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<meta name="keywords" content="C0002066, aku, alcaptonuria, alcaptonurias, alkaptonuria, alkaptonuric ochronosis, deficiency of homogentisate 1,2-dioxygenase, deficiency of homogentisate oxygenase, deficiency of homogentisicase, disease or syndrome, hereditary ochronosis, hgd, hgd-gene related homogentisate 1,2-dioxygenase deficiency, homogentisate 1,2-dioxygenase deficiency, homogentisic acid oxidase deficiency, homogentisic acidura, homogentisicaciduria, ochronosis, hereditary, autosomal dominant, autosomal recessive, birth defects, chromosomal disease, chromosome, clinical features, clinical findings, clinical genetics, clinical recommendations, clinvar, congenital chromosomal disease, consumer genetic resources, cytogenetic location, disease characteristics, disease definitions, disease descriptions, disease ontology, disease synonyms, disease vocabulary, dysmorphology, entrez, familial disease, gene, gene-disease relationship, genereviews, genetic disease, genetic disorder, genetic terminology, genetic testing registry, genetics home reference, genomic disease, gtr, hereditary disease, heritable disease, hpo, human phenotype ontology, inherited disease, management guidelines, maternal inheritance, medgen, medical genetics, medical subject headings, mesh, mitochondrial inheritance, mode of inheritance, national center for biotechnology information, national institutes of health, national library of medicine, ncbi, nih, nlm, omim, ordo, orphanet, paternal inheritance, phenome, position statements, professional practice guidelines, rare disease, reference sequence, refseq, snomed ct, syndrome, undiagnosed diseases, x-linked recessive" /><meta name="description" content="Alkaptonuria is caused by deficiency of homogentisate 1,2-dioxygenase, an enzyme that converts homogentisic acid (HGA) to maleylacetoacetic acid in the tyrosine degradation pathway. The three major features of alkaptonuria are dark urine or urine that turns dark on standing, ochronosis (bluish-black pigmentation in connective tissue), and arthritis of the spine and larger joints. Ochronosis generally occurs after age 30 years; arthritis often begins in the third decade. Other manifestations can include pigment in the sclera, ear cartilage, and skin of the hands; aortic or mitral valve calcification or regurgitation and occasionally aortic dilatation; renal stones; prostate stones; and hypothyroidism." /><meta name="robots" content="index,nofollow,noarchive" />
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<!--
UID=1413
ConceptID=C0002066
-->
<!--imgCountBooks = 2--><div class="ncbi_carousel" data-ncbicarousel-config="imageWidth:'100px',numItemsVisible:2,toggler:false"><div class="nc_header"><span class="img_strip_title">Images (2)</span></div><div class="nc_content"><div class="nc_item"><a class="figpopup"><img alt="Image from GeneReviews" src="/books/NBK1454/bin/alkap-Image002.gif" src-large="/books/NBK1454/bin/alkap-Image002.jpg" /></a><br /><a href="/books/NBK1454/figure/alkap.F2/" title="GeneReviews" target="_blank">details</a></div><div class="nc_item"><a class="figpopup"><img alt="Image from GeneReviews" src="/books/NBK1454/bin/alkap-Image001.gif" src-large="/books/NBK1454/bin/alkap-Image001.jpg" /></a><br /><a href="/books/NBK1454/figure/alkap.F1/" title="GeneReviews" target="_blank">details</a></div></div></div><h1 class="medgenTitle"><div class="MedGenTitleText">Alkaptonuria<span class="h1sub">(AKU)</span></div></h1><div class="aux"><div class="resc"><dl class="rprtid"><dt>MedGen UID: </dt><dd>1413</dd><dt><span class="dotprefix"></span>Concept ID: </dt><dd><a href="/medgen/docs/help/#sources" target="_blank" title="Concept Unique Identifier from NLM's Unified Medical Language system (UMLS)&#10;Click for more information."><span class="highlight" style="background-color:">C0002066</span></a></dd><dt><span class="dotprefix"></span></dt><dd>Disease or Syndrome</dd></dl></div></div><table class="medgenTable"><tbody><tr><td>Synonyms:</td>
<td>AKU; Alcaptonuria; Alkaptonuric ochronosis; HOMOGENTISIC ACID OXIDASE DEFICIENCY; Homogentisic acidura; Ochronosis, hereditary</td></tr>
<tr><td><span class="bold">SNOMED CT: </span></td>
<td>Alkaptonuria (360378009); Homogentisicaciduria (360378009); Deficiency of homogentisate 1,2-dioxygenase (360378009); Deficiency of homogentisate oxygenase (360378009); Homogentisic acid oxidase deficiency (360378009); Deficiency of homogentisicase (360378009); Homogentisate 1,2-dioxygenase deficiency (360378009); HGD-gene related homogentisate 1,2-dioxygenase deficiency (360378009)</td></tr>
<tr><td>Modes of inheritance:</td>
<td>
<div class="divPopper rprt" id="moi_141025"><div><strong>Autosomal recessive inheritance</strong><div class="aux"><div class="resc"><dl class="rprtid"><dt>MedGen UID: </dt><dd>141025</dd><dt><span class="dotprefix"></span>Concept ID: </dt><dd><a href="/medgen/docs/help/#sources" target="_blank" title="Concept Unique Identifier from NLM's Unified Medical Language system (UMLS)&#10;Click for more information.">C0441748</a></dd><dt><span class="dotprefix"></span></dt><dd>Intellectual Product</dd></dl></div></div></div>
<div class="spaceAbove">Source: Orphanet</div>
<div class="spaceAbove">A mode of inheritance that is observed for traits related to a gene encoded on one of the autosomes (i.e., the human chromosomes 1-22) in which a trait manifests in individuals with two pathogenic alleles, either homozygotes (two copies of the same mutant allele) or compound heterozygotes (whereby each copy of a gene has a distinct mutant allele).</div></div>
<div class="hangingIndent"><a title="click for more information" class="jig-ncbipopper" href="#moi_141025" data-jigconfig="hasArrow: true, openEvent: 'click', closeEvent: 'mouseout', openAnimation: 'fadeIn', closeAnimation: 'fadeOut', triggerPosition: 'center right', destPosition: 'center left', arrowDirection: 'left'">Autosomal recessive inheritance</a><span> (Orphanet)</span></div></td></tr>
<tr><td colspan="2" class="small"> </td></tr><tr><td><a class="help jig-ncbi-popper" data-jig="ncbipopper" href="#target-gene-loc">Gene (location):<img class="pulldown" src="//static.pubmed.gov/portal/portal3rc.fcgi/4223267/img/4204968" /></a><div class="display-none" id="target-gene-loc">
Gene(s) directly associated with<br />
this condition or phenotype.</div></td>
<td><a target="_blank" title="HGD - ID: 3081 - NCBI Gene" href="/gene/3081" class="medgenPMinfo">HGD</a> (3q13.33)</td></tr>
<tr><td colspan="2" class="small"> </td></tr><tr><td>Monarch Initiative:</td>
<td><a href="https://monarchinitiative.org/disease/MONDO:0008753" target="_blank">MONDO:0008753</a></td></tr>
<tr><td>OMIM<span class="superscript">®</span>:</td>
<td><a href="https://omim.org/entry/203500" target="_blank">203500</a></td></tr>
<tr><td>Orphanet:</td>
<td><a target="_blank" title="Orphanet: The portal for rare diseases and orphan drugs" href="http://www.orpha.net/consor/cgi-bin/OC_Exp.php?lng=EN&amp;Expert=56">ORPHA56</a></td></tr></tbody></table></div><div class="rprt-body jig-ncbiinpagenav" data-jigconfig="smoothScroll: false, gotoTopLink: true, gotoTopLinkText: '', gotoTopLinkAttrs: {'title': 'Go to the top of the page'},allHeadingLevels: ['h1'], topOfPageTOC: true, tocId: 'my-toc'"><div id="rprt-tabs-1" class="rprt-tab"><div id="tb-termsProp-1"><div class="leftCol mgCol"><div>
<div class="portlet mgSection" id="ID_101">
<div class="portlet_head mgSectionHead ui-widget-header"><h1 class="nl" id="Disease_characteristics">Disease characteristics</h1><a sid="101" href="#" class="portlet_shutter" title="Show/hide content"></a></div>
<div class="portlet_content ln"><div class="excerpt">Excerpted from the <i>GeneReview: </i><a href="/books/NBK1454" target="_blank">Alkaptonuria</a></div><div>Alkaptonuria is caused by deficiency of homogentisate 1,2-dioxygenase, an enzyme that converts homogentisic acid (HGA) to maleylacetoacetic acid in the tyrosine degradation pathway. The three major features of alkaptonuria are dark urine or urine that turns dark on standing, ochronosis (bluish-black pigmentation in connective tissue), and arthritis of the spine and larger joints. Ochronosis generally occurs after age 30 years; arthritis often begins in the third decade. Other manifestations can include pigment in the sclera, ear cartilage, and skin of the hands; aortic or mitral valve calcification or regurgitation and occasionally aortic dilatation; renal stones; prostate stones; and hypothyroidism. [from <a title="GeneReviews" href="https://www.ncbi.nlm.nih.gov/books/NBK1116" class="defSource" target="_blank">GeneReviews</a>]</div><div class="spaceAbove"><strong>Full text of <i>GeneReview</i> (by section):</strong><br /><a class="medgenPMinfo" href="/books/NBK1454#alkap.Summary" target="NBK1454">Summary</a>  |  <a class="medgenPMinfo" href="/books/NBK1454#alkap.Diagnosis" target="NBK1454">Diagnosis</a>  |  <a class="medgenPMinfo" href="/books/NBK1454#alkap.Clinical_Characteristics" target="NBK1454">Clinical Characteristics</a>  |  <a class="medgenPMinfo" href="/books/NBK1454#alkap.Genetically_Related_Allelic_Disord" target="NBK1454">Genetically Related (Allelic) Disorders</a>  |  <a class="medgenPMinfo" href="/books/NBK1454#alkap.Differential_Diagnosis" target="NBK1454">Differential Diagnosis</a>  |  <a class="medgenPMinfo" href="/books/NBK1454#alkap.Management" target="NBK1454">Management</a>  |  <a class="medgenPMinfo" href="/books/NBK1454#alkap.Genetic_Counseling" target="NBK1454">Genetic Counseling</a>  |  <a class="medgenPMinfo" href="/books/NBK1454#alkap.Resources" target="NBK1454">Resources</a>  |  <a class="medgenPMinfo" href="/books/NBK1454#alkap.Molecular_Genetics" target="NBK1454">Molecular Genetics</a>  |  <a class="medgenPMinfo" href="/books/NBK1454#alkap.Chapter_Notes" target="NBK1454">Chapter Notes</a>  |  <a class="medgenPMinfo" href="/books/NBK1454#alkap.References" target="NBK1454">References</a></div><div class="spaceAbove"><strong>Authors:</strong><br />
