Hermansky Pudlak syndrome

Hermansky Pudlak syndrome

National Organization for Rare Disorders, Inc.

Important

It is possible that the main title of the report Hermansky Pudlak syndrome is not the name you expected. Please check the synonyms listing to find the alternate name(s) and disorder subdivision(s) covered by this report.

Synonyms

  • HPS
  • delta storage pool disease
  • albinism with hemorrhagic diathesis and pigmented reticuloendothelial cells

Disorder Subdivisions

  • None

General Discussion

Hermansky-Pudlak syndrome is a rare, hereditary disorder that consists of three characteristics: lack of skin pigmentation (albinism), blood platelet dysfunction with prolonged bleeding, and visual impairment. Some patients have lung fibrosis, colitis, or an abnormal storage of a fatty-like substance (ceroid lipofuscin) in various tissues of the body.

Symptoms

Frequently the first symptoms of Hermansky-Pudlak syndrome include easy bruising, bleeding gums, nose bleeds, and excessive bleeding after surgery or accidents. The classic symptoms of Hermansky-Pudlak syndrome include the lack of color (pigmentation) in the skin, hair, and eyes (oculocutaneous albinism), and dysfunction of blood platelets leading to prolonged bleeding (storage pool-deficient platelets).



The skin, hair, and eyes of a person with Hermansky-Pudlak syndrome may vary in color from very pale to almost normal coloring. Eyesight is almost always impaired, commonly with visual acuities of 20/200 or worse (i.e., legally blind). The blood storage abnormality may cause excessive bleeding, especially in women during menstruation. Bleeding may become life-threatening, especially after taking aspirin. Approximately one-sixth of HPS patients develop a bleeding inflammation of the colon. Patients with type 1, type 2, or type 4 HPS (see below) develop a fatal lung disease called pulmonary fibrosis that can lead to death in their thirties, forties, or fifties.



The deposits of fatty-like ceroid lipofuscin may occur in many of the body's tissues such as the lungs, colon, heart, and kidneys.

Causes

Hermansky-Pudlak syndrome is inherited as an autosomal recessive genetic disease. Mutations in one of 9 genes (HPS1, AP3B1, HPS3, HPS4, HPS5, HPS6, DTNBP1, BLOC1S3, and PLDN) are responsible for this disorder. Research suggests that an abnormality of the formation or movement of lysosome-like vesicles may be responsible for the development of the disease. Humans inherit one gene from the father and one from the mother. In recessive disorders, the condition does not appear unless a person inherits one defective gene from each parent. If an individual receives one normal gene and one gene for the disease, the person will be a carrier for the disease, but will not show symptoms. If both parents are carriers for a recessive disorder, the risk of transmitting the disease to a child is 25 percent; the risk that a child would be a carrier for the disease is 50 percent, and a child would inherit two normal genes 25 percent of the time. The risk is the same for each pregnancy.

Affected Populations

Hermansky-Pudlak syndrome is a rare disorder that affects males and females in equal numbers. It is most prevalent in persons from northwest Puerto Rico, where Hermansky-Pudlack syndrome affects one of every 1,800 individuals. One in 21 individuals of northwest Puerto Rican descent are believed to be carriers of the Hermansky-Pudlack syndrome type 1 gene. However, Hermansky-Pudlack syndrome does occur in other populations as well. It is the third most prevalent form of albinism.

Standard Therapies

Treatment of Hermansky-Pudlak syndrome patients with excessive bleeding may consist of transfusions of normal blood platelets. Women with excessive menstrual bleeding (menorrhagia) can be treated with oral contraceptives. The drug desmopressin acetate (DDAVP) can also be administered to patients with excessive bleeding and has proved effective for some patients with this symptom. Individuals with Hermansky-Pudlak syndrome should avoid blood anticoagulants, such as aspirin.



Genetic counseling may be of benefit for affected individuals and their families. Other treatment is symptomatic and supportive.

Investigational Therapies

Information on current clinical trials is posted on the Internet at www.clinicaltrials.gov. All studies receiving U.S. government funding, and some supported by private industry, are posted on this government website.



