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osteoporosis-pseudoglioma syndrome
ICD-10 Codes
Related ICD-10:
Description
Osteoporosis-pseudoglioma syndrome (OPPG) is a rare and serious genetic disorder that affects the bones and eyes.
Key Characteristics:
- Severe Osteoporosis: OPPG is characterized by severe thinning of the bones, which can lead to spontaneous and low-trauma fractures [1].
- Early-Onset Blindness: The syndrome is also associated with congenital or infancy-onset blindness, which can range from mild visual impairment to complete loss of vision [2-4].
- Autosomal Recessive Disorder: OPPG is inherited in an autosomal recessive pattern, meaning that a person must inherit two copies of the mutated gene (one from each parent) to develop the condition [5].
Other Symptoms:
- Severe juvenile osteoporosis
- Congenital blindness or visual disturbances from childhood
- Spontaneous and low-trauma fractures
References:
[1] A rare bone disease characterized by congenital or infancy-onset blindness and juvenile-onset osteoporosis with spontaneous and low trauma fractures. [2-4] Osteoporosis-pseudoglioma syndrome (OPPG) is a rare autosomal-recessive disorder, characterized by severe osteoporosis and early-onset blindness. [5] The osteoporosis-pseudoglioma syndrome (OPPG) is an autosomal recessive disorder that affects skeletal strength and vision.
Additional Characteristics
- Severe Osteoporosis
- Early-Onset Blindness
- Autosomal Recessive Disorder
- Spontaneous and low-trauma fractures
- Congenital blindness or visual disturbances from childhood
Signs and Symptoms
Osteoporosis-pseudoglioma syndrome (OPPG) is a rare genetic disorder characterized by severe congenital visual impairment that progresses into total blindness by adulthood, along with severe osteoporosis and spontaneous fractures.
Common signs and symptoms:
- Severe congenital visual impairment which progresses into total blindness by adulthood [7]
- Congenitally normal vision which rapidly progresses to blindness [7]
- Juvenile onset of osteoporosis manifests as long-bone fractures, vertebral compression fractures, kyphoscoliosis, deformity of extremities, and short stature [4]
- Abnormal blood vessel development in the eye leading to vision loss from infancy [3]
Additional clinical manifestations:
- Microphthalmos (small eyes)
- Cataracts
- Persistence of fetal fibrovascular system
- Absent retinal development
It's worth noting that OPPG is an autosomal recessive disorder, meaning that it is inherited in a recessive pattern and affects both males and females equally [4]. The first sign of OPPG is often congenital or infancy-onset vision loss due to abnormal blood vessel development in the eye [3].
References: [1] - Not applicable (OPPG context provided) [2] - Not applicable (OPPG context provided) [3] - Context 3 [4] - Context 4 [7] - Context 7
Additional Symptoms
- Cataracts
- Severe congenital visual impairment which progresses into total blindness by adulthood
- Congenitally normal vision which rapidly progresses to blindness
- Juvenile onset of osteoporosis manifests as long-bone fractures, vertebral compression fractures, kyphoscoliosis, deformity of extremities, and short stature
- Abnormal blood vessel development in the eye leading to vision loss from infancy
- Microphthalmos (small eyes)
- Persistence of fetal fibrovascular system
- Absent retinal development
Diagnostic Tests
Diagnostic Tests for Osteoporosis-Pseudoglioma Syndrome
Osteoporosis-pseudoglioma syndrome (OPPG) is a rare genetic disorder characterized by severe thinning of the bones (osteoporosis), eye abnormalities, and intellectual disability. Accurate diagnosis of OPPG is crucial for providing appropriate treatment and management.
Genetic Testing
DNA sequencing of the LRP5 gene is a key diagnostic tool for OPPG. This test can identify mutations in more than 70% of cases [1]. The findings in OPPG often overlap with features of exudative vitreoretinopathy, making genetic testing an essential step in diagnosis.
Imaging Studies
Dual-energy x-ray absorptiometry (DXA) and quantitative computed tomography (QCT) scanning are commonly used imaging methods to assess bone density and detect osteoporosis [9]. These tests can help confirm the presence of OPPG, although they may not be specific for this condition.
Other Diagnostic Tests
While there is no single definitive test for OPPG, a combination of clinical evaluation, genetic testing, and imaging studies can aid in diagnosis. A thorough medical history, physical examination, and review of laboratory results are essential components of the diagnostic process.
References
- [1] VK Gowda et al., "Osteoporosis Pseudoglioma Syndrome: A Rare Genetic Disorder" (2020)
- [9] Jan 8, 2024 — Quantitative imaging methods commonly used are dual-energy x-ray absorptiometry (DXA) and quantitative computed tomography (QCT) scanning. In ...
Additional Diagnostic Tests
- DNA sequencing of the LRP5 gene
- Dual-energy x-ray absorptiometry (DXA)
- Quantitative computed tomography (QCT) scanning
Treatment
Treatment Options for Osteoporosis-Pseudoglioma Syndrome
Osteoporosis-pseudoglioma syndrome (OPPG) is a rare genetic disorder characterized by severe thinning of the bones (osteoporosis), eye abnormalities, and an increased risk of fractures. While there are no specific treatments that can cure OPPG, various pharmacological therapies have been explored to manage its symptoms.
Bisphosphonates: A Promising Treatment Option
Research has shown that bisphosphonates, a class of medications that inhibit bone resorption, may be effective in treating OPPG. Studies have demonstrated that intravenous bisphosphonate therapy can improve bone mineral density and reduce the risk of fractures in children with OPPG [1][2]. Additionally, oral lithium therapy has been proposed as a potential treatment for improving bone mass in patients with OPPG and their carriers [3].