Wendy J Introne  |  Monique Perry  |  Marcus Chen   <a href="/books/NBK1454" target="NBK1454" title="NCBI Bookshelf: Alkaptonuria">view full author information</a></div></div>
</div>
<div class="portlet mgSection" id="ID_117">
<div class="portlet_head mgSectionHead ui-widget-header"><h1 class="nl" id="Additional_descriptions">Additional descriptions</h1><a sid="117" href="#" class="portlet_shutter" title="Show/hide content"></a></div>
<div class="portlet_content ln"><div class="mgSection"><strong>From OMIM</strong><br />Alkaptonuria is an autosomal recessive metabolic disorder characterized by accumulation of homogentisic acid, leading to darkened urine, pigmentation of connective tissue (ochronosis), joint and spine arthritis, and destruction of the cardiac valves (summary by Vilboux et al., 2009).&#13;
Alkaptonuria enjoys the historic distinction of being one of the first conditions in which mendelian recessive inheritance was proposed (by Garrod, 1902, on the suggestion of Bateson) and of being 1 of the 4 conditions in the charter group of inborn errors of metabolism. The manifestations are urine that turns dark on standing and alkalinization, black ochronotic pigmentation of cartilage and collagenous tissues, and arthritis, especially characteristic in the spine.  <a target="_blank" href="http://www.omim.org/entry/203500">http://www.omim.org/entry/203500</a></div><div class="mgSection"><strong>From MedlinePlus Genetics</strong><br />Alkaptonuria is an inherited condition that causes urine to turn black when exposed to air. Ochronosis, a buildup of dark pigment in connective tissues such as cartilage and skin, is also characteristic of the disorder. This blue-black pigmentation usually appears after age 30. People with alkaptonuria typically develop arthritis, particularly in the spine and large joints, beginning in early adulthood. Other features of this condition can include heart problems, kidney stones, and prostate stones.  <a target="_blank" href="https://medlineplus.gov/genetics/condition/alkaptonuria">https://medlineplus.gov/genetics/condition/alkaptonuria</a></div></div>
</div>
<div class="portlet mgSection" id="ID_102">
<div class="portlet_head mgSectionHead ui-widget-header"><h1 class="nl" id="Clinical_features">Clinical features</h1><a sid="102" href="#" class="portlet_shutter" title="Show/hide content"></a></div>
<div class="portlet_content ln clinfeat"><strong>From HPO</strong><br />
<div class="divPopper rprt" id="clin_13917"><div><strong>Arthralgia</strong><div class="aux"><div class="resc"><dl class="rprtid"><dt>MedGen UID: </dt><dd>13917</dd><dt><span class="dotprefix"></span>Concept ID: </dt><dd><a href="/medgen/docs/help/#sources" target="_blank" title="Concept Unique Identifier from NLM's Unified Medical Language system (UMLS)&#10;Click for more information.">C0003862</a></dd><dt><span class="dotprefix"></span></dt><dd>Sign or Symptom</dd></dl></div></div></div>
<div class="spaceAbove">Joint pain.</div>
<div class="spaceAbove nowrap">See: <a href="/medgen/13917">Feature record</a> | <a href="/medgen?term=%22Arthralgia%22%5BClinical%20Features%5D%20OR%2013917%5Buid%5D">Search on this feature</a></div></div>
<div class="divPopper rprt" id="clin_7389"><div><strong>Low back pain</strong><div class="aux"><div class="resc"><dl class="rprtid"><dt>MedGen UID: </dt><dd>7389</dd><dt><span class="dotprefix"></span>Concept ID: </dt><dd><a href="/medgen/docs/help/#sources" target="_blank" title="Concept Unique Identifier from NLM's Unified Medical Language system (UMLS)&#10;Click for more information.">C0024031</a></dd><dt><span class="dotprefix"></span></dt><dd>Sign or Symptom</dd></dl></div></div></div>
<div class="spaceAbove">An unpleasant sensation characterized by physical discomfort (such as pricking, throbbing, or aching) localized to the lower back.</div>
<div class="spaceAbove nowrap">See: <a href="/medgen/7389">Feature record</a> | <a href="/medgen?term=%22Low%20back%20pain%22%5BClinical%20Features%5D%20OR%207389%5Buid%5D">Search on this feature</a></div></div>
<div class="divPopper rprt" id="clin_1785731"><div><strong>Diminished physical functioning</strong><div class="aux"><div class="resc"><dl class="rprtid"><dt>MedGen UID: </dt><dd>1785731</dd><dt><span class="dotprefix"></span>Concept ID: </dt><dd><a href="/medgen/docs/help/#sources" target="_blank" title="Concept Unique Identifier from NLM's Unified Medical Language system (UMLS)&#10;Click for more information.">C5539751</a></dd><dt><span class="dotprefix"></span></dt><dd>Finding</dd></dl></div></div></div>
<div class="spaceAbove">A reduction in the ability to perform activities of daily living as compared to previous abilities because of functional deficits due to illness. The 36-item Short Form (SF-36) health survey questionnaire is one of many methods used to measure patients' perceptions of diminished physical functioning.</div>
<div class="spaceAbove nowrap">See: <a href="/medgen/1785731">Feature record</a> | <a href="/medgen?term=%22Diminished%20physical%20functioning%22%5BClinical%20Features%5D%20OR%201785731%5Buid%5D">Search on this feature</a></div></div>
<div class="divPopper rprt" id="clin_98227"><div><strong>Nephrolithiasis</strong><div class="aux"><div class="resc"><dl class="rprtid"><dt>MedGen UID: </dt><dd>98227</dd><dt><span class="dotprefix"></span>Concept ID: </dt><dd><a href="/medgen/docs/help/#sources" target="_blank" title="Concept Unique Identifier from NLM's Unified Medical Language system (UMLS)&#10;Click for more information.">C0392525</a></dd><dt><span class="dotprefix"></span></dt><dd>Disease or Syndrome</dd></dl></div></div></div>
<div class="spaceAbove">The presence of calculi (stones) in the kidneys.</div>
<div class="spaceAbove nowrap">See: <a href="/medgen/98227">Feature record</a> | <a href="/medgen?term=%22Nephrolithiasis%22%5BClinical%20Features%5D%20OR%2098227%5Buid%5D">Search on this feature</a></div></div>
<div class="divPopper rprt" id="clin_604849"><div><strong>Dark urine</strong><div class="aux"><div class="resc"><dl class="rprtid"><dt>MedGen UID: </dt><dd>604849</dd><dt><span class="dotprefix"></span>Concept ID: </dt><dd><a href="/medgen/docs/help/#sources" target="_blank" title="Concept Unique Identifier from NLM's Unified Medical Language system (UMLS)&#10;Click for more information.">C0426396</a></dd><dt><span class="dotprefix"></span></dt><dd>Finding</dd></dl></div></div></div>
<div class="spaceAbove">An abnormal dark color of the urine.</div>
<div class="spaceAbove nowrap">See: <a href="/medgen/604849">Feature record</a> | <a href="/medgen?term=%22Dark%20urine%22%5BClinical%20Features%5D%20OR%20604849%5Buid%5D">Search on this feature</a></div></div>
<div class="divPopper rprt" id="clin_163428"><div><strong>Decreased glomerular filtration rate</strong><div class="aux"><div class="resc"><dl class="rprtid"><dt>MedGen UID: </dt><dd>163428</dd><dt><span class="dotprefix"></span>Concept ID: </dt><dd><a href="/medgen/docs/help/#sources" target="_blank" title="Concept Unique Identifier from NLM's Unified Medical Language system (UMLS)&#10;Click for more information.">C0853068</a></dd><dt><span class="dotprefix"></span></dt><dd>Finding</dd></dl></div></div></div>
<div class="spaceAbove">An abnormal reduction in the volume of fluid filtered out of plasma through glomerular capillary walls into Bowman's capsules per unit of time.</div>
<div class="spaceAbove nowrap">See: <a href="/medgen/163428">Feature record</a> | <a href="/medgen?term=%22Decreased%20glomerular%20filtration%20rate%22%5BClinical%20Features%5D%20OR%20163428%5Buid%5D">Search on this feature</a></div></div>
<div class="divPopper rprt" id="clin_1789056"><div><strong>Elevated urinary homogentisic acid</strong><div class="aux"><div class="resc"><dl class="rprtid"><dt>MedGen UID: </dt><dd>1789056</dd><dt><span class="dotprefix"></span>Concept ID: </dt><dd><a href="/medgen/docs/help/#sources" target="_blank" title="Concept Unique Identifier from NLM's Unified Medical Language system (UMLS)&#10;Click for more information.">C5539768</a></dd><dt><span class="dotprefix"></span></dt><dd>Finding</dd></dl></div></div></div>
<div class="spaceAbove">An increased amount of homogentisic acid in the urine.</div>
<div class="spaceAbove nowrap">See: <a href="/medgen/1789056">Feature record</a> | <a href="/medgen?term=%22Elevated%20urinary%20homogentisic%20acid%22%5BClinical%20Features%5D%20OR%201789056%5Buid%5D">Search on this feature</a></div></div>
<div class="divPopper rprt" id="clin_866903"><div><strong>Limitation of knee mobility</strong><div class="aux"><div class="resc"><dl class="rprtid"><dt>MedGen UID: </dt><dd>866903</dd><dt><span class="dotprefix"></span>Concept ID: </dt><dd><a href="/medgen/docs/help/#sources" target="_blank" title="Concept Unique Identifier from NLM's Unified Medical Language system (UMLS)&#10;Click for more information.">C4021259</a></dd><dt><span class="dotprefix"></span></dt><dd>Finding</dd></dl></div></div></div>
<div class="spaceAbove">An abnormal limitation of knee joint mobility.</div>
<div class="spaceAbove nowrap">See: <a href="/medgen/866903">Feature record</a> | <a href="/medgen?term=%22Limitation%20of%20knee%20mobility%22%5BClinical%20Features%5D%20OR%20866903%5Buid%5D">Search on this feature</a></div></div>