For information about clinical trials being conducted at the National Institutes of Health (NIH) in Bethesda, MD, contact the NIH Patient Recruitment Office:



Tollfree: (800) 411-1222

TTY: (866) 411-1010

Email: prpl@cc.nih.gov



For information about clinical trials sponsored by private sources, contact:

www.centerwatch.com



A study is being conducted at the National Institutes of Health/National Human Genome Research Institute to gather information on Hermansky-Pudlak syndrome. More studies are needed to determine the safety and effectiveness of treatments for Hermansky-Pudlak syndrome.

References

TEXTBOOKS

The Metabolic Basis of Inherited Disease, 6th Ed.: Charles R. Scriver, et al., Editors; McGraw Hill, 1989. Pp. 2905, 2916, 2929-2930.



Hematology, 4th Ed,: William J. Williams, et al., Editors; McGraw-Hill, Inc., P. 1177.



JOURNAL ARTICLES

Gahl WA, Brantly M, Kaiser-Kupfer MI, Iwata F, Hazelwood S, Shotelersuk V, Duffy LF, Kuehl EM, Bernardini I. Genetic defects and clinical characteristics of patients with a form of oculocutaneous albinism (Hermansky-Pudlak syndrome). N Engl J Med 338:1258-64, 1998.



INTERNET

Gahl, WA. Updated:July 8, 2010.Hermansky-Pudlak Syndrome. In: GeneReviews at GeneTests: Medical Genetics Information Resource (database online). Copyright, University of Washington, Seattle. 1997-2012. Available at http://www.genetests.org. Accessed on:February 1, 2012.



McKusick VA, ed. Online Mendelian Inheritance in Man (OMIM), Baltimore, MD. The Johns Hopkins University; http://www.ncbi.nlm.nih.gov/omim

Resources

National Organization for Albinism and Hypopigmentation

PO Box 959

East Hempstead, NH 03826-0959

Tel: (603)887-2310

Fax: (800)648-2310

Tel: (800)473-2310

Email: noah@albinism.org

Internet: http://www.albinism.org



Lighthouse International

111 E 59th St

New York, NY 10022-1202

Tel: (800)829-0500

Email: info@lighthouse.org

Internet: http://www.lighthouse.org



Hermansky-Pudlak Syndrome Network, Inc.

One South Road

Oyster Bay, NY 11771-1905

Tel: (516)922-4022

Fax: (516)624-0640

Tel: (800)789-9477

Email: appell@worldnet.att.net or dappell@hpsnetwork.org

Internet: http://www.hpsnetwork.org/en



National Association for Parents of Children with Visual Impairments (NAPVI)

P.O. Box 317

Watertown, MA 02272-0317

Tel: (617)972-7441

Fax: (617)972-7444

Tel: (800)562-6265

Email: napvi@perkins.org

Internet: http://www.napvi.org



NIH/National Institute of Arthritis and Musculoskeletal and Skin Diseases

Information Clearinghouse

One AMS Circle

Bethesda, MD 20892-3675

USA

Tel: (301)495-4484

Fax: (301)718-6366

Tel: (877)226-4267

TDD: (301)565-2966

Email: NIAMSinfo@mail.nih.gov

Internet: http://www.niams.nih.gov/



NIH/National Institute of Child Health and Human Development

31 Center Dr

Building 31, Room 2A32

MSC2425

Bethesda, MD 20892

Fax: (866)760-5947

Tel: (800)370-2943

TDD: (888)320-6942

Email: NICHDInformationResourceCenter@mail.nih.gov

Internet: http://www.nichd.nih.gov/



Genetic and Rare Diseases (GARD) Information Center

PO Box 8126

Gaithersburg, MD 20898-8126

Tel: (301)251-4925

Fax: (301)251-4911

Tel: (888)205-2311

TDD: (888)205-3223

Internet: http://rarediseases.info.nih.gov/GARD/



Madisons Foundation

PO Box 241956

Los Angeles, CA 90024

Tel: (310)264-0826

Fax: (310)264-4766

Email: getinfo@madisonsfoundation.org

Internet: http://www.madisonsfoundation.org



For a Complete Report

This is an abstract of a report from the National Organization for Rare Disorders, Inc.® (NORD). Cigna members can access the complete report by logging into myCigna.com. For non-Cigna members, a copy of the complete report can be obtained for a small fee by visiting the NORD website. The complete report contains additional information including symptoms, causes, affected population, related disorders, standard and investigational treatments (if available), and references from medical literature. For a full-text version of this topic, see http://www.rarediseases.org/search/rdblist.html.

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