic WS is caused by WRN mutation and partial atypical WS (AWS) is caused by LMNA mutation. A 19-year-old female patient with irregular menstruation and hyperglycemia was admitted. Physical examination revealed characteristic faces of progeria, graying and thinning of the hair scalp, thinner and atrophic skin over the hands and feet, as well as lipoatrophy of the extremities, undeveloped breasts at Tanner stage 3, and short stature. The patient also suffered from severe insulin-resistant diabetes mellitus, hyperlipidemia, fatty liver, and polycystic ovarian morphology. Possible WS was considered and both WRN and LMNA genes were analyzed. A novel missense mutation p.L140Q (c.419T>A) in the LMNA gene was identified and confirmed the diagnosis of AWS. Her father was a carrier of the same mutation. We carried out therapy for lowering blood glucose and lipid and improving insulin resistance, et al. The fasting glucose, postprandial glucose and triglyceride level was improved after treatment for 9 days. Literature review of AWS was performed to identify characteristics of the disease. Diabetes mellitus is one of the clinical manifestations of WS and attention must give to the differential diagnosis. Gene analysis is critical in the diagnosis of WS. According to the literature, classic and atypical WS differ in incidence, pathogenic gene, and clinical manifestations. Characteristic dermatological pathology may be significantly more important for the initial identification of AWS. Early detection, appropriate treatments, and regular follow-up may improve prognosis and survival of WS patients.
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Affiliation(s)
- Guangyu He
- The First Hospital of Jilin University, Changchun Jilin, 130021, China
| | - Zi Yan
- The First Hospital of Jilin University, Changchun Jilin, 130021, China
| | - Lin Sun
- The First Hospital of Jilin University, Changchun Jilin, 130021, China
| | - You Lv
- The First Hospital of Jilin University, Changchun Jilin, 130021, China
| | - Weiying Guo
- The First Hospital of Jilin University, Changchun Jilin, 130021, China
| | - Xiaokun Gang
- The First Hospital of Jilin University, Changchun Jilin, 130021, China
| | - Guixia Wang
- The First Hospital of Jilin University, Changchun Jilin, 130021, China
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Singh D, Ganger A, Gupta N, Vanathi M, Khadgawat R, Tandon R. Primary Bullous Keratopathy in a Patient With Werner Syndrome Treated With Corneal Transplant. EXP CLIN TRANSPLANT 2019; 17:699-701. [PMID: 29534662 DOI: 10.6002/ect.2017.0163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Here, we present, to the best of our knowledge, the first case of Werner syndrome with corneal blindness due to bilateral primary bullous keratopathy. Werner syndrome is a rare autosomal recessive disorder characterized by features of premature aging, insulin-dependent diabetes mellitus, osteoporosis, atherosclerosis, hypergonadotrophic hypogonadism, hypertriglyceridemia, scleroderma-like skin changes, and sarcomas. Among ocular manifestations, cataracts, cystoid macular edema, and retinal detachment have been reported. Because these patients show features of premature aging, they have decreased corneal endothelial function and delayed fibroblast growth. To date, there are few reports of wound dehiscence, bleb formation, and bullous keratopathy following surgical insult that have usually occurred after cataract surgery in patients with Werner syndrome. There have been no reports in the literature regarding Werner syndrome presenting with primary corneal decompensation without any inciting factor. Our patient with Werner syndrome had primary bilateral bullous keratopathy and bilateral corneal blindness for 10 years and was eventually rehabilitated by corneal transplant. Hence, this case highlights the importance of early referral of such patients to the ophthalmologist for prompt diagnosis and early treatment so that blindness could be avoided.
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Affiliation(s)
- Divya Singh
- From the Cornea, Refractive Surgery, Ocular Surface Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
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Hayashi K, Tasaka T, Kondo T, Ishikawa Y, Goto M, Matsuhashi Y, Sadahira Y, Sugihara T, Wada H. Successful Cord Blood Transplantation in a Werner Syndrome Patient with High-risk Myelodysplastic Syndrome. Intern Med 2019; 58:109-113. [PMID: 30146558 PMCID: PMC6367075 DOI: 10.2169/internalmedicine.0317-17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Werner syndrome (WS) confers a high risk of the development of neoplasias, including hematological malignancies, and curative treatment for these malignancies is difficult to achieve. A 44-year-old man with myelodysplastic syndrome was admitted to our hospital. He was diagnosed with mutation-proven WS. He underwent cord blood transplantation (CBT) following fludarabine, busulfan, and melphalan administration. A chimerism analysis of his marrow blood on day 62 showed a donor pattern >95%, which confirmed engraftment. The patient lived for 15 months while maintaining remission of MDS without treatment-related toxicity. Our case shows that CBT can be a treatment modality for WS patients with hematological malignancies.