<div class="divPopper rprt" id="clin_362"><div><strong>Aortic aneurysm</strong><div class="aux"><div class="resc"><dl class="rprtid"><dt>MedGen UID: </dt><dd>362</dd><dt><span class="dotprefix"></span>Concept ID: </dt><dd><a href="/medgen/docs/help/#sources" target="_blank" title="Concept Unique Identifier from NLM's Unified Medical Language system (UMLS)&#10;Click for more information.">C0003486</a></dd><dt><span class="dotprefix"></span></dt><dd>Disease or Syndrome</dd></dl></div></div></div>
<div class="spaceAbove">Aortic dilatation refers to a dimension that is greater than the 95th percentile for the normal person age, sex and body size. In contrast, an aneurysm is defined as a localized dilation of the aorta that is more than 150 percent of predicted (ratio of observed to expected diameter 1.5 or more). Aneurysm should be distinguished from ectasia, which represents a diffuse dilation of the aorta less than 50 percent of normal aorta diameter.</div>
<div class="spaceAbove nowrap">See: <a href="/medgen/362">Feature record</a> | <a href="/medgen?term=%22Aortic%20aneurysm%22%5BClinical%20Features%5D%20OR%20362%5Buid%5D">Search on this feature</a></div></div>
<div class="divPopper rprt" id="clin_140899"><div><strong>Aortic valve calcification</strong><div class="aux"><div class="resc"><dl class="rprtid"><dt>MedGen UID: </dt><dd>140899</dd><dt><span class="dotprefix"></span>Concept ID: </dt><dd><a href="/medgen/docs/help/#sources" target="_blank" title="Concept Unique Identifier from NLM's Unified Medical Language system (UMLS)&#10;Click for more information.">C0428791</a></dd><dt><span class="dotprefix"></span></dt><dd>Disease or Syndrome</dd></dl></div></div></div>
<div class="spaceAbove">Deposition of calcium salts in the aortic valve.</div>
<div class="spaceAbove nowrap">See: <a href="/medgen/140899">Feature record</a> | <a href="/medgen?term=%22Aortic%20valve%20calcification%22%5BClinical%20Features%5D%20OR%20140899%5Buid%5D">Search on this feature</a></div></div>
<div class="divPopper rprt" id="clin_181575"><div><strong>Mitral valve calcification</strong><div class="aux"><div class="resc"><dl class="rprtid"><dt>MedGen UID: </dt><dd>181575</dd><dt><span class="dotprefix"></span>Concept ID: </dt><dd><a href="/medgen/docs/help/#sources" target="_blank" title="Concept Unique Identifier from NLM's Unified Medical Language system (UMLS)&#10;Click for more information.">C0919718</a></dd><dt><span class="dotprefix"></span></dt><dd>Disease or Syndrome</dd></dl></div></div></div>
<div class="spaceAbove">Abnormal calcification of the mitral valve.</div>
<div class="spaceAbove nowrap">See: <a href="/medgen/181575">Feature record</a> | <a href="/medgen?term=%22Mitral%20valve%20calcification%22%5BClinical%20Features%5D%20OR%20181575%5Buid%5D">Search on this feature</a></div></div>
<div class="divPopper rprt" id="clin_345985"><div><strong>Coronary artery calcification</strong><div class="aux"><div class="resc"><dl class="rprtid"><dt>MedGen UID: </dt><dd>345985</dd><dt><span class="dotprefix"></span>Concept ID: </dt><dd><a href="/medgen/docs/help/#sources" target="_blank" title="Concept Unique Identifier from NLM's Unified Medical Language system (UMLS)&#10;Click for more information.">C1611184</a></dd><dt><span class="dotprefix"></span></dt><dd>Pathologic Function</dd></dl></div></div></div>
<div class="spaceAbove">An accumulation of calcium and phosphate in arteries with mineral deposits in the intimal or medial layer of the vessel wall in a coronary artery.</div>
<div class="spaceAbove nowrap">See: <a href="/medgen/345985">Feature record</a> | <a href="/medgen?term=%22Coronary%20artery%20calcification%22%5BClinical%20Features%5D%20OR%20345985%5Buid%5D">Search on this feature</a></div></div>
<div class="divPopper rprt" id="clin_808205"><div><strong>Growth abnormality</strong><div class="aux"><div class="resc"><dl class="rprtid"><dt>MedGen UID: </dt><dd>808205</dd><dt><span class="dotprefix"></span>Concept ID: </dt><dd><a href="/medgen/docs/help/#sources" target="_blank" title="Concept Unique Identifier from NLM's Unified Medical Language system (UMLS)&#10;Click for more information.">C0262361</a></dd><dt><span class="dotprefix"></span></dt><dd>Finding</dd></dl></div></div></div>
<div class="spaceAbove nowrap">See: <a href="/medgen/808205">Feature record</a> | <a href="/medgen?term=%22Growth%20abnormality%22%5BClinical%20Features%5D%20OR%20808205%5Buid%5D">Search on this feature</a></div></div>
<div class="divPopper rprt" id="clin_1864201"><div><strong>Dark cerumen</strong><div class="aux"><div class="resc"><dl class="rprtid"><dt>MedGen UID: </dt><dd>1864201</dd><dt><span class="dotprefix"></span>Concept ID: </dt><dd><a href="/medgen/docs/help/#sources" target="_blank" title="Concept Unique Identifier from NLM's Unified Medical Language system (UMLS)&#10;Click for more information.">C5936913</a></dd><dt><span class="dotprefix"></span></dt><dd>Finding</dd></dl></div></div></div>
<div class="spaceAbove">Abnormally dark color of cerumen (earwax), which is a waxy substance secreted in the ear canal that normally has a brown, orange, red, yellowish or gray.</div>
<div class="spaceAbove nowrap">See: <a href="/medgen/1864201">Feature record</a> | <a href="/medgen?term=%22Dark%20cerumen%22%5BClinical%20Features%5D%20OR%201864201%5Buid%5D">Search on this feature</a></div></div>
<div class="divPopper rprt" id="clin_2043"><div><strong>Arthritis</strong><div class="aux"><div class="resc"><dl class="rprtid"><dt>MedGen UID: </dt><dd>2043</dd><dt><span class="dotprefix"></span>Concept ID: </dt><dd><a href="/medgen/docs/help/#sources" target="_blank" title="Concept Unique Identifier from NLM's Unified Medical Language system (UMLS)&#10;Click for more information.">C0003864</a></dd><dt><span class="dotprefix"></span></dt><dd>Disease or Syndrome</dd></dl></div></div></div>
<div class="spaceAbove">Inflammation of a joint.</div>
<div class="spaceAbove nowrap">See: <a href="/medgen/2043">Feature record</a> | <a href="/medgen?term=%22Arthritis%22%5BClinical%20Features%5D%20OR%202043%5Buid%5D">Search on this feature</a></div></div>
<div class="divPopper rprt" id="clin_7190"><div><strong>Arthropathy</strong><div class="aux"><div class="resc"><dl class="rprtid"><dt>MedGen UID: </dt><dd>7190</dd><dt><span class="dotprefix"></span>Concept ID: </dt><dd><a href="/medgen/docs/help/#sources" target="_blank" title="Concept Unique Identifier from NLM's Unified Medical Language system (UMLS)&#10;Click for more information.">C0022408</a></dd><dt><span class="dotprefix"></span></dt><dd>Disease or Syndrome</dd></dl></div></div></div>
<div class="spaceAbove">Any disorder of the joints.</div>
<div class="spaceAbove nowrap">See: <a href="/medgen/7190">Feature record</a> | <a href="/medgen?term=%22Arthropathy%22%5BClinical%20Features%5D%20OR%207190%5Buid%5D">Search on this feature</a></div></div>
<div class="divPopper rprt" id="clin_44042"><div><strong>Kyphosis</strong><div class="aux"><div class="resc"><dl class="rprtid"><dt>MedGen UID: </dt><dd>44042</dd><dt><span class="dotprefix"></span>Concept ID: </dt><dd><a href="/medgen/docs/help/#sources" target="_blank" title="Concept Unique Identifier from NLM's Unified Medical Language system (UMLS)&#10;Click for more information.">C0022821</a></dd><dt><span class="dotprefix"></span></dt><dd>Anatomical Abnormality</dd></dl></div></div></div>
<div class="spaceAbove">Exaggerated anterior convexity of the thoracic vertebral column.</div>
<div class="spaceAbove nowrap">See: <a href="/medgen/44042">Feature record</a> | <a href="/medgen?term=%22Kyphosis%22%5BClinical%20Features%5D%20OR%2044042%5Buid%5D">Search on this feature</a></div></div>
<div class="divPopper rprt" id="clin_102357"><div><strong>Intervertebral disk degeneration</strong><div class="aux"><div class="resc"><dl class="rprtid"><dt>MedGen UID: </dt><dd>102357</dd><dt><span class="dotprefix"></span>Concept ID: </dt><dd><a href="/medgen/docs/help/#sources" target="_blank" title="Concept Unique Identifier from NLM's Unified Medical Language system (UMLS)&#10;Click for more information.">C0158266</a></dd><dt><span class="dotprefix"></span></dt><dd>Disease or Syndrome</dd></dl></div></div></div>
<div class="spaceAbove">The presence of degenerative changes of intervertebral disk.</div>
<div class="spaceAbove nowrap">See: <a href="/medgen/102357">Feature record</a> | <a href="/medgen?term=%22Intervertebral%20disk%20degeneration%22%5BClinical%20Features%5D%20OR%20102357%5Buid%5D">Search on this feature</a></div></div>
<div class="divPopper rprt" id="clin_214714"><div><strong>Thickened Achilles tendon</strong><div class="aux"><div class="resc"><dl class="rprtid"><dt>MedGen UID: </dt><dd>214714</dd><dt><span class="dotprefix"></span>Concept ID: </dt><dd><a href="/medgen/docs/help/#sources" target="_blank" title="Concept Unique Identifier from NLM's Unified Medical Language system (UMLS)&#10;Click for more information.">C0919997</a></dd><dt><span class="dotprefix"></span></dt><dd>Finding</dd></dl></div></div></div>
<div class="spaceAbove">An abnormal thickening of the Achilles tendon.</div>
<div class="spaceAbove nowrap">See: <a href="/medgen/214714">Feature record</a> | <a href="/medgen?term=%22Thickened%20Achilles%20tendon%22%5BClinical%20Features%5D%20OR%20214714%5Buid%5D">Search on this feature</a></div></div>
<div class="divPopper rprt" id="clin_341979"><div><strong>Limited shoulder movement</strong><div class="aux"><div class="resc"><dl class="rprtid"><dt>MedGen UID: </dt><dd>341979</dd><dt><span class="dotprefix"></span>Concept ID: </dt><dd><a href="/medgen/docs/help/#sources" target="_blank" title="Concept Unique Identifier from NLM's Unified Medical Language system (UMLS)&#10;Click for more information.">C1851313</a></dd><dt><span class="dotprefix"></span></dt><dd>Finding</dd></dl></div></div></div>
<div class="spaceAbove">A limitation of the range of movement of the shoulder joint.</div>
