Introduction
Progeria, also known as Hutchinson-Gilford Progeria Syndrome (HGPS), is an exceedingly rare genetic disorder characterized by accelerated aging in children. The term "Progeria" originates from the Greek word "geras," which means "old age." This condition was initially described in the late 1800s by Dr. Jonathan Hutchinson and Dr. Hastings Gilford, hence it is also referred to as Hutchinson-Gilford progeria syndrome. This condition is always fatal. In this article, we embark on a quest to unravel the mysteries of progeria by discussing its etiology, symptoms, diagnosis, complications, and management.
Epidemiology and Prevalence of Progeria
Progeria is exceptionally uncommon, It manifests in approximately 1 in every 4 million live births globally. Presently, around 400 children and young adults worldwide are living with HGPS.
Etiology of Progeria
De novo point mutation in the LMNA gene is the reason behind the condition. The LMNA is responsible for the synthesis of a protein termed lamin A. A small alteration in the LMNA gene prompts the production of an abnormal variant of the Lamin A protein known as Progerin. Progerin substitutes for Lamin A, destabilizing the nuclei of cells over time and gradually causing damage. Consequently, it leads to the death of every cell in the body, which causes the process of premature aging.
Symptoms of Progeria
Infants born with the condition typically exhibit normal health at birth; however, signs of premature aging typically manifest within the first one to two years of life, which include;
Short stature
Wrinkled skin
Alopecia
Nail dystrophy
Increased stiffness of joints limits the mobility of joints
Loss of fat from the body
Coxa vulga
Skin with a tough texture resembling scleroderma
Craniofacial abnormalities are:
Disproportionately small face compared to head
Abnormally prominent eyes
Narrow nasal bridge and tip
Micrognathia
Delayed eruption and loss of tooth
At later stages, symptoms that are less obvious begin to develop. Which includes
Partial absence of eruption of Permanent teeth
Cataract
Arthritis
Dislocation of hip
Building up of plaque in arteries
Diagnosis of Progeria
Physical examination: The physician will perform a physical examination and ask for symptoms.
CT and MRI scanning: scanning reveals generalized osteopenia, bone resorption around phalanges and distal clavicle, fish-mouth vertebral bodies, and wide metaphyses with narrow diaphysis. Craniofacial abnormalities like abnormal mandibular condyles, kinking of the optic nerve, and articular eminence hypoplasia. Soft tissue abnormalities also can be seen.
Histological examination: In the initial stages, the skin from sclerotic and firm regions exhibits characteristics of scleroderma, including epidermal acanthosis. Thickened collagen bundles are observable in the dermis, extending into the subcutaneous tissue. Mild perivascular infiltrate may be evident, accompanied by an elevated level of mucopolysaccharides acid.
Complications of Progeria
Severe atherosclerosis
Cardiac disorders such as myocardial infarction or heart failure
Cerebrovascular shock
As a result of these complications death occurs at ages between 6 to 20 years
Management and treatment of Progeria
At present there is no cure for Progeria treatments are available treatments available only for symptomatic relief.
The use of a drug called “Lonafarnib” increased the average survival rate of children by 2.5 years by improving the bone structure and hearing increasing flexibility of blood vessels and weight gain.
Physical therapy to improve mobility, balance, and posture.
Regular monitoring of the health condition is necessary. The health care provider will monitor and manage the patient’s health by:
Monitoring of heart condition: Regular echocardiogram and monitoring of blood pressure, therapy with low-dose Aspirin and Statin to reduce the risk of heart diseases.
MRI: To check the chances of stroke, headache, and seizures.
Hearing test: A hearing test can be performed to check for any hearing impairments and can be corrected by using hearing aids.
Eye test: dryness and irritation can be seen in patients because their inability to close the eyelids completely as it advances leads to the development of cataracts. Patients may advised to wear sunglasses in case of light sensitivity.
Dental check-ups: Regular dental check-ups are necessary to treat various dental diseases like dental caries, tooth crowding, delayed eruption of teeth, and receding gums.
Monitoring of skin condition: The healthcare provider will look for skin changes, alopecia, itching, and skin tightness that can make breathing and eating difficult.
CONCLUSION
In conclusion, Hutchinson-Gilford Progeria Syndrome presents a profound challenge, both medically and emotionally, for those affected and their families. Despite its rarity and severity, advancements in research and medical technology offer hope for improved treatments and possibly even a cure in the future. The resilience and strength of individuals living with Progeria, coupled with the dedication of researchers and healthcare professionals, underscore a collective commitment to overcoming this rare genetic condition. As awareness grows and scientific understanding deepens, we move closer to a world where Progeria is no longer a barrier to a full and vibrant life.
REFERENCES
Hutchinson-Gilford Progeria Syndrome: A literature review by Alexander Muacevic and John R Adler, 2022
Progeria: A rare genetic premature aging disorder by Jitendra kumar Sinha, Shamba Ghosh, Manchala Raghunath.
Hutchinson-Gilford Progeria Syndrome:Cellular mechanisms and therapeutic perspectives by Bulmaro Cisneros, Ian Garcia-aguirre, Marlon D Ita, Isabel Arietta-Cruz, Hydee Rosas-Vergas ,2023.