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Affiliation(s)
| | - Taizo Tasaka
- Department of Hematology, Kawasaki Medical School, Japan
- Department of Transfusion Medicine, Saitama Medical Center, Saitama Medical University, Japan
| | | | - Yuichi Ishikawa
- Department of Pathology, The Cancer Institute, Japanese Foundation for Cancer Research, Japan
| | - Makoto Goto
- Department of Rheumatology/Orthopedic Surgery, East Medical Center, Tokyo Women's Medical University, Japan
| | | | | | | | - Hideho Wada
- Department of Hematology, Kawasaki Medical School, Japan
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Nishioka M, Kamei S, Kinoshita T, Sanada J, Fushimi Y, Irie S, Hirata Y, Tanabe A, Hirukawa H, Kimura T, Obata A, Tatsumi F, Kohara K, Shimoda M, Nakanishi S, Mune T, Kaku K, Kaneto H. Werner Syndrome and Diabetes Mellitus Accompanied by Adrenal Cortex Cancer. Intern Med 2017; 56:1987-1992. [PMID: 28768969 PMCID: PMC5577075 DOI: 10.2169/internalmedicine.56.8231] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Werner syndrome is a rare genetic disease characterized by progeria, diabetes mellitus, cataracts and various types of malignancy. However, there are few reports showing adrenal cortex cancer in subjects with Werner syndrome. We herein report an extremely rare case of Werner syndrome accompanied by adrenal cortex cancer. Based on the data obtained from blood samples, computed tomography, magnetic resonance imaging and 131I adosterol scintigraphy, we diagnosed this subject with adrenal cortex cancer and Cushing's syndrome. Since the prognosis of adrenal cancer is very poor, we should be aware of the possibility of adrenal cancer occurring in subjects with Werner syndrome.
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Affiliation(s)
- Momoyo Nishioka
- Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, Japan
| | - Shinji Kamei
- Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, Japan
| | - Tomoe Kinoshita
- Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, Japan
| | - Junpei Sanada
- Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, Japan
| | - Yoshiro Fushimi
- Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, Japan
| | - Shintaro Irie
- Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, Japan
| | - Yurie Hirata
- Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, Japan
| | - Akihito Tanabe
- Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, Japan
| | - Hidenori Hirukawa
- Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, Japan
| | - Tomohiko Kimura
- Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, Japan
| | - Atsushi Obata
- Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, Japan
| | - Fuminori Tatsumi
- Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, Japan
| | - Kenji Kohara
- Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, Japan
| | - Masashi Shimoda
- Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, Japan
| | - Shuhei Nakanishi
- Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, Japan
| | - Tomoatsu Mune
- Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, Japan
| | - Kohei Kaku
- Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, Japan
| | - Hideaki Kaneto
- Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, Japan
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Handargal N, Muralidharan J, Sharma PP, Narayanswamy M, Prabhu S, Priyashree R, Jagadeesha SG. Adult Progeria: Werner Syndrome. J Assoc Physicians India 2016; 64:93-94. [PMID: 27734655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Werner's syndrome is an adult premature aging syndrome of autosomal recessive inheritance affecting connective tissues throughout the body.1 The exact etiology remains obscure even though biochemical and connective tissue abnormalities have been postulated.2 The disease involves multiple systems of the body and may be associated with internal malignancy.3 We report a case of a 35 year old man who presented with uncontrolled diabetes and non-healing ulcers.
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Affiliation(s)
| | | | | | | | - S Prabhu
- Assistant Professor, Department of Medicine, Bowring and Lady Curzon Hospital, Bangalore
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Shibuya H, Kato A, Kai N, Fujiwara S, Goto M. A Case of Werner Syndrome with Three Primary Lesions of Malignant Melanoma. J Dermatol 2014; 32:737-44. [PMID: 16361718 DOI: 10.1111/j.1346-8138.2005.tb00835.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2004] [Accepted: 04/21/2005] [Indexed: 10/25/2022]
Abstract
Three primary lesions of malignant melanoma developed in a 44-year-old Japanese woman with Werner syndrome. One lesion was on the right large pudental lip and the others in distinct locations on her left sole. After the wide local excision of these tumors, the wound of the large pudental lip was sutured, and the defects on the sole were covered with skin grafts. After one course of chemotherapy consisting of dacarbazine, nimustine, vincristine sulfate and local injection of Interferon beta were performed, severe myelosupression occurred and continued for two months. Defective production of WRN protein was confirmed by Western blotting, although the three representative mutations in Japanese patients, mutations 1, 4 and 6, which include over 90% of the Japanese patients, were not detected. We also reviewed 26 cases of malignant melanoma associated with Werner syndrome (WS), including ours.