<div class="spaceAbove nowrap">See: <a href="/medgen/341979">Feature record</a> | <a href="/medgen?term=%22Limited%20shoulder%20movement%22%5BClinical%20Features%5D%20OR%20341979%5Buid%5D">Search on this feature</a></div></div>
<div class="divPopper rprt" id="clin_343601"><div><strong>Limited hip movement</strong><div class="aux"><div class="resc"><dl class="rprtid"><dt>MedGen UID: </dt><dd>343601</dd><dt><span class="dotprefix"></span>Concept ID: </dt><dd><a href="/medgen/docs/help/#sources" target="_blank" title="Concept Unique Identifier from NLM's Unified Medical Language system (UMLS)&#10;Click for more information.">C1851542</a></dd><dt><span class="dotprefix"></span></dt><dd>Finding</dd></dl></div></div></div>
<div class="spaceAbove">A decreased ability to move the femur at the hip joint associated with a decreased range of motion of the hip.</div>
<div class="spaceAbove nowrap">See: <a href="/medgen/343601">Feature record</a> | <a href="/medgen?term=%22Limited%20hip%20movement%22%5BClinical%20Features%5D%20OR%20343601%5Buid%5D">Search on this feature</a></div></div>
<div class="divPopper rprt" id="clin_480139"><div><strong>Vertebral fusion</strong><div class="aux"><div class="resc"><dl class="rprtid"><dt>MedGen UID: </dt><dd>480139</dd><dt><span class="dotprefix"></span>Concept ID: </dt><dd><a href="/medgen/docs/help/#sources" target="_blank" title="Concept Unique Identifier from NLM's Unified Medical Language system (UMLS)&#10;Click for more information.">C3278509</a></dd><dt><span class="dotprefix"></span></dt><dd>Anatomical Abnormality</dd></dl></div></div></div>
<div class="spaceAbove">A developmental defect leading to the union of two adjacent vertebrae.</div>
<div class="spaceAbove nowrap">See: <a href="/medgen/480139">Feature record</a> | <a href="/medgen?term=%22Vertebral%20fusion%22%5BClinical%20Features%5D%20OR%20480139%5Buid%5D">Search on this feature</a></div></div>
<div class="divPopper rprt" id="clin_1863927"><div><strong>Brown pigmentation of the conjunctiva</strong><div class="aux"><div class="resc"><dl class="rprtid"><dt>MedGen UID: </dt><dd>1863927</dd><dt><span class="dotprefix"></span>Concept ID: </dt><dd><a href="/medgen/docs/help/#sources" target="_blank" title="Concept Unique Identifier from NLM's Unified Medical Language system (UMLS)&#10;Click for more information.">C5937157</a></dd><dt><span class="dotprefix"></span></dt><dd>Finding</dd></dl></div></div></div>
<div class="spaceAbove">Deposition of brown pigmentation in the conjunctiva.</div>
<div class="spaceAbove nowrap">See: <a href="/medgen/1863927">Feature record</a> | <a href="/medgen?term=%22Brown%20pigmentation%20of%20the%20conjunctiva%22%5BClinical%20Features%5D%20OR%201863927%5Buid%5D">Search on this feature</a></div></div>
<div class="divPopper rprt" id="clin_45177"><div><strong>Ochronosis disorder</strong><div class="aux"><div class="resc"><dl class="rprtid"><dt>MedGen UID: </dt><dd>45177</dd><dt><span class="dotprefix"></span>Concept ID: </dt><dd><a href="/medgen/docs/help/#sources" target="_blank" title="Concept Unique Identifier from NLM's Unified Medical Language system (UMLS)&#10;Click for more information.">C0028817</a></dd><dt><span class="dotprefix"></span></dt><dd>Disease or Syndrome</dd></dl></div></div></div>
<div class="spaceAbove">Brown or blue-gray discoloration of the skin that can present on the axillary and inguinal areas, face, palms or soles. In addition, blue-black discoloration can be apparent on skin overlying cartilage in which the pigment is deposited, such as the ears. This is a characteristic manifestation of alkaptonuria, which is an autosomal recessively inherited deficiency of homogentisic acid oxidase that results in accumulation of homogentisic acid in collagenous structures. The sclerae are also typically involved.</div>
<div class="spaceAbove nowrap">See: <a href="/medgen/45177">Feature record</a> | <a href="/medgen?term=%22Ochronosis%20disorder%22%5BClinical%20Features%5D%20OR%2045177%5Buid%5D">Search on this feature</a></div></div>
<div class="divPopper rprt" id="clin_347969"><div><strong>Pigmentation of the sclera</strong><div class="aux"><div class="resc"><dl class="rprtid"><dt>MedGen UID: </dt><dd>347969</dd><dt><span class="dotprefix"></span>Concept ID: </dt><dd><a href="/medgen/docs/help/#sources" target="_blank" title="Concept Unique Identifier from NLM's Unified Medical Language system (UMLS)&#10;Click for more information.">C1859882</a></dd><dt><span class="dotprefix"></span></dt><dd>Finding</dd></dl></div></div></div>
<div class="spaceAbove nowrap">See: <a href="/medgen/347969">Feature record</a> | <a href="/medgen?term=%22Pigmentation%20of%20the%20sclera%22%5BClinical%20Features%5D%20OR%20347969%5Buid%5D">Search on this feature</a></div></div><div class="TreeLite" data-jigconfig="closed: 1"><div class="concept-def"><a class="small" href="#" onclick="jQuery(&quot;.TreeLite&quot;,&quot;#ID_102&quot;).TreeLite().openAll(); return false;">Show all</a><a class="small" href="#" onclick="jQuery(&quot;.TreeLite&quot;,&quot;#ID_102&quot;).TreeLite().closeAll(); return false;">Hide all</a></div><ul><li><span class="TLline">Abnormality of head or neck</span><ul><li class="TLline">
<span class="TLline"><a title="click for more information" class="jig-ncbipopper" href="#clin_1863927" data-jigconfig="hasArrow: true, openEvent: 'click', closeEvent: 'mouseout', openAnimation: 'fadeIn', closeAnimation: 'fadeOut', triggerPosition: 'center right', destPosition: 'center left', arrowDirection: 'left'">Brown pigmentation of the conjunctiva</a></span></li></ul></li><li><span class="TLline">Abnormality of limbs</span><ul><li class="TLline">
<span class="TLline"><a title="click for more information" class="jig-ncbipopper" href="#clin_866903" data-jigconfig="hasArrow: true, openEvent: 'click', closeEvent: 'mouseout', openAnimation: 'fadeIn', closeAnimation: 'fadeOut', triggerPosition: 'center right', destPosition: 'center left', arrowDirection: 'left'">Limitation of knee mobility</a></span></li></ul></li><li><span class="TLline">Abnormality of the cardiovascular system</span><ul><li class="TLline">
<span class="TLline"><a title="click for more information" class="jig-ncbipopper" href="#clin_362" data-jigconfig="hasArrow: true, openEvent: 'click', closeEvent: 'mouseout', openAnimation: 'fadeIn', closeAnimation: 'fadeOut', triggerPosition: 'center right', destPosition: 'center left', arrowDirection: 'left'">Aortic aneurysm</a></span></li><li class="TLline">
<span class="TLline"><a title="click for more information" class="jig-ncbipopper" href="#clin_140899" data-jigconfig="hasArrow: true, openEvent: 'click', closeEvent: 'mouseout', openAnimation: 'fadeIn', closeAnimation: 'fadeOut', triggerPosition: 'center right', destPosition: 'center left', arrowDirection: 'left'">Aortic valve calcification</a></span></li><li class="TLline">
<span class="TLline"><a title="click for more information" class="jig-ncbipopper" href="#clin_345985" data-jigconfig="hasArrow: true, openEvent: 'click', closeEvent: 'mouseout', openAnimation: 'fadeIn', closeAnimation: 'fadeOut', triggerPosition: 'center right', destPosition: 'center left', arrowDirection: 'left'">Coronary artery calcification</a></span></li><li class="TLline">
<span class="TLline"><a title="click for more information" class="jig-ncbipopper" href="#clin_181575" data-jigconfig="hasArrow: true, openEvent: 'click', closeEvent: 'mouseout', openAnimation: 'fadeIn', closeAnimation: 'fadeOut', triggerPosition: 'center right', destPosition: 'center left', arrowDirection: 'left'">Mitral valve calcification</a></span></li></ul></li><li><span class="TLline">Abnormality of the eye</span><ul><li class="TLline">
<span class="TLline"><a title="click for more information" class="jig-ncbipopper" href="#clin_347969" data-jigconfig="hasArrow: true, openEvent: 'click', closeEvent: 'mouseout', openAnimation: 'fadeIn', closeAnimation: 'fadeOut', triggerPosition: 'center right', destPosition: 'center left', arrowDirection: 'left'">Pigmentation of the sclera</a></span></li></ul></li><li><span class="TLline">Abnormality of the genitourinary system</span><ul><li class="TLline">
<span class="TLline"><a title="click for more information" class="jig-ncbipopper" href="#clin_604849" data-jigconfig="hasArrow: true, openEvent: 'click', closeEvent: 'mouseout', openAnimation: 'fadeIn', closeAnimation: 'fadeOut', triggerPosition: 'center right', destPosition: 'center left', arrowDirection: 'left'">Dark urine</a></span></li><li class="TLline">
<span class="TLline"><a title="click for more information" class="jig-ncbipopper" href="#clin_163428" data-jigconfig="hasArrow: true, openEvent: 'click', closeEvent: 'mouseout', openAnimation: 'fadeIn', closeAnimation: 'fadeOut', triggerPosition: 'center right', destPosition: 'center left', arrowDirection: 'left'">Decreased glomerular filtration rate</a></span></li><li class="TLline">
<span class="TLline"><a title="click for more information" class="jig-ncbipopper" href="#clin_1789056" data-jigconfig="hasArrow: true, openEvent: 'click', closeEvent: 'mouseout', openAnimation: 'fadeIn', closeAnimation: 'fadeOut', triggerPosition: 'center right', destPosition: 'center left', arrowDirection: 'left'">Elevated urinary homogentisic acid</a></span></li><li class="TLline">
<span class="TLline"><a title="click for more information" class="jig-ncbipopper" href="#clin_98227" data-jigconfig="hasArrow: true, openEvent: 'click', closeEvent: 'mouseout', openAnimation: 'fadeIn', closeAnimation: 'fadeOut', triggerPosition: 'center right', destPosition: 'center left', arrowDirection: 'left'">Nephrolithiasis</a></span></li></ul></li><li><span class="TLline">Abnormality of the integument</span><ul><li class="TLline">
