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Review
. 2015 Dec;38(12):1249-63.
doi: 10.1007/s40618-015-0312-9. Epub 2015 Jun 11.

Prader-Willi syndrome: a review of clinical, genetic, and endocrine findings

M A Angulo  1 , M G Butler  2 , M E Cataletto  3
Affiliations
Review

Prader-Willi syndrome: a review of clinical, genetic, and endocrine findings

M A Angulo et al. J Endocrinol Invest. 2015 Dec.

Abstract

Introduction: Prader-Willi syndrome (PWS) is a multisystemic complex genetic disorder caused by lack of expression of genes on the paternally inherited chromosome 15q11.2-q13 region. There are three main genetic subtypes in PWS: paternal 15q11-q13 deletion (65-75 % of cases), maternal uniparental disomy 15 (20-30 % of cases), and imprinting defect (1-3 %). DNA methylation analysis is the only technique that will diagnose PWS in all three molecular genetic classes and differentiate PWS from Angelman syndrome. Clinical manifestations change with age with hypotonia and a poor suck resulting in failure to thrive during infancy. As the individual ages, other features such as short stature, food seeking with excessive weight gain, developmental delay, cognitive disability and behavioral problems become evident. The phenotype is likely due to hypothalamic dysfunction, which is responsible for hyperphagia, temperature instability, high pain threshold, hypersomnia and multiple endocrine abnormalities including growth hormone and thyroid-stimulating hormone deficiencies, hypogonadism and central adrenal insufficiency. Obesity and its complications are the major causes of morbidity and mortality in PWS.

Methods: An extensive review of the literature was performed and interpreted within the context of clinical practice and frequently asked questions from referring physicians and families to include the current status of the cause and diagnosis of the clinical, genetics and endocrine findings in PWS.

Conclusions: Updated information regarding the early diagnosis and management of individuals with Prader-Willi syndrome is important for all physicians and will be helpful in anticipating and managing or modifying complications associated with this rare obesity-related disorder.

Keywords: Chromosome 15 abnormalities; Endocrine disturbances; Genomic imprinting; Hypogonadism; Obesity; Prader-Willi syndrome; Short stature.

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Figures

Fig. 1
Fig. 1
a Obesity, almond shape eyes, down-turned mouth and straight borders of inner legs. b Straight borders of ulnar side of hands and scares from skin picking. c Active and healing skin lesions on scalp
Fig. 2
Fig. 2
High resolution chromosome 15 ideogram and locations of breakpoints BP1 and BP2 [at 15q11.2 band] and BP3 [at 15q13.1 band] are shown with position of the four non-imprinted genes between breakpoints BP1 and BP2 and those imprinted and non-imprinted genes between breakpoints BP2 and BP3. Three recognized deletion subtypes and their locations in the 15q11-q13 region (i.e., 15q11.2 BP1-BP2; typical 15q11-q13 type I; typical 15q11-q13 type II) are represented
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