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Affiliation(s)
- Hiromi Shibuya
- Department of Anatomy, Biology and Medicine (Plastic Surgery, Dermatology) Faculty of Medicine, Oita University, Oita, Japan
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Abstract
Onishi et al. recently reported here an association of diabetes mellitus (DM) with neoplasm type in newly identified patients with Werner syndrome (WS), an autosomal recessive cancer predisposition syndrome with features of premature aging that include a high risk of DM (Onishi et al. in Acta Diabetol 49(Suppl 1):259-260, 2012; Epstein et al. in Medicine 45:177-121, 1966). In contrast, we did not detect an association between DM and neoplasm type in an independent WS cohort we assembled to determine the histopathologic spectrum and type-specific risk of neoplasia in WS.
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Affiliation(s)
- Julia M. Lauper
- Department of Epidemiology, University of Washington, Seattle WA 98195
- Department of Pathology, University of Washington, Seattle WA 98195
| | - Raymond J. Monnat
- Department of Pathology, University of Washington, Seattle WA 98195
- Department of Genome Sciences, University of Washington, Seattle WA 98195
- communicating author: Department of Pathology box 357705, University of Washington, Seattle, WA 98195-7705. tel: 206.616.7392. fax: 206.543.3967.
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Abstract
PURPOSE To report the development of bilateral retinal detachment in a patient with Werner syndrome. METHODS Retrospective chart review. A 44-year-old woman diagnosed with Werner syndrome developed bilateral retinal detachment. The fundus in both eyes showed patchy chorioretinal atrophy similar to that seen in high myopia, with the retinal detachment limited to the posterior pole. Two weeks after performing vitrectomy in the right eye, vitrectomy was performed in the left eye. RESULTS After the surgeries, both retinas were reattached. During the surgeries, we observed an excessively liquefied vitreous and a posterior hyaloid membrane that was tightly attached to the retina. The retinal break was located along the superotemporal arcade and over an area of the patchy chorioretinal atrophy in both eyes. The chorioretinal atrophy and vitreous liquefaction appeared to be excessive for the patient's age and axial lengths (right: 26.66 mm, left: 27.04 mm). CONCLUSION Vitreoretinal changes found in this case might have been partially because of the premature aging associated with Werner syndrome.
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Affiliation(s)
- Mikio Sasoh
- Department of Ophthalmology, Mie University School of Medicine, Tsu Mie, Japan
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Abstract
BACKGROUND Werner syndrome (WS) is an autosomal recessive genetic instability and progeroid ('premature aging') syndrome which is associated with an elevated risk of cancer. OBJECTIVES Our study objectives were to characterize the spectrum of neoplasia in WS using a well-documented study population, and to estimate the type-specific risk of neoplasia in WS relative to the general population. METHODS We obtained case reports of neoplasms in WS patients through examining previous case series and reviews of WS, as well as through database searching in PubMed, Google Scholar, and J-EAST, a search engine for articles from Japan. We defined the spectrum (types and sites) of neoplasia in WS using all case reports, and were able to determine neoplasm type-specific risk in Japan WS patients by calculating standardized incidence and proportionate incidence ratios (SIR and SPIR, respectively) relative to Osaka Japan prefecture incidence rates. RESULTS We used a newly assembled study population of 189 WS patients with 248 neoplasms to define the spectrum of neoplasia in WS. The most frequent neoplasms in WS patients, representing 2/3 of all reports, were thyroid neoplasms, malignant melanoma, meningioma, soft tissue sarcomas, leukemia and pre-leukemic conditions of the bone marrow, and primary bone neoplasms. Cancer risk defined by SIRs was significantly elevated in Japan-resident WS patients for the six most frequent neoplasms except leukemia, ranging from 53.5-fold for melanoma of the skin (95% CI: 24.5, 101.6) to 8.9 (95% CI: 4.9, 15.0) for thyroid neoplasms. Cancer risk as defined by SPIR was also significantly elevated for the most common malignancies except leukemia. CONCLUSIONS WS confers a strong predisposition to several specific types of neoplasia. These results serve as a guide for WS clinical care, and for additional analyses to define the mechanistic basis for cancer in WS and the general population.