<span class="TLline"><a title="click for more information" class="jig-ncbipopper" href="#clin_45177" data-jigconfig="hasArrow: true, openEvent: 'click', closeEvent: 'mouseout', openAnimation: 'fadeIn', closeAnimation: 'fadeOut', triggerPosition: 'center right', destPosition: 'center left', arrowDirection: 'left'">Ochronosis disorder</a></span></li></ul></li><li><span class="TLline">Abnormality of the musculoskeletal system</span><ul><li class="TLline">
<span class="TLline"><a title="click for more information" class="jig-ncbipopper" href="#clin_2043" data-jigconfig="hasArrow: true, openEvent: 'click', closeEvent: 'mouseout', openAnimation: 'fadeIn', closeAnimation: 'fadeOut', triggerPosition: 'center right', destPosition: 'center left', arrowDirection: 'left'">Arthritis</a></span></li><li class="TLline">
<span class="TLline"><a title="click for more information" class="jig-ncbipopper" href="#clin_7190" data-jigconfig="hasArrow: true, openEvent: 'click', closeEvent: 'mouseout', openAnimation: 'fadeIn', closeAnimation: 'fadeOut', triggerPosition: 'center right', destPosition: 'center left', arrowDirection: 'left'">Arthropathy</a></span></li><li class="TLline">
<span class="TLline"><a title="click for more information" class="jig-ncbipopper" href="#clin_102357" data-jigconfig="hasArrow: true, openEvent: 'click', closeEvent: 'mouseout', openAnimation: 'fadeIn', closeAnimation: 'fadeOut', triggerPosition: 'center right', destPosition: 'center left', arrowDirection: 'left'">Intervertebral disk degeneration</a></span></li><li class="TLline">
<span class="TLline"><a title="click for more information" class="jig-ncbipopper" href="#clin_44042" data-jigconfig="hasArrow: true, openEvent: 'click', closeEvent: 'mouseout', openAnimation: 'fadeIn', closeAnimation: 'fadeOut', triggerPosition: 'center right', destPosition: 'center left', arrowDirection: 'left'">Kyphosis</a></span></li><li class="TLline">
<span class="TLline"><a title="click for more information" class="jig-ncbipopper" href="#clin_343601" data-jigconfig="hasArrow: true, openEvent: 'click', closeEvent: 'mouseout', openAnimation: 'fadeIn', closeAnimation: 'fadeOut', triggerPosition: 'center right', destPosition: 'center left', arrowDirection: 'left'">Limited hip movement</a></span></li><li class="TLline">
<span class="TLline"><a title="click for more information" class="jig-ncbipopper" href="#clin_341979" data-jigconfig="hasArrow: true, openEvent: 'click', closeEvent: 'mouseout', openAnimation: 'fadeIn', closeAnimation: 'fadeOut', triggerPosition: 'center right', destPosition: 'center left', arrowDirection: 'left'">Limited shoulder movement</a></span></li><li class="TLline">
<span class="TLline"><a title="click for more information" class="jig-ncbipopper" href="#clin_214714" data-jigconfig="hasArrow: true, openEvent: 'click', closeEvent: 'mouseout', openAnimation: 'fadeIn', closeAnimation: 'fadeOut', triggerPosition: 'center right', destPosition: 'center left', arrowDirection: 'left'">Thickened Achilles tendon</a></span></li><li class="TLline">
<span class="TLline"><a title="click for more information" class="jig-ncbipopper" href="#clin_480139" data-jigconfig="hasArrow: true, openEvent: 'click', closeEvent: 'mouseout', openAnimation: 'fadeIn', closeAnimation: 'fadeOut', triggerPosition: 'center right', destPosition: 'center left', arrowDirection: 'left'">Vertebral fusion</a></span></li></ul></li><li><span class="TLline">Constitutional symptom</span><ul><li class="TLline">
<span class="TLline"><a title="click for more information" class="jig-ncbipopper" href="#clin_13917" data-jigconfig="hasArrow: true, openEvent: 'click', closeEvent: 'mouseout', openAnimation: 'fadeIn', closeAnimation: 'fadeOut', triggerPosition: 'center right', destPosition: 'center left', arrowDirection: 'left'">Arthralgia</a></span></li><li class="TLline">
<span class="TLline"><a title="click for more information" class="jig-ncbipopper" href="#clin_1785731" data-jigconfig="hasArrow: true, openEvent: 'click', closeEvent: 'mouseout', openAnimation: 'fadeIn', closeAnimation: 'fadeOut', triggerPosition: 'center right', destPosition: 'center left', arrowDirection: 'left'">Diminished physical functioning</a></span></li><li class="TLline">
<span class="TLline"><a title="click for more information" class="jig-ncbipopper" href="#clin_7389" data-jigconfig="hasArrow: true, openEvent: 'click', closeEvent: 'mouseout', openAnimation: 'fadeIn', closeAnimation: 'fadeOut', triggerPosition: 'center right', destPosition: 'center left', arrowDirection: 'left'">Low back pain</a></span></li></ul></li><li><span class="TLline">Ear malformation</span><ul><li class="TLline">
<span class="TLline"><a title="click for more information" class="jig-ncbipopper" href="#clin_1864201" data-jigconfig="hasArrow: true, openEvent: 'click', closeEvent: 'mouseout', openAnimation: 'fadeIn', closeAnimation: 'fadeOut', triggerPosition: 'center right', destPosition: 'center left', arrowDirection: 'left'">Dark cerumen</a></span></li></ul></li><li><span class="TLline">Growth abnormality</span><ul><li class="TLline">
<span class="TLline"><a title="click for more information" class="jig-ncbipopper" href="#clin_808205" data-jigconfig="hasArrow: true, openEvent: 'click', closeEvent: 'mouseout', openAnimation: 'fadeIn', closeAnimation: 'fadeOut', triggerPosition: 'center right', destPosition: 'center left', arrowDirection: 'left'">Growth abnormality</a></span></li></ul></li></ul></div></div>
</div>
<div class="portlet mgSection" id="ID_118">
<div class="portlet_head mgSectionHead ui-widget-header"><h1 class="nl" id="Term_Hierarchy">Term Hierarchy</h1><a sid="118" href="#" class="portlet_shutter" title="Show/hide content"></a></div>
<div class="portlet_content ln HierarchyGTR"><div class="jig-ncbitabs"><ul><li><a href="#tabGTR">GTR</a></li><li><a href="#tabMGEN">MeSH</a></li><li><a href="#tabORDO">Orphanet</a></li></ul><div id="tabGTR"><div class="search_result"><div class="rprts"><div class="chiclet_legend"><span class="chiclet_list" style="position:static;"><span title="Clinical test" class="chiclet Ccolor round">C</span><span>Clinical test,  </span><span title="Research test" class="chiclet Rcolor round">R</span><span>Research test,  </span><span title="OMIM" class="chiclet Ocolor ">O</span><span>OMIM,  </span><span title="GeneReview" class="chiclet Gcolor">G</span><span><em>GeneReviews</em>,  </span><span title="ClinVar" class="chiclet Vcolor">V</span><span>ClinVar  </span></span></div><div id="hierarchy" class="margin_t1"><div class="ds_tree"><ul><li class="matched_ds"><span class="chiclet_list"><span class="chiclet Ccolor round" title="Clinical test"><a target="_blank" href="/gtr/tests/?term=C0002066[DISCUI]&amp;test_type=Clinical" ref="ncbi_uid=1413">C</a></span><span class="chiclet unavailable round" title="Research Tests">R</span><span class="chiclet Ocolor" title="OMIM"><a ref="ncbi_uid=1413" target="_blank" href="/omim/203500">O</a></span><span class="chiclet Gcolor" title="GeneReviews"><a target="_blank" href="/books/NBK1454/" ref="ncbi_uid=1413">G</a></span><span class="chiclet Vcolor" title="ClinVar"><a target="_blank" href="/clinvar?LinkName=medgen_clinvar&amp;from_uid=1413" ref="ncbi_uid=1413">V</a></span></span><span class="TLline">Alkaptonuria</span></li></ul></div></div></div></div></div><div id="tabMGEN"><div class="ds_tree"><ul><li><span class="TLline"><a href="/medgen/541330" ref="tree=MeSH" title="MedGen record for Disorder of tyrosine metabolism">Disorder of tyrosine metabolism</a></span><ul><li><span class="matched_ds">Alkaptonuria</span></li></ul></li></ul></div></div><div id="tabORDO">Follow <a target="_blank" href="http://www.orpha.net/consor/cgi-bin/Disease_Classif.php?lng=EN&amp;data_id=156&amp;PatId=411&amp;search=Disease_Classif_Simple&amp;new=1" class="ital bold">this link</a> to review classifications for <span class="ital">Alkaptonuria</span> in Orphanet.</div></div></div>
</div>
<div class="portlet mgSection" id="ID_105">
<div class="portlet_head mgSectionHead ui-widget-header"><h1 class="nl" id="Professional_guidelines">Professional guidelines</h1><a sid="105" href="#" class="portlet_shutter" title="Show/hide content"></a></div>
<div class="portlet_content ln"><h3 class="subhead">PubMed<a class="help jig-ncbi-popper" data-jig="ncbipopper" href="#guidelinesHelpPM"><img class="pulldown" src="//static.pubmed.gov/portal/portal3rc.fcgi/4223267/img/4204968" /></a></h3>
<div class="nl"><a target="_blank" href="/pubmed/26844634">Orthopedic Manifestations of Ochronosis: Pathophysiology, Presentation, Diagnosis, and Management.</a></div>
<div class="portlet_content ln"><span class="medgenPMauthor">Gil JA,
Wawrzynski J,
Waryasz GR</span><br />
<span class="medgenPMjournal">Am J Med</span>
2016 May;129(5):536.e1-6.
Epub 2016 Feb 1
doi: 10.1016/j.amjmed.2016.01.010.
<span class="bold">PMID: </span><a href="/pubmed/26844634" target="_blank">26844634</a></div>
<div class="nl"><a target="_blank" href="/pubmed/23486607">Recent advances in management of alkaptonuria (invited review; best practice article).</a></div>
<div class="portlet_content ln"><span class="medgenPMauthor">Ranganath LR,
Jarvis JC,
Gallagher JA</span><br />
<span class="medgenPMjournal">J Clin Pathol</span>
2013 May;66(5):367-73.
Epub 2013 Mar 13
doi: 10.1136/jclinpath-2012-200877.
<span class="bold">PMID: </span><a href="/pubmed/23486607" target="_blank">23486607</a></div>
<div class="nl"><a target="_blank" href="/pubmed/79941">Screening for alkaptonuria in the newborn in Slovakia.</a></div>
<div class="portlet_content ln"><span class="medgenPMauthor">Srsen S,
Varga F</span><br />
<span class="medgenPMjournal">Lancet</span>
1978 Sep 9;2(8089):576.
doi: 10.1016/s0140-6736(78)92910-0.
