Saturday 10 August 2013

Rare Condition: Growing Old Before Growing Up



Imagine a child of ten years looking like an eighty-year-old. It doesn’t even end there. This child also shows other signs associated with old age like growth failure, shrunken or wrinkled face, baldness, loss of eyebrows and eyelashes amongst other symptoms. It may sound far-fetched but that is exactly what some children with a condition known as Progeria suffer from.

Progeria is an extremely rare genetic disease of childhood characterized by dramatic, premature aging. Symptoms resembling aspects of aging are manifested at a very early age. The word Progeria comes from the Greek words "pro" meaning "before" or "premature", and "gēras" meaning "old age".

There are different forms of the condition but the classical type is the Hutchinson-Gilford Progeria Syndrome (HGPS). Progeria was first described in 1886 by Jonathan Hutchinson.  It was also described independently in 1897 by Hastings Gilford and the condition was later named after them.

Prevalence
There is a reported incidence of Progeria of approximately 1 in every 4 to 8 million newborns. Currently, there are 80 known cases in the world and approximately 140 cases have been reported in medical history. Both boys and girls run an equal risk of having Progeria and it appears to affect children of all races equally.

Signs and Symptoms
Children with Progeria are born looking healthy. When they are about 10 to 24 months old, features of accelerated aging start to appear. Signs of Progeria may include:
  • Growth failure
  • Loss of body fat
  • Loss of hair
  • Skin starts to look aged
  • Stiffness in the joints
  • Hip dislocation
  • Generalized atherosclerosis (cardio and heart disease)
  • Stroke
Children who suffer from Progeria are genetically susceptible to premature, progressive heart disease. Nearly all Progeria patients die from heart disease. They commonly experience cardiovascular events, such as hypertension (high blood pressure), stroke, enlarged heart and heart failure - conditions linked to aging.

Causes
90% of children with Progeria have a mutation on the gene that encodes Lamin A, a protein that holds the nucleus of the cell together. It is believed that the defective Lamin A protein makes the nucleus unstable. This instability seems to lead to the process of premature aging among Progeria patients.
Progeria appears to occur without cause - it is not seen in siblings of affected children. In extremely rare cases more than one child in the same family may have the condition.

Is Progeria hereditary?
Experts do not believe that Progeria is hereditary. They say it is due to a rare gene change which happens purely by chance. A non-twin sibling runs the same risk of having Progeria as any other child from another family. In about 1 in every 100 cases of HGPS the syndrome is passed down to the next generation within the same family.

Prognosis
As there is no known cure, few people with progeria exceed 13 years of age. At least 90% of patients die from complications of atherosclerosis, such as heart attack or stroke.

Treatment
No treatments have been proven effective. Most treatment focuses on reducing complications (such as cardiovascular disease) with heart bypass surgery or low-dose aspirin. Children may also benefit from a high-energy diet.
A type of anticancer drug, the farnesyltransferase inhibitors (FTIs), has been proposed, but their use has been mostly limited to animal models.

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