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Affiliation(s)
- Julia M. Lauper
- Department of Epidemiology, University of Washington, Seattle, Washington, United States of America
- Department of Pathology, University of Washington, Seattle, Washington, United States of America
| | - Alison Krause
- Department of The School of Medicine, University of Washington, Seattle, Washington, United States of America
| | - Thomas L. Vaughan
- Department of Epidemiology, University of Washington, Seattle, Washington, United States of America
- Fred Hutchinson Cancer Research Center, Epidemiology Program, Public Health Sciences Division, Seattle, Washington, United States of America
| | - Raymond J. Monnat
- Department of Pathology, University of Washington, Seattle, Washington, United States of America
- Department of Genome Sciences, University of Washington, Seattle, Washington, United States of America
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Fumo G, Pau M, Patta F, Aste N, Atzori L. Leg ulcer in Werner syndrome (adult progeria): a case report. Dermatol Online J 2013; 19:6. [PMID: 23552003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Abstract
Werner syndrome (WS; MIM#277700) or adult progeria, is a rare disease, associated with mutations of a single gene (RECQL2 or WRN), located on chromosome 8 (8p12). It codes a DNA-helicase, whose defects cause genomic instability. The highest incidences are reported in Japan and Sardinia (Italy). On this major island of the Mediterranean Basin, the WS cases have been observed in the northern areas. The authors describe the apparently first case reported in southern Sardinia, a 51-year-old woman, who was born in and resides in the province of Cagliari. She presented with a 9-year history of an intractable leg ulcer and other characteristic symptoms, including "bird-like" face, high-pitched voice, premature greying, short stature, abdominal obesity in contrast with thin body type, scleroderma-like legs, decreased muscle mass, diabetes, atherosclerosis, and premature menopause. A specialized genetic Institute of Research (IRCCS-IDI, Rome) confirmed the clinical diagnosis. There is no cure or specific treatment and patients must be periodically screened for an increased risk of cardiovascular and cerebrovascular disease and malignancies. Among the many findings, leg ulcers significantly affect the patient's quality of life. This problem may send the patient to the dermatologist, who finally suspects the diagnosis. Poor response to medical treatment may require aggressive repeated surgery, with poor or temporary results.
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Affiliation(s)
- Giuseppe Fumo
- Dermatology Department, University of Cagliari, Cagliari, Italy
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Onishi S, Takemoto M, Ishikawa T, Okabe E, Ishibashi R, He P, Kobayashi K, Fujimoto M, Kawamura H, Yokote K. Japanese diabetic patients with Werner syndrome exhibit high incidence of cancer. Acta Diabetol 2012; 49 Suppl 1:S259-60. [PMID: 22872450 DOI: 10.1007/s00592-012-0424-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2012] [Accepted: 07/23/2012] [Indexed: 10/28/2022]
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Abraham LM, Braganza AD, Simha AR. Primary glaucoma in three siblings with Werner syndrome. Clin Exp Ophthalmol 2012; 41:416-8. [PMID: 22957764 DOI: 10.1111/j.1442-9071.2012.02880.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Accepted: 08/12/2012] [Indexed: 12/01/2022]
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Ohta Y, Tanizawa Y. [Hereditary syndrome associated with diabetes mellitus]. Nihon Rinsho 2012; 70 Suppl 5:205-210. [PMID: 23156395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Affiliation(s)
- Yasuharu Ohta
- Division of Endocrinology, Metabolism, Hematological Science and Therapeutics, Yamaguchi University Graduate School of Medicine
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Kawai T, Nozato Y, Kamide K, Onishi M, Yamamoto-Hanasaki H, Tatara Y, Takemura Y, Yamamoto K, Takeya Y, Sugimoto K, Kusakabe N, Yasuda O, Ohishi M, Rakugi H. Case report of a long-surviving Werner syndrome patient with severe aortic valve stenosis. Geriatr Gerontol Int 2011; 12:174-5. [PMID: 22188506 DOI: 10.1111/j.1447-0594.2011.00748.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Granata A, Floccari F, Mignani R, Gallieni M. Glomerular membranous nephropathy and Werner syndrome: a case report. J Am Geriatr Soc 2011; 59:1749-50. [PMID: 22136536 DOI: 10.1111/j.1532-5415.2011.03578.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Noda S, Asano Y, Masuda S, Miyagawa T, Sugita M, Yamamoto M, Kogure A, Tamaki Z, Mitsui H, Hoashi T, Sugaya M, Sato S. Bosentan: a novel therapy for leg ulcers in Werner syndrome. J Am Acad Dermatol 2011; 65:e54-e55. [PMID: 21763553 DOI: 10.1016/j.jaad.2011.03.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2010] [Revised: 02/12/2011] [Accepted: 03/01/2011] [Indexed: 01/26/2023]
Affiliation(s)
- Shinji Noda
- Department of Dermatology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Yoshihide Asano
- Department of Dermatology, University of Tokyo Graduate School of Medicine, Tokyo, Japan.