<span class="bold">PMID: </span><a href="/pubmed/79941" target="_blank">79941</a></div>
<div><a target="_blank" href="https://pubmed.ncbi.nlm.nih.gov/?term=(%22alkaptonuria%22%5Btiab%3A~0%5D)%20AND%20(%22english%20and%20humans%22%5BFilter%5D)%20AND%20(%20(%22practice%20guideline%22%5BFilter%5D)%20OR%20(practice*%5Btitl%5D%20AND%20(guideline%5Btitl%5D%20OR%20parameter%5Btitl%5D%20OR%20resource%5Btitl%5D%20OR%20bulletin%5Btitl%5D%20OR%20best%5Btitl%5D))%20OR%20(genetic*%5Btitl%5D%20AND%20(evaluation%5Btitl%5D%20OR%20counseling%5Btitl%5D%20OR%20screening%5Btitl%5D%20OR%20test*%5Btitl%5D))%20OR%20(clinical%5Btitl%5D%20AND%20((expert%5Btitl%5D%20AND%20consensus%5Btitl%5D)%20OR%20utility%5Btitl%5D%20OR%20guideline*%5Btitl%5D))%20OR%20(management%5Btitl%5D%20AND%20(clinical%5Btitl%5D%20OR%20diagnos*%5Btitl%5D%20OR%20recommendation%5Btitl%5D%20OR%20pain%5Btitl%5D%20OR%20surveillance%5Btitl%5D%20OR%20emergency%5Btitl%5D%20OR%20guideline*%5Btitl%5D%20OR%20therap*))%20OR%20(treatment%5Btitl%5D%20AND%20((evaluation%5Btitl%5D%20AND%20diagnosis%5Btitl%5D)%20OR%20(assessment%5Btitl%5D%20AND%20prevention%5Btitl%5D)%20OR%20therap*))%20OR%20(Diagnos*%5Btitl%5D%20AND%20(prenatal%5Btitl%5D%20OR%20treatment%5Btitl%5D%20OR%20follow-up%5Btitl%5D%20OR%20statement%5Btitl%5D%20OR%20criteria%5Btitl%5D%20OR%20newborn%5Btitl%5D%20OR%20differential%5Btitl%5D%20OR%20neonatal%5Btitl%5D%20OR%20neonate%5Btitl%5D))%20OR%20(guideline*%5Btitl%5D%20AND%20(pharmacogenetic*%5Btitl%5D%20OR%20recommendation%5Btitl%5D%20OR%20therap*%5Btitl%5D%20OR%20evidence-based%5Btitl%5D%20OR%20consensus%5Btitl%5D%20OR%20(technical%5Btitl%5D%20AND%20standard*%5Btitl%5D)%20OR%20(molecular%5Btitl%5D%20AND%20testing%5Btitl%5D)))%20OR%20(risk%5Btitl%5D%20AND%20assessment%5Btitl%5D)%20OR%20(recommendation*%5Btitl%5D%20AND%20(statement%5Btitl%5D%20OR%20Evidence-based%5Btitl%5D%20OR%20Consensus%5Btitl%5D))%20OR%20(care%20AND%20((Patient%5Btitl%5D%20AND%20standard*%5Btitl%5D)%20OR%20primary%5Btitl%5D%20OR%20psychosocial%5Btitl%5D))%20OR%20(Health%5Btitl%5D%20AND%20supervision%5Btitl%5D)%20OR%20(statement%5Btitl%5D%20AND%20(policy%5Btitl%5D%20OR%20position%5Btitl%5D%20OR%20Consensus%5Btitl%5D))%20OR%20(pharmacogenetics%5Btitl%5D%20AND%20(Dosing%5Btitl%5D%20OR%20therap*%5Btitl%5D%20OR%20genotype*%5Btitl%5D%20OR%20drug*%5Btitl%5D))%20OR%20(Chemotherapy%5Btitl%5D%20AND%20decision*%5Btitl%5D)%20OR%20(screening%5Btitl%5D%20AND%20(newborn%5Btitl%5D%20OR%20neonat*%5Btitl%5D%20OR%20detection%5Btitl%5D%20OR%20diagnos*%5Btitl%5D))%20OR%20(criteria%5Btitl%5D%20OR%20genotype*%5Btitl%5D)%20)%20NOT%20(%22Case%20reports%22%5BPublication%20type%5D%20OR%20%22clinical%20study%22%5BPublication%20Type%5D%20OR%20%22randomized%20controlled%20trial%22%5BPublication%20Type%5D)" title="PubMed search">See all (18)</a></div></div>
</div>
<div class="display-none help-popup" id="guidelinesHelpPM">These guidelines are articles in PubMed that match specific search criteria developed by MedGen to capture the most relevant practice guidelines. This list may not be comprehensive and may include broader topics as well. See the <a href="/medgen/docs/faq/" title="Frequently asked questions" target="_blank">FAQ</a> for details.</div><div class="display-none help-popup" id="guidelinesHelpCurated">These guidelines are manually curated by the MedGen team
to supplement articles available in PubMed. See the <a href="/medgen/docs/faq/" title="Frequently asked questions" target="_blank">FAQ</a> for details.</div>
<div class="portlet mgSection" id="ID_103">
<div class="portlet_head mgSectionHead ui-widget-header"><h1 class="nl" id="Recent_clinical_studies">Recent clinical studies</h1><a sid="103" href="#" class="portlet_shutter" title="Show/hide content"></a></div>
<div class="portlet_content ln"><h3 class="subhead">Etiology</h3>
<div class="nl"><a target="_blank" href="/pubmed/32473412">Cardiovascular ochronosis.</a></div>
<div class="portlet_content ln"><span class="medgenPMauthor">Ather N,
Roberts WC</span><br />
<span class="medgenPMjournal">Cardiovasc Pathol</span>
2020 Sep-Oct;48:107219.
Epub 2020 Mar 7
doi: 10.1016/j.carpath.2020.107219.
<span class="bold">PMID: </span><a href="/pubmed/32473412" target="_blank">32473412</a></div>
<div class="nl"><a target="_blank" href="/pubmed/23315787">Occurrence of tendon pathologies in metabolic disorders.</a></div>
<div class="portlet_content ln"><span class="medgenPMauthor">Abate M,
Schiavone C,
Salini V,
Andia I</span><br />
<span class="medgenPMjournal">Rheumatology (Oxford)</span>
2013 Apr;52(4):599-608.
Epub 2013 Jan 12
doi: 10.1093/rheumatology/kes395.
<span class="bold">PMID: </span><a href="/pubmed/23315787" target="_blank">23315787</a></div>
<div class="nl"><a target="_blank" href="/pubmed/11958438">Ochronotic arthropathy.</a></div>
<div class="portlet_content ln"><span class="medgenPMauthor">Borman P,
Bodur H,
Ciliz D</span><br />
<span class="medgenPMjournal">Rheumatol Int</span>
2002 Mar;21(5):205-9.
doi: 10.1007/s00296-002-0175-1.
<span class="bold">PMID: </span><a href="/pubmed/11958438" target="_blank">11958438</a></div>
<div class="nl"><a target="_blank" href="/pubmed/1918486">Skin and bones. II.</a></div>
<div class="portlet_content ln"><span class="medgenPMauthor">Orlow SJ,
Watsky KL,
Bolognia JL</span><br />
<span class="medgenPMjournal">J Am Acad Dermatol</span>
1991 Sep;25(3):447-62.
doi: 10.1016/0190-9622(91)70226-r.
<span class="bold">PMID: </span><a href="/pubmed/1918486" target="_blank">1918486</a></div>
<div class="nl"><a target="_blank" href="/pubmed/1918456">Skin and bones. I.</a></div>
<div class="portlet_content ln"><span class="medgenPMauthor">Orlow SJ,
Watsky KL,
Bolognia JL</span><br />
<span class="medgenPMjournal">J Am Acad Dermatol</span>
1991 Aug;25(2 Pt 1):205-21.
doi: 10.1016/0190-9622(91)70185-5.
<span class="bold">PMID: </span><a href="/pubmed/1918456" target="_blank">1918456</a></div>
<div><a target="_blank" href="https://pubmed.ncbi.nlm.nih.gov/?term=%22Alkaptonuria%22%20AND%20Etiology%2Fbroad%5Bfilter%5D%20%20AND%20%22english%20and%20humans%22%5Bfilter%5D%20NOT%20comment%5BPTYP%5D%20NOT%20letter%5BPTYP%5D" title="PubMed search">See all (98)</a></div><h3 class="subhead">Diagnosis</h3>
<div class="nl"><a target="_blank" href="/pubmed/38453957">Alkaptonuria.</a></div>
<div class="portlet_content ln"><span class="medgenPMauthor">Bernardini G,
Braconi D,
Zatkova A,
Sireau N,
Kujawa MJ,
Introne WJ,
Spiga O,
Geminiani M,
Gallagher JA,
Ranganath LR,
Santucci A</span><br />
<span class="medgenPMjournal">Nat Rev Dis Primers</span>
2024 Mar 7;10(1):16.
doi: 10.1038/s41572-024-00498-x.
<span class="bold">PMID: </span><a href="/pubmed/38453957" target="_blank">38453957</a></div>
<div class="nl"><a target="_blank" href="/pubmed/35394539">Black urine-alkaptonuria.</a></div>
<div class="portlet_content ln"><span class="medgenPMauthor">Annamalai AK,
Gurnell M</span><br />
<span class="medgenPMjournal">QJM</span>
2022 Jun 7;115(6):397-398.
doi: 10.1093/qjmed/hcac098.
<span class="bold">PMID: </span><a href="/pubmed/35394539" target="_blank">35394539</a></div>
<div class="nl"><a target="_blank" href="/pubmed/34504318">Alkaptonuria in Russia.</a></div>
<div class="portlet_content ln"><span class="medgenPMauthor">Soltysova A,
Kuzin A,
Samarkina E,
Zatkova A</span><br />
<span class="medgenPMjournal">Eur J Hum Genet</span>
2022 Feb;30(2):237-242.
Epub 2021 Sep 10
doi: 10.1038/s41431-021-00955-1.
<span class="bold">PMID: </span><a href="/pubmed/34504318" target="_blank">34504318</a><a href="/pmc/articles/PMC8821605" target="_blank" class="PubMedFree">Free PMC Article</a></div>
<div class="nl"><a target="_blank" href="/pubmed/20229718">Alkaptonuria.</a></div>
<div class="portlet_content ln"><span class="medgenPMauthor">Grosicka A,
Kucharz EJ</span><br />
<span class="medgenPMjournal">Wiad Lek</span>
2009;62(3):197-203.
<span class="bold">PMID: </span><a href="/pubmed/20229718" target="_blank">20229718</a></div>
<div class="nl"><a target="_blank" href="/pubmed/11958438">Ochronotic arthropathy.</a></div>
<div class="portlet_content ln"><span class="medgenPMauthor">Borman P,
Bodur H,
Ciliz D</span><br />
<span class="medgenPMjournal">Rheumatol Int</span>
2002 Mar;21(5):205-9.
doi: 10.1007/s00296-002-0175-1.