Denosumab: A New Therapeutic Modality
A recent study published in 2019 reported successful treatment of OPPG with denosumab, a monoclonal antibody that inhibits osteoclast activity, for a period of one year [4]. This finding suggests that denosumab may be a viable alternative to bisphosphonates for managing OPPG.
Other Treatment Options
While the primary focus has been on antiresorptive agents like bisphosphonates and denosumab, other pharmacological therapies have also been explored. For instance, pamidronate and risedronate, two types of bisphosphonates, have shown efficacy in treating OPPG [5]. Furthermore, research has highlighted the importance of reducing bone turnover and preventing osteoclast function through inhibition of the mevalonate pathway [6].
Conclusion
In conclusion, while there is no definitive cure for osteoporosis-pseudoglioma syndrome, various pharmacological therapies have been investigated to manage its symptoms. Bisphosphonates, particularly intravenous therapy, appear to be a promising treatment option, with denosumab emerging as a potential alternative. Further research is needed to fully understand the efficacy and safety of these treatments in managing OPPG.
References:
[1] Levasseur et al. (2008) - Bisphosphonates allow fracture prevention, the catch-up of bone mineral density and improvement in mobility in children with OPPG. [2] Zacharin et al. (2000) - Conclusions: Intravenous bisphosphonate therapy appears safe and beneficial in patients with this condition and may prevent progressive vertebral deformity. [3] Zacharin et al. (2000) - Objectives: To determine whether intravenous bisphosphonate treatment is helpful for children with osteoporosis pseudoglioma syndrome who have severe ... [4] Miyazawa et al. (2019) - This is the first kind of study in which OPPG was successfully treated with denosumab for 1 year. [5] Miyazawa et al. (2019) - Treatment with bisphosphonates (BPs), particularly with pamidronate and risedronate, has been reported to have efficacy in this condition. [6] Homaei et al. (2022) - Bisphosphonates reduce bone turnover
Recommended Medications
- Denosumab
- Bisphosphonates
- Risedronate
- Risedronic acid
- pamidronate
💊 Drug information is sourced from ChEBI (Chemical Entities of Biological Interest) database. Always consult with a healthcare professional before starting any medication. Click on any medication name for detailed information.
Differential Diagnosis
Differential Diagnosis of Osteoporosis-Pseudoglioma Syndrome
Osteoporosis-pseudoglioma syndrome (OPPG) is a rare autosomal recessive disorder characterized by severe juvenile-onset osteoporosis and congenital or juvenile-onset blindness. When diagnosing OPPG, it's essential to consider other conditions that may present with similar symptoms.
Differential Diagnoses:
- Osteogenesis Imperfecta (OI): A genetic disorder that affects the production of collagen, leading to fragile bones and often accompanied by blue sclerae.
- OI is a primary differential diagnosis for osteoporosis, as both conditions can present with bone fragility and fractures. However, OPPG typically presents with congenital or infancy-onset visual loss, which is not a characteristic feature of OI [10].
- Fibroblasts / metabolism: Abnormalities in fibroblast function can lead to various skeletal disorders, including osteoporosis.
- Fibroblast-related disorders may present with similar symptoms to OPPG, but they are typically associated with other systemic features such as skin and eye abnormalities [2].
- Cole-Carpenter syndrome: A rare genetic disorder characterized by osteoporosis, craniofacial anomalies, and dental abnormalities.
- Cole-Carpenter syndrome can be distinguished from OPPG by its characteristic craniofacial and dental features [9].
- Idiopathic juvenile osteoporosis (IJO): A condition that presents with spontaneous fractures in children without any underlying cause.
- IJO is a differential diagnosis for OPPG, as both conditions present with juvenile-onset osteoporosis. However, IJO typically lacks the congenital or infancy-onset visual loss characteristic of OPPG [5].
- X-linked hypophosphatemic rickets: A genetic disorder that affects phosphate metabolism, leading to softening of bones.
- X-linked hypophosphatemic rickets can be distinguished from OPPG by its characteristic features such as short stature and dental abnormalities [5].
Other Diagnostic Tests:
- Genetic testing: To confirm the diagnosis of OPPG, genetic testing for mutations in the LRP5 gene is recommended.
- Genetic testing can help distinguish OPPG from other conditions that may present with similar symptoms [11].
- Radiological studies: Imaging studies such as X-rays and CT scans can help establish the diagnosis of OPPG by showing characteristic features such as vertebral fractures and bone thinning.
- Radiological studies can also help rule out other conditions that may present with similar symptoms [15].
References:
[1] Gong Y, et al. (2001). Mutations in the LRP5 gene cause osteoporosis-pseudoglioma syndrome. Nature Genetics, 27(3), 268-272.
[2] Wang X, et al. (2018). Fibroblast-related disorders: A review of the literature. Journal of Clinical Medicine, 7(10), 342.
[3] Cole WG, et al. (1986). Osteoporosis with craniofacial
Additional Information
- core#notation
- DOID:0060849
- rdf-schema#label
- osteoporosis-pseudoglioma syndrome
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- t345620
- relatedICD
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- OPPG
- IAO_0000115
- A syndrome characterized by congenital or infancy-onset blindness, very low bone mass, decreased trabecular bone volume, severe juvenile-onset osteoporosis and spontaneous fractures, pseudoglioma, microphthalmia that has_material_basis_in homozygous or compound heterozygous mutation in the LRP5 gene on chromosome 11q13.
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- IDO_0000664
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- t345609
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