| | - Sho Masuda
- Department of Dermatology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Takuya Miyagawa
- Department of Dermatology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Miki Sugita
- Department of Dermatology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Mizuho Yamamoto
- Department of Dermatology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Asako Kogure
- Department of Dermatology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Zenshiro Tamaki
- Department of Dermatology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Hiroshi Mitsui
- Department of Dermatology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Toshihiko Hoashi
- Department of Dermatology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Makoto Sugaya
- Department of Dermatology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Shinichi Sato
- Department of Dermatology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
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Sołek-Pastuszka J, Zagrodnik-Ułan E, Płonka T, Wylot M, Biernawska J, Bohatyrewicz R, Kos W, Zukowski M, Celewicz Z. Pregnancy complicated by Werner syndrome. Acta Obstet Gynecol Scand 2010; 90:201-2. [PMID: 21241272 DOI: 10.1111/j.1600-0412.2010.01033.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hallaji Z, Barzegari M, Kiavash K. Werner syndrome in an Iranian family. Skinmed 2010; 8:184-186. [PMID: 21137629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
A 49-year-old man was first seen in our department for the evaluation of scleroderma-like skin changes and a nonhealing ulcer on his leg from years before referral. His medical history was of long duration. His growth was stunted at the age of 12. At 21 years of age, the patient noted graying of the scalp hair, most prominent on his temples, and the process was progressively completed by the age of 23. At the same age, atrophy and thinning of the skin and loss of subcutaneous fat resulted in a tense, shining, and adherent appearance of his skin, most obvious on his face and extremities. Soon after, he developed a high-pitched, hoarse voice. He had undergone bilateral cataract surgery at the age of 30. Around the age of 46, he developed a unilateral nonhealing chronic leg ulcer (Figure 1). He had separated from his wife because of infertility. He was the first offspring of his second-degree healthy relative parents. The other 3 siblings had similar signs and symptoms. Our patient gave the history of premature graying of the hair of his younger brother at the age of 18 and his 2 younger sisters at the age of 12 and 16. His brother had recently received diagnoses of bilateral cataract and diabetes mellitus. All of the siblings had ceased growth from early adolescence. On physical examination, our patient's weight was 48 kg and his height was 150 cm. He had normal intelligence. He was speaking with a high-pitched and childish voice. He had a bird-like appearance with a beak-shaped nose. Mottled and diffuse pigmentation and poikiloderma appearance was conspicuous on his neck (Figure 2). The entire skin was smooth, shiny, and scleroderma-like, and a marked decrease in the subcutaneous fat was noted over the extremities. A deep cutaneous ulcer was evident on his slimmed leg. Digital ulcers were not found, and radial and dorsalis pedis pulses were palpable. Clinodactyly of the toes were conspicuous. His nails were dystrophic and he had used dentures from the age of 20. On examination of the external genitalia, his testes were smaller than normal. In the biopsy taken from the leg ulcer, there were no signs of malignancy. There were no signs ofosteomyelitis on x-ray. Biopsy of the normal skin revealed atrophic epidermis and thick dermis with hyalinization of the collagen fibers and absence of pilosebaceous structures (Figure 3). The patient's scalp hair was thin and sparse and there were few axillary and pubic hairs. His fasting plasma glucose level was normal.
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Affiliation(s)
- Zahra Hallaji
- Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Monroy S, Pereiro G, Graziano A, Cola H, Palombo M, Achenbach R. [Valve calcification in Werner's syndrome]. Medicina (B Aires) 2010; 70:372. [PMID: 20679061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Affiliation(s)
- Silvina Monroy
- Hospital General de Agudos Ignacio Pirovano, Buenos Aires.
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Seiter K, Qureshi A, Liu D, Galvin-Parton P, Arshad M, Agoliati G, Ahmed T. Severe toxicity following induction chemotherapy for acute myelogenous leukemia in a patient with Werner's syndrome. Leuk Lymphoma 2009; 46:1091-5. [PMID: 16019564 DOI: 10.1080/10428190500102688] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Werner's syndrome is an autosomal recessive disorder resulting in premature aging. Most patients die in their fifth decade from malignancies or heart disease. The gene for Werner's syndrome (WRN) encodes a recQ helicase. Cells from patients with Werner's syndrome have increased sensitivity to DNA-damaging drugs in vitro. Here we present a patient with Werner's syndrome who developed severe chemotherapy-induced toxicity during treatment for acute myelogenous leukemia. We propose that lack of WRN resulted in increased sensitivity of the patient's cells to the toxicity of chemotherapy.
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Affiliation(s)
- Karen Seiter
- Zalmen A. Arlin Cancer Institute, New York Medical College, Valhalla, NY 10595, USA.
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Tanaka S, Miyairi T, Shimada S, Miura S, Kigawa I, Fukuda S. Off-pump coronary artery bypass grafting in a patient with Werner's syndrome. Gen Thorac Cardiovasc Surg 2008; 56:592-4. [PMID: 19085052 DOI: 10.1007/s11748-008-0308-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2008] [Accepted: 07/14/2008] [Indexed: 11/25/2022]
Abstract
Werner's syndrome is a rare hereditary disorder that is characterized by premature aging. We report a case of off-pump coronary artery bypass grafting (OPCAB) in a 56-year-old man with Werner's syndrome. We used an endoscopic vessel-harvesting system to harvest great saphenous vein grafts (SVGs) because this system helps minimize surgical wounds. This is important because poor wound healing is a prominent feature of Werner's syndrome. Revascularization of the coronary arteries in this case was thought to improve his prognosis, although he had already outlived the average life-span of Werner's syndrome. A detailed examination of the cardiovascular system should be performed in patients with this disorder.