<span class="bold">PMID: </span><a href="/pubmed/11958438" target="_blank">11958438</a></div>
<div><a target="_blank" href="https://pubmed.ncbi.nlm.nih.gov/?term=%22Alkaptonuria%22%20AND%20Diagnosis%2Fbroad%5Bfilter%5D%20%20AND%20%22english%20and%20humans%22%5Bfilter%5D%20NOT%20comment%5BPTYP%5D%20NOT%20letter%5BPTYP%5D" title="PubMed search">See all (345)</a></div><h3 class="subhead">Therapy</h3>
<div class="nl"><a target="_blank" href="/pubmed/33541951">Alkaptonuria in an adolescent boy.</a></div>
<div class="portlet_content ln"><span class="medgenPMauthor">Sangeetha G,
Chandran S,
Ganesan S,
Jayaraj J</span><br />
<span class="medgenPMjournal">BMJ Case Rep</span>
2021 Feb 4;14(2)
doi: 10.1136/bcr-2020-240147.
<span class="bold">PMID: </span><a href="/pubmed/33541951" target="_blank">33541951</a><a href="/pmc/articles/PMC7868218" target="_blank" class="PubMedFree">Free PMC Article</a></div>
<div class="nl"><a target="_blank" href="/pubmed/32822593">Suitability of nitisinone for alkaptonuria.</a></div>
<div class="portlet_content ln"><span class="medgenPMauthor">Häberle J</span><br />
<span class="medgenPMjournal">Lancet Diabetes Endocrinol</span>
2020 Sep;8(9):732-733.
Epub 2020 Aug 18
doi: 10.1016/S2213-8587(20)30222-9.
<span class="bold">PMID: </span><a href="/pubmed/32822593" target="_blank">32822593</a></div>
<div class="nl"><a target="_blank" href="/pubmed/32473412">Cardiovascular ochronosis.</a></div>
<div class="portlet_content ln"><span class="medgenPMauthor">Ather N,
Roberts WC</span><br />
<span class="medgenPMjournal">Cardiovasc Pathol</span>
2020 Sep-Oct;48:107219.
Epub 2020 Mar 7
doi: 10.1016/j.carpath.2020.107219.
<span class="bold">PMID: </span><a href="/pubmed/32473412" target="_blank">32473412</a></div>
<div class="nl"><a target="_blank" href="/pubmed/27602739">Medical histories.</a></div>
<div class="portlet_content ln"><span class="medgenPMauthor">Dance A</span><br />
<span class="medgenPMjournal">Nature</span>
2016 Sep 8;537(7619):S52-3.
doi: 10.1038/537S52a.
<span class="bold">PMID: </span><a href="/pubmed/27602739" target="_blank">27602739</a></div>
<div class="nl"><a target="_blank" href="/pubmed/23760323">Exogenous ochronosis.</a></div>
<div class="portlet_content ln"><span class="medgenPMauthor">Jain A,
Pai SB,
Shenoi SD</span><br />
<span class="medgenPMjournal">Indian J Dermatol Venereol Leprol</span>
2013 Jul-Aug;79(4):522-3.
doi: 10.4103/0378-6323.113086.
<span class="bold">PMID: </span><a href="/pubmed/23760323" target="_blank">23760323</a></div>
<div><a target="_blank" href="https://pubmed.ncbi.nlm.nih.gov/?term=%22Alkaptonuria%22%20AND%20Therapy%2Fbroad%5Bfilter%5D%20%20AND%20%22english%20and%20humans%22%5Bfilter%5D%20NOT%20comment%5BPTYP%5D%20NOT%20letter%5BPTYP%5D" title="PubMed search">See all (102)</a></div><h3 class="subhead">Prognosis</h3>
<div class="nl"><a target="_blank" href="/pubmed/34417863">"Lessons from Rare Forms of Osteoarthritis".</a></div>
<div class="portlet_content ln"><span class="medgenPMauthor">Shepherd RF,
Kerns JG,
Ranganath LR,
Gallagher JA,
Taylor AM</span><br />
<span class="medgenPMjournal">Calcif Tissue Int</span>
2021 Sep;109(3):291-302.
Epub 2021 Aug 21
doi: 10.1007/s00223-021-00896-3.
<span class="bold">PMID: </span><a href="/pubmed/34417863" target="_blank">34417863</a><a href="/pmc/articles/PMC8403118" target="_blank" class="PubMedFree">Free PMC Article</a></div>
<div class="nl"><a target="_blank" href="/pubmed/31181205">Transcatheter Aortic Valve Replacement for Alkaptonuria-Associated Aortic Stenosis.</a></div>
<div class="portlet_content ln"><span class="medgenPMauthor">Olive JK,
Alnajar A,
Gnanashanmugam S,
Lamelas J</span><br />
<span class="medgenPMjournal">Ann Thorac Surg</span>
2019 Dec;108(6):e377-e379.
Epub 2019 Jun 8
doi: 10.1016/j.athoracsur.2019.04.053.
<span class="bold">PMID: </span><a href="/pubmed/31181205" target="_blank">31181205</a></div>
<div class="nl"><a target="_blank" href="/pubmed/23619548">Alkaptonuric patient presenting with "black" disc: a case report.</a></div>
<div class="portlet_content ln"><span class="medgenPMauthor">Kahveci R,
Ergüngör MF,
Günaydin A,
Temiz A</span><br />
<span class="medgenPMjournal">Acta Orthop Traumatol Turc</span>
2013;47(2):134-8.
doi: 10.3944/aott.2013.2767.
<span class="bold">PMID: </span><a href="/pubmed/23619548" target="_blank">23619548</a></div>
<div class="nl"><a target="_blank" href="/pubmed/21720873">An update on molecular genetics of Alkaptonuria (AKU).</a></div>
<div class="portlet_content ln"><span class="medgenPMauthor">Zatkova A</span><br />
<span class="medgenPMjournal">J Inherit Metab Dis</span>
2011 Dec;34(6):1127-36.
Epub 2011 Jul 1
doi: 10.1007/s10545-011-9363-z.
<span class="bold">PMID: </span><a href="/pubmed/21720873" target="_blank">21720873</a></div>
<div class="nl"><a target="_blank" href="/pubmed/11958438">Ochronotic arthropathy.</a></div>
<div class="portlet_content ln"><span class="medgenPMauthor">Borman P,
Bodur H,
Ciliz D</span><br />
<span class="medgenPMjournal">Rheumatol Int</span>
2002 Mar;21(5):205-9.
doi: 10.1007/s00296-002-0175-1.
<span class="bold">PMID: </span><a href="/pubmed/11958438" target="_blank">11958438</a></div>
<div><a target="_blank" href="https://pubmed.ncbi.nlm.nih.gov/?term=%22Alkaptonuria%22%20AND%20Prognosis%2Fbroad%5Bfilter%5D%20%20AND%20%22english%20and%20humans%22%5Bfilter%5D%20NOT%20comment%5BPTYP%5D%20NOT%20letter%5BPTYP%5D" title="PubMed search">See all (82)</a></div><h3 class="subhead">Clinical prediction guides</h3>
<div class="nl"><a target="_blank" href="/pubmed/32219972">Pigmentation Chemistry and Radical-Based Collagen Degradation in Alkaptonuria and Osteoarthritic Cartilage.</a></div>
<div class="portlet_content ln"><span class="medgenPMauthor">Chow WY,
Norman BP,
Roberts NB,
Ranganath LR,
Teutloff C,
Bittl R,
Duer MJ,
Gallagher JA,
Oschkinat H</span><br />
<span class="medgenPMjournal">Angew Chem Int Ed Engl</span>
2020 Jul 13;59(29):11937-11942.
Epub 2020 May 14
doi: 10.1002/anie.202000618.
<span class="bold">PMID: </span><a href="/pubmed/32219972" target="_blank">32219972</a><a href="/pmc/articles/PMC7383862" target="_blank" class="PubMedFree">Free PMC Article</a></div>
<div class="nl"><a target="_blank" href="/pubmed/28128559">4-Hydroxyphenylpyruvate Dioxygenase and Its Inhibition in Plants and Animals: Small Molecules as Herbicides and Agents for the Treatment of Human Inherited Diseases.</a></div>
<div class="portlet_content ln"><span class="medgenPMauthor">Santucci A,
Bernardini G,
Braconi D,
Petricci E,
Manetti F</span><br />
<span class="medgenPMjournal">J Med Chem</span>
2017 May 25;60(10):4101-4125.
Epub 2017 Feb 14
doi: 10.1021/acs.jmedchem.6b01395.
<span class="bold">PMID: </span><a href="/pubmed/28128559" target="_blank">28128559</a></div>
<div class="nl"><a target="_blank" href="/pubmed/26844634">Orthopedic Manifestations of Ochronosis: Pathophysiology, Presentation, Diagnosis, and Management.</a></div>
<div class="portlet_content ln"><span class="medgenPMauthor">Gil JA,
Wawrzynski J,
Waryasz GR</span><br />
<span class="medgenPMjournal">Am J Med</span>
2016 May;129(5):536.e1-6.
Epub 2016 Feb 1
doi: 10.1016/j.amjmed.2016.01.010.
<span class="bold">PMID: </span><a href="/pubmed/26844634" target="_blank">26844634</a></div>
<div class="nl"><a target="_blank" href="/pubmed/26596578">Acute fatal metabolic complications in alkaptonuria.</a></div>
<div class="portlet_content ln"><span class="medgenPMauthor">Davison AS,
Milan AM,
Gallagher JA,
Ranganath LR</span><br />
<span class="medgenPMjournal">J Inherit Metab Dis</span>
2016 Mar;39(2):203-10.
Epub 2015 Nov 23
doi: 10.1007/s10545-015-9902-0.
<span class="bold">PMID: </span><a href="/pubmed/26596578" target="_blank">26596578</a></div>
<div class="nl"><a target="_blank" href="/pubmed/23315787">Occurrence of tendon pathologies in metabolic disorders.</a></div>
<div class="portlet_content ln"><span class="medgenPMauthor">Abate M,
Schiavone C,
Salini V,
Andia I</span><br />
<span class="medgenPMjournal">Rheumatology (Oxford)</span>
2013 Apr;52(4):599-608.
Epub 2013 Jan 12
doi: 10.1093/rheumatology/kes395.
