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Prader-Willi Syndrome Symptoms, Causes, Diagnosis, Treatment

Prader-Willi syndrome is a genetic disorder that occurs infrequently due to the malfunction of specific genes located on chromosome 15. Learn about PWS symptoms, causes, and treatment here.
authorImageNivedita Dar18 Mar, 2024
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Prader-Willi Syndrome Symptoms, Causes, Diagnosis, Treatment

Prader-Willi Syndrome (PWS) is the most common genetic disorder causing severe obesity in children. It affects many aspects of a person's life, including eating habits, behavior, mood, physical growth, and intellectual development.

In 1887, Langdon Down identified the first patient with Prader-Willi syndrome as a teenage girl with mental impairment, short stature, underdeveloped sexual organs, and obesity. He attributed these symptoms to overeating. Read this article to learn about Prader-Willi Syndrome symptoms, causes, treatments, and how doctors can treat them.

What is Prader-Willi Syndrome?

P rader-Willi Syndrome is a genetic disorder occurring in about one in 15,000 births, affecting both males and females equally across all racial and ethnic groups. It stands as the leading genetic cause of severe childhood obesity. his condition poses life-threatening risks. It impacts an estimated 1 in 10,000 to 30,000 individuals globally. This syndrome is named after Swiss doctors Andrea Prader and Heinrich Willi, who, together with Alexis Labhart, provided its description in 1956. Yet, the syndrome's history extends back to 1887, when British physician John Langdon Down initially observed its characteristics.

Prader-Willi Life Expectancy

The average life expectancy of prader-willi syndrome patients is 30 years, but people have been known to live into their 60s .

Prader-Willi Syndrome Symptoms

Prader-Willi syndrome can vary among individuals. Symptoms may slowly change over time from childhood to adulthood. Here are some common manifestations:

During Infancy:

  • Weak cry and lethargy (constant tiredness)
  • Poor feeding ability and weak muscle tone (hypotonia)
  • Distinct facial features like almond-shaped eyes and a triangular mouth
  • Short stature and small hands and feet
  • Underdeveloped genitals in males and females

From Early Childhood to Adulthood:

  • Intense food cravings lead to rapid weight gain
  • Underdeveloped sex organs and delayed puberty
  • Stunted growth and physical development
  • Cognitive impairment ranging from mild to moderate intellectual disability
  • Delayed motor skills development and speech difficulties
  • Behavioral challenges such as stubbornness and obsessive-compulsive behaviors
  • Sleep disorders, including disruptions of the sleep cycle and sleep apnea
  • Other physical symptoms like scoliosis, hip problems, and vision issues

Prader-Willi Syndrome Causes

Here are a few common Prader-Willi syndrome causes that individuals may experience: Deletions : The loss or deletion of a part of the father's chromosome 15 results in several genes losing function. These genes are crucial for regulating hunger and satiety. Since the mother's corresponding genes on chromosome 15 are inactive, they can't compensate for the father's deletion, leading to PWS in most cases. Maternal Uniparental Disomy : In about 25% of PWS cases, a child inherits two copies of chromosome 15 from the mother and none from the father. The PWCR genes, which are usually inactive in the mother's chromosome, remain inactive because there's no paternal chromosome to activate them, resulting in PWS. Imprinting Center Defect : In a few instances, chromosome 15 from the father is incorrectly imprinted, similar to the mother's chromosome. This may happen due to a small deletion in a specific region of the father's chromosome, known as the imprinting center, responsible for gene imprinting. Consequently, the genes in the PWCR of both sets of chromosome 15 are inactive, causing PWS.

Prader-Willi Syndrome Facial Features

I ndividuals with Prader-Willi syndrome often have distinctive facial features such as :
  • Almond-shaped eyes,
  • a narrow nose bridge,
  • a narrowed forehead and
  • a thin upper lip with an upturned mouth.
Other common physical characteristics include:
  • low birth weight,
  • weak muscles (hypotonia),
  • underdeveloped sexual organs (hypoplasia),
  • fair complexion (hypopigmentation),
  • crossed eyes (strabismus),
  • short stature due to low human growth hormone levels, and
  • a tendency toward obesity due to excessive eating (hyperphagia) and poor muscle tone.

How is PWS Diagnosed?

PWS diagnosis typically involves a blood test called "methylation analysis." This test is specifically designed to detect genetic abnormalities associated with PWS. While a FISH (fluorescence in-situ hybridization) test can identify PWS through deletion, it doesn't cover all syndrome forms. The methylation test is the preferred diagnostic method as it can identify all types of PWS. However, if a methylation test is initially performed and PWS is confirmed, additional testing may be required to determine the specific genetic cause. This includes determining whether PWS is caused by paternal deletion, maternal uniparental disomy (UPD), or an imprinting defect. In cases where an imprinting defect is suspected, blood samples may be obtained from the parents for further analysis, aiding in the comprehensive diagnosis of Prader-Willi syndrome.

Prader-Willi Syndrome Treatment

Prader-Willi Syndrome treatment involves a multidisciplinary approach to managing various symptoms and improving individuals' overall quality of life. Here are some ways to treat prader-willi syndrome
  • Children with Prader-Willi Syndrome (PWS) may have difficulty eating and can gain weight rapidly. Babies might need special feeding methods or special formulas to help them grow. As they age, it's important to have structured meal times and limit access to high-calorie snacks to prevent them from overheating.
  • Some children with PWS might have low levels of growth hormone, which can affect their growth and muscle tone. Doctors can give them extra growth hormone through injections to help them grow and develop better muscles. They might also need hormone replacement therapy when they reach puberty to help their bodies develop properly.
  • Children with PWS need to eat less than other kids because they gain weight very easily. Dietitians can help plan healthy meals with fewer calories. It's also important for them to do activities that make them move around more to stay healthy.
  • Some kids with PWS have trouble sleeping, which can make them tired and grumpy during the day. Doctors can help treat sleep problems so they can feel better and behave better.
  • Children with PWS might need different kinds of therapy to help them learn and grow. Physical therapy helps them get stronger and move better. Speech therapy helps them learn to talk better. Occupational therapy helps them learn everyday skills like dressing themselves or using utensils. Developmental therapy helps them learn how to behave like other kids their age.
  • Kids with PWS might have trouble controlling their behavior, so parents need to set rules and limits. Sometimes, they might need medicine to help them behave better.
  • Some children with PWS might have other problems, like feeling sad or anxious. Doctors can help them feel better by talking to them and sometimes giving them medicine.
  • Kids with PWS might need to see different kinds of doctors for other health problems like problems with their eyesight or their thyroid. It's important to check for these problems regularly.
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How are behavioral issues managed in individuals with Prader-Willi syndrome?

Behavioral issues in individuals with Prader-Willi syndrome are typically managed through behavioral therapy, structured routines, and sometimes medication.

What dietary guidelines are advised for those with Prader-Willi syndrome?

Patients with PWS are often recommended a diet comprising about 40% complex carbohydrates, 30% protein, and 30% healthy fats. The focus is on incorporating nonstarchy vegetables, fiber-rich foods, and high-quality protein sources while completely avoiding processed foods and sugary drinks.

Is obesity commonly associated with Prader-Willi syndrome (PWS)?

Prader-Willi syndrome (PWS) is recognized as one of the most prevalent genetic contributors to obesity, affecting approximately 1 in every 10,000 to 30,000 live births.

What brain area does Prader-Willi syndrome influence?

Prader-Willi syndrome arises from a genetic anomaly on chromosome 15, resulting in various challenges. It is believed to impact the hypothalamus, a crucial region responsible for hormone regulation, growth, and appetite.
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