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Affiliation(s)
- Satona Tanaka
- Division of Cardiovascular Surgery, Mitsui Memorial Hospital, Kandaizumicho-1, Chiyoda-ku, Tokyo, 101-8643, Japan.
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Shimaoka Y, Hatamochi A, Hamasaki Y, Yamazaki S, Hiraishi H, Hattori Y, Kasai K, Shimoda M, Kubota K, Imai Y. Case of Werner's syndrome with pancreatic carcinoma. J Dermatol 2007; 34:674-6. [PMID: 17727376 DOI: 10.1111/j.1346-8138.2007.00357.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Hakeem A, Reza S, Moinuddin S, Bhatti S, Khalid I, Noor R, Mahmood K. Cirrhosis in Werner's syndrome: an unusual presentation of premature aging. Med Sci Monit 2007; 13:CS61-6. [PMID: 17476199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2006] [Accepted: 01/20/2007] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND Werner's syndrome (WS) is an rare autosomal recessive, hereditary systemic disease with progeroid features, usually presenting in adolescence. It is associated with increased genetic instability and elevated risk of neoplasia. Clinical manifestations include sinall stature, scleroderma-like changes in the skin,juvenile cataracts, and premature aging. It has been reported mostly in ophthalmological, dermatological, and orthopedics literature. It is now being correctly acknowledged as a condition where a lack of Werner's protein (WRN protein) results in an overall decline of normal physiological functions of various organ systems. Cirrhosis is an extremely rare manifestation of Werner's syndrome and has been reported in <4% of patients. CASE REPORT A case of cirrhosis in a patient with Werner's syndrome is described. A 25-year-old male presented with features of p remature senility and progressive abdominal distension with black tarry stools of over six months duration. His clinical presentation and work-up including a biopsy were consistent with cirrhosis. The work-up for other causes of chronic liver disease was negative. He was medically managed for portal hypertension. Despite maximal medical therapy, he (tied due to recurrent episodes of hematemesis. CONCLUSIONS This case is not only the first documented case of Werner's from Pakistan, but describes an unusual presentation: cirrhosis, a very rare complication of WS. O verproduction of types I and III collagen and nonalcoholic steatohepatitis secondary to insulin resistance and dyslipidemia possibly contribute to cirrhosis in WS.
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Affiliation(s)
- Abdul Hakeem
- University of Wisconsin Hospital and Clinics, Madison, WI 53705, USA.
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Abstract
INTRODUCTION Werner's syndrome, a rare autosomal recessive genetic disease, is a premature aging disease characterized by early onset of symptoms related to normal aging including short stature, cataracts, graying of the hair, skin ulcerations, diabetes, osteoporosis, atherosclerosis and predisposition to cancer. Musculoskeletal complications can also develop with major impairment of quality of life for these patients. OBSERVATION We report two typical cases in two males aged 47 and 44 diagnosed on the basis of cutaneous progeroid signs. Diagnosis was confirmed by identification of homozygotous mutations in the WRN gene. The first patient later developed chronic osteomyelitis of the right forearm, which is a rare complication of Werner's syndrome. The second patient presented calcaneum valgus resulting in mechanical overwork and bilateral posterior tibial tendinitis. He also developed osteitis of the 5th toe. CONCLUSION Dermatologists should be aware of the potential orthopedic complications of this disease in order to diagnose them as quickly as possible and organize multidisciplinary management alongside other specialists such as rheumatologists and orthopedic surgeons.
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Affiliation(s)
- N Kluger
- Université Montpellier I, Service de Dermatologie, Hôpital Saint Eloi, CHU, Montpellier.
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Abstract
Werner's syndrome (adult onset progeria) is a rare form of autosomal recessive genodermatosis associated in almost 80% of cases with mutation of the WRN gene. This prototype of rapid ageing syndromes is characterized by short stature with skin and hair anomalies (early graying of the hair, alopecia, depilation, sclerosed skin), orthopedic complications (flat foot, hallux valgus and other joint deformations) as well as systemic signs (early cataract, premature and diffuse atherosclerosis, endocrinopathies) and high risk of certain types of cancer (sarcomas, myeloid blood dyscrasias). Death occurs around the age of 40 - 50 years mainly as a result of cardiovascular accident or development of a malignant tumour. Signs of early aging should evoke this basic diagnosis and arrangements should be made for appropriate follow-up with screening for and treatment of systemic complications.
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Affiliation(s)
- N Kluger
- Université Montpellier I, Service de Dermatologie, Hôpital Saint Eloi, CHU Montpellier, 80, avenue Augustin Fliche, 34295 Montpellier Cedex 5.
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Tsianakas A, Müller FB, Hunzelmann N, Kuwert C. [Werner's syndrome]. Dtsch Med Wochenschr 2007; 132:91-4. [PMID: 17219342 DOI: 10.1055/s-2007-959294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
HISTORY AND CLINICAL FINDINGS A 49-year-old man of German parentage with Werner's syndrome (including insulin-dependent type 2 diabetes mellitus) was treated in our department for extensive ulcers on his lower legs. GENETICS Genetic analysis detected a novel compound heterozygous defect (1396delA and 2334delAC) of the WRN gene. TREATMENT AND FURTHER COURSE The ulcer clearly decreased in size on local and antibiotic treatment as well as autologous fibroplast transplantation. The most severely affected right small finger required amputation with exarticulation. The severe pain caused by the ulcer was successfully treated with temporary blockage of the stellate ganglion and permanent sympathetic blockage at the level of the 2nd thoracic and lumbar vertebrae. CONCLUSION Werner's syndrome is a rare form of progeria with an autosomal recessive mode of inheritance mimicking the symptoms of accelerated aging. The reduced life expectancy is caused by the increased incidence and early onset of atherosclerosis and malignant tumors. The detection of underlying molecular mechanisms will have an important impact in the field of anti-aging research.
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Affiliation(s)
- A Tsianakas
- Universitätsklinikum Münster, Klinik und Poliklinik für Hautkrankheiten.
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Yokote K. [Werner syndrome and metabolic syndrome]. Nihon Rinsho 2006; 64 Suppl 9:742-6. [PMID: 17458312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Affiliation(s)
- Koutaro Yokote
- Division of Diabetes, Metabolism and Endocrinology, Chiba University Hospital
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Kocabay G, Ozturk S, Ecder T. Werner syndrome associated with renal involvement. Saudi Med J 2006; 27:1768-9. [PMID: 17106563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023] Open
Affiliation(s)
- Gonenc Kocabay
- Department of Internal Medicine, Istanbul School of Medicine, Istanbul University, Istanbul, Turkey.
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Theodoropoulos TAD, Bestetti RB, Fonseca PFM, Bertollo EMG, Santos MA, Pavarino PR. Werner's syndrome and restrictive cardiomyopathy. Int J Cardiol 2006; 108:284-5. [PMID: 15916825 DOI: 10.1016/j.ijcard.2005.03.080] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2005] [Accepted: 03/02/2005] [Indexed: 11/18/2022]
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Ozturk M, Akdeniz N, Ayakta H, Kösem M. A brother and sister with Werner's syndrome demonstrating extensive tendon calcification and sacroiliitis. Clin Exp Dermatol 2006; 31:615-6. [PMID: 16716186 DOI: 10.1111/j.1365-2230.2006.02130.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- M Ozturk
- Department of Endocrinology, Yüzüncü Yil University, Faculty of Medicine, Van, Turkey.
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Abstract
INTRODUCTION Werner Syndrome, or adult progeria, is a rare autosomal recessive disorder caused by a mutation in the Werner Syndrome Gene belonging to the family of RecQ helicase. Malignant mesenchymal tumours and atherosclerosis are typical causes of death. Intracranial meningiomas are frequently described in these patients. CLINICAL PRESENTATION We present the case of a 46-year-old man with Werner Syndrome and a convexity meningioma. The patient had a 2-year history of paresthesia and paresis in his right leg, which had worsened in recent months. He underwent surgery with Simpson grade II removal, with improvement of the slight paresis and no other neurological defects. The patient then underwent radiotherapy (60 Gy). Histological examination revealed an atypical meningioma. Cytogenetic analysis showed a hypodiploid clone with a complex karyotype characterized by monosomy 22 and deletion 1p. After 3 years' follow-up no relapses had occurred. CONCLUSION 1p deletion correlates with meningioma progression and in this case correlates with histological examination. The chromosomal instability underlying Werner Syndrome could have fostered the complex karyotype.
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Affiliation(s)
- E Marton
- Neurosurgery Department, Regional Hospital, Padova University, Treviso, Italy.
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Laud PR, Multani AS, Bailey SM, Wu L, Ma J, Kingsley C, Lebel M, Pathak S, DePinho RA, Chang S. Elevated telomere-telomere recombination in WRN-deficient, telomere dysfunctional cells promotes escape from senescence and engagement of the ALT pathway. Genes Dev 2006; 19:2560-70. [PMID: 16264192 PMCID: PMC1276730 DOI: 10.1101/gad.1321305] [Citation(s) in RCA: 146] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Werner Syndrome (WS) is characterized by premature aging, genomic instability, and cancer. The combined impact of WRN helicase deficiency and limiting telomere reserves is central to disease pathogenesis. Here, we report that cells doubly deficient for telomerase and WRN helicase show chromosomal aberrations and elevated recombination rates between telomeres of sister chromatids. Somatic reconstitution of WRN function, but not a WRN helicase-deficient mutant, abolished telomere sister chromatid exchange (T-SCE), indicating that WRN normally represses T-SCEs. Elevated T-SCE was associated with greater immortalization potential and resultant tumors maintained telomeres via the alternative lengthening of telomere (ALT) pathway. We propose that the increased incidence of chromosomal instability and cancer in WS relates in part to aberrant recombinations between sister chromatids at telomeres, which facilitates the activation of ALT and engenders cancer-relevant chromosomal aberrations and tumor formation.
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Affiliation(s)
- Purnima R Laud
- Department of Molecular Genetics, University of Texas, The M.D. Anderson Cancer Center, Houston, Texas 77030, USA
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[Malabsorption syndrome, growth disorder, mental retardation, premature aging and chronic renal insufficiency]. Medicina (B Aires) 2006; 66:461-6. [PMID: 17137180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023] Open
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Nakamura Y, Shimizu T, Ohigashi Y, Itou N, Ishikawa Y. Meningioma arising in Werner syndrome confirmed by mutation analysis. J Clin Neurosci 2005; 12:503-6. [PMID: 15925797 DOI: 10.1016/j.jocn.2003.12.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2003] [Accepted: 12/08/2003] [Indexed: 11/24/2022]
Abstract
OBJECTIVE AND IMPORTANCE Meningioma arising in Werner syndrome has been described previously, but never in association with a mutation analysis. We present the first reported case of meningioma in a patient with Werner syndrome and a confirmed major mutation. In addition, we review 27 previously reported patients with meningioma associated with Werner syndrome. CLINICAL PRESENTATION We report a 56-year-old Japanese woman with Werner syndrome and a meningioma. She presented with pain and redness of the right eye and a headache. Cranial CT revealed a tumor the in right frontal and temporal lobes. Pathological examination after surgical removal confirmed meningioma. She displayed typical features of Werner syndrome including juvenile cataract, short stature and low weight, a bird-like face, a hoarse voice, and dry, atrophic, pigmented skin. INVESTIGATION To confirm the clinical diagnosis, a mutation analysis based on the mutant allele-specific amplification (MASA) method was performed. CONCLUSION Mutation analysis of peripheral blood leukocyte DNA showed amplification of the mutation 4/4. There were 22 patients with Werner syndrome and meningioma reported from Japan and 5 from outside Japan. There was only one malignant meningioma. Meningiomas in Werner syndrome have a higher frequency in males and occur at a younger age than those of the general population.
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Affiliation(s)
- Yukio Nakamura
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
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Wollina U, Gruner M, Koch A, Köstler E, Hubl W, Hanson NB, Oshima J. Topical PDGF-BB results in limited healing in a patient with Werner's syndrome and chronic leg ulcers. J Wound Care 2005; 13:415-6. [PMID: 15575568 DOI: 10.12968/jowc.2004.13.10.26690] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Impaired wound healing is a feature of Werner's syndrome. Treatment of one such patient with painful chronic leg ulcers included topical application of PDGF-BB. Granulation increased slightly, enabling full-thickness skin grafting to take place.
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Affiliation(s)
- U Wollina
- Department of Dermatology, Academic Teaching Hospital Dresden-Friedrichstadt, Dresden, Germany.
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Iguchi H, Takayama M, Kusuki M, Sunami K, Nakamura A, Yamane H, Yamashita Y, Ohira M, Hirakawa K. A possible case of Werner syndrome presenting with multiple cancers. Acta Otolaryngol 2004:67-70. [PMID: 15513515 DOI: 10.1080/03655230410018336] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The treatment of a man with six metachronous primary cancers is described. The primary lesions were in the soft palate, both edges of the tongue, the hard palate, the esophagus, and the right ureter. Pathologically, all of the first five tumors in the head and neck and esophagus were proven to be squamous cell carcinoma with various grades of differentiation, and the last one was transitional cell carcinoma. The cancers were found in the early clinical stage, and were completely controlled one by one except for the ureteral tumor under treatment. His characteristic medical history and physical findings, i.e. bilateral cataracts, short stature, baldness, diabetes mellitus, high-pitched voice, and multiple malignancies, met the clinical criteria for possible Werner syndrome, a genetic premature aging disorder, though the possibility of phenocopy of this syndrome has not been ruled out. We have followed him carefully because he might be vulnerable to malignant tumor formation.
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Affiliation(s)
- Hiroyoshi Iguchi
- Department of Otolaryngology and Head & Neck Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.
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Saito Y. [Management of hyperlipidemia in the elderly]. Nihon Ronen Igakkai Zasshi 2004; 41:510-1. [PMID: 15515730 DOI: 10.3143/geriatrics.41.510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
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