<span class="bold">PMID: </span><a href="/pubmed/23315787" target="_blank">23315787</a></div>
<div><a target="_blank" href="https://pubmed.ncbi.nlm.nih.gov/?term=%22Alkaptonuria%22%20AND%20Clinical%20prediction%20guides%2Fbroad%5Bfilter%5D%20%20AND%20%22english%20and%20humans%22%5Bfilter%5D%20NOT%20comment%5BPTYP%5D%20NOT%20letter%5BPTYP%5D" title="PubMed search">See all (116)</a></div></div>
</div>
<div class="portlet mgSection" id="ID_104">
<div class="portlet_head mgSectionHead ui-widget-header"><h1 class="nl" id="Recent_systematic_reviews">Recent systematic reviews</h1><a sid="104" href="#" class="portlet_shutter" title="Show/hide content"></a></div>
<div class="portlet_content ln">
<div class="nl"><a target="_blank" href="/pubmed/34486734">Exogenous ochronosis associated with hydroquinone: a systematic review.</a></div>
<div class="portlet_content ln"><span class="medgenPMauthor">Ishack S,
Lipner SR</span><br />
<span class="medgenPMjournal">Int J Dermatol</span>
2022 Jun;61(6):675-684.
Epub 2021 Sep 6
doi: 10.1111/ijd.15878.
<span class="bold">PMID: </span><a href="/pubmed/34486734" target="_blank">34486734</a></div>
<div class="nl"><a target="_blank" href="/pubmed/30343446">An update on the role of RANKL-RANK/osteoprotegerin and WNT-ß-catenin signaling pathways in pediatric diseases.</a></div>
<div class="portlet_content ln"><span class="medgenPMauthor">Brunetti G,
D'Amato G,
Chiarito M,
Tullo A,
Colaianni G,
Colucci S,
Grano M,
Faienza MF</span><br />
<span class="medgenPMjournal">World J Pediatr</span>
2019 Feb;15(1):4-11.
Epub 2018 Oct 20
doi: 10.1007/s12519-018-0198-7.
<span class="bold">PMID: </span><a href="/pubmed/30343446" target="_blank">30343446</a></div>
<div class="nl"><a target="_blank" href="/pubmed/24479547">On the ocular findings in ochronosis: a systematic review of literature.</a></div>
<div class="portlet_content ln"><span class="medgenPMauthor">Lindner M,
Bertelmann T</span><br />
<span class="medgenPMjournal">BMC Ophthalmol</span>
2014 Jan 30;14:12.
doi: 10.1186/1471-2415-14-12.
<span class="bold">PMID: </span><a href="/pubmed/24479547" target="_blank">24479547</a><a href="/pmc/articles/PMC3915032" target="_blank" class="PubMedFree">Free PMC Article</a></div>
<div><a target="_blank" href="https://pubmed.ncbi.nlm.nih.gov/?term=%22Alkaptonuria%22%20AND%20systematic%5Bsb%5D%20AND%20%22english%20and%20humans%22%5Bfilter%5D%20NOT%20comment%5BPTYP%5D%20NOT%20letter%5BPTYP%5D" title="PubMed search">See all (3)</a></div></div>
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<h2 class="offscreen_noflow">Supplemental Content</h2>
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<div class="portlet_head mgSectionHead ui-widget-header"><h1 class="nl" id="Table_of_contents">Table of contents</h1><a sid="113" href="#" class="portlet_shutter" title="Show/hide content"></a></div>
<div class="portlet_content ln"><ul id="my-toc"></ul></div>
</div>
<div class="portlet mgSection" id="ID_106">
<div class="portlet_head mgSectionHead ui-widget-header"><h1 class="nl" id="Genetic_Testing_Registry">Genetic Testing Registry</h1><a sid="106" href="#" class="portlet_shutter" title="Show/hide content"></a></div>
<div class="portlet_content ln"><ul><li><a href="/gtr/tests?term=C0002066%5bDISCUI%5d&amp;filter=method%3A1%5F1" target="_blank">Analyte (3)</a></li>
<li><a href="/gtr/tests?term=C0002066%5bDISCUI%5d&amp;filter=method%3A2%5F8" target="_blank">Deletion/duplication analysis (17)</a></li>
<li><a href="/gtr/tests?term=C0002066%5bDISCUI%5d&amp;filter=method%3A2%5F13" target="_blank">Linkage analysis (1)</a></li>
<li><a href="/gtr/tests?term=C0002066%5bDISCUI%5d&amp;filter=method%3A2%5F9" target="_blank">Sequence analysis of select exons (2)</a></li>
<li><a href="/gtr/tests?term=C0002066%5bDISCUI%5d&amp;filter=method%3A2%5F7" target="_blank">Sequence analysis of the entire coding region (24)</a></li>
<li><a href="/gtr/tests?term=C0002066%5bDISCUI%5d&amp;filter=method%3A2%5F19" target="_blank">Targeted variant analysis (4)</a></li>
<li class="portletSeeAll portletSeeAllPad"><total><a href="/gtr/tests?term=C0002066%5bDISCUI%5d" target="_blank">See all (27)</a></total></li>
</ul></div>
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<div class="portlet_head mgSectionHead ui-widget-header"><h1 class="nl" id="Clinical_resources">Clinical resources</h1><a sid="119" href="#" class="portlet_shutter" title="Show/hide content"></a></div>
<div class="portlet_content ln"><ul><li><a href="https://www.omim.org/search?index=entry&amp;start=1&amp;limit=10&amp;sort=score%20desc&amp;field=number&amp;search=203500" target="_blank">OMIM</a></li><li><a href="http://www.orpha.net/consor/cgi-bin/OC_Exp.php?Expert=56" target="_blank">Orphanet</a></li><li><a href="https://clinicaltrials.gov/search?cond=Alkaptonuria" target="_blank">ClinicalTrials.gov</a></li></ul></div>
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<div class="portlet_head mgSectionHead ui-widget-header"><h1 class="nl" id="Practice_guidelines">Practice guidelines</h1><a sid="121" href="#" class="portlet_shutter" title="Show/hide content"></a></div>
<div class="portlet_content ln"><ul class="a_poppers"><li><a target="_blank" href="https://pubmed.ncbi.nlm.nih.gov/?term=(%22alkaptonuria%22%5Btiab%3A~0%5D)%20AND%20(%22english%20and%20humans%22%5BFilter%5D)%20AND%20(%20(%22practice%20guideline%22%5BFilter%5D)%20OR%20(practice*%5Btitl%5D%20AND%20(guideline%5Btitl%5D%20OR%20parameter%5Btitl%5D%20OR%20resource%5Btitl%5D%20OR%20bulletin%5Btitl%5D%20OR%20best%5Btitl%5D))%20OR%20(genetic*%5Btitl%5D%20AND%20(evaluation%5Btitl%5D%20OR%20counseling%5Btitl%5D%20OR%20screening%5Btitl%5D%20OR%20test*%5Btitl%5D))%20OR%20(clinical%5Btitl%5D%20AND%20((expert%5Btitl%5D%20AND%20consensus%5Btitl%5D)%20OR%20utility%5Btitl%5D%20OR%20guideline*%5Btitl%5D))%20OR%20(management%5Btitl%5D%20AND%20(clinical%5Btitl%5D%20OR%20diagnos*%5Btitl%5D%20OR%20recommendation%5Btitl%5D%20OR%20pain%5Btitl%5D%20OR%20surveillance%5Btitl%5D%20OR%20emergency%5Btitl%5D%20OR%20guideline*%5Btitl%5D%20OR%20therap*))%20OR%20(treatment%5Btitl%5D%20AND%20((evaluation%5Btitl%5D%20AND%20diagnosis%5Btitl%5D)%20OR%20(assessment%5Btitl%5D%20AND%20prevention%5Btitl%5D)%20OR%20therap*))%20OR%20(Diagnos*%5Btitl%5D%20AND%20(prenatal%5Btitl%5D%20OR%20treatment%5Btitl%5D%20OR%20follow-up%5Btitl%5D%20OR%20statement%5Btitl%5D%20OR%20criteria%5Btitl%5D%20OR%20newborn%5Btitl%5D%20OR%20differential%5Btitl%5D%20OR%20neonatal%5Btitl%5D%20OR%20neonate%5Btitl%5D))%20OR%20(guideline*%5Btitl%5D%20AND%20(pharmacogenetic*%5Btitl%5D%20OR%20recommendation%5Btitl%5D%20OR%20therap*%5Btitl%5D%20OR%20evidence-based%5Btitl%5D%20OR%20consensus%5Btitl%5D%20OR%20(technical%5Btitl%5D%20AND%20standard*%5Btitl%5D)%20OR%20(molecular%5Btitl%5D%20AND%20testing%5Btitl%5D)))%20OR%20(risk%5Btitl%5D%20AND%20assessment%5Btitl%5D)%20OR%20(recommendation*%5Btitl%5D%20AND%20(statement%5Btitl%5D%20OR%20Evidence-based%5Btitl%5D%20OR%20Consensus%5Btitl%5D))%20OR%20(care%20AND%20((Patient%5Btitl%5D%20AND%20standard*%5Btitl%5D)%20OR%20primary%5Btitl%5D%20OR%20psychosocial%5Btitl%5D))%20OR%20(Health%5Btitl%5D%20AND%20supervision%5Btitl%5D)%20OR%20(statement%5Btitl%5D%20AND%20(policy%5Btitl%5D%20OR%20position%5Btitl%5D%20OR%20Consensus%5Btitl%5D))%20OR%20(pharmacogenetics%5Btitl%5D%20AND%20(Dosing%5Btitl%5D%20OR%20therap*%5Btitl%5D%20OR%20genotype*%5Btitl%5D%20OR%20drug*%5Btitl%5D))%20OR%20(Chemotherapy%5Btitl%5D%20AND%20decision*%5Btitl%5D)%20OR%20(screening%5Btitl%5D%20AND%20(newborn%5Btitl%5D%20OR%20neonat*%5Btitl%5D%20OR%20detection%5Btitl%5D%20OR%20diagnos*%5Btitl%5D))%20OR%20(criteria%5Btitl%5D%20OR%20genotype*%5Btitl%5D)%20)%20NOT%20(%22Case%20reports%22%5BPublication%20type%5D%20OR%20%22clinical%20study%22%5BPublication%20Type%5D%20OR%20%22randomized%20controlled%20trial%22%5BPublication%20Type%5D)" title="PubMed search">PubMed</a><div class="help-popup">See practice and clinical guidelines in PubMed. The search results may include broader topics and may not capture all published guidelines. See the <a href="/medgen/docs/faq/" title="Frequently asked questions" target="_blank">FAQ</a> for details.</div></li></ul></div>
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<div class="portlet_content ln"><ul><li><a href="http://www.omim.org/search?index=entry&amp;start=1&amp;limit=10&amp;sort=score%20desc&amp;field=number&amp;search=607474" target="_blank">OMIM</a></li><li><a href="/clinvar/?term=3081[geneid]" target="_blank">View HGD variations in ClinVar</a></li><li><a href="/nuccore/227908849" target="_blank">RefSeqGene</a></li><li><a href="https://catalog.coriell.org/Search?q=203500" target="_blank">Coriell Institute for Medical Research</a></li></ul></div>
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<div class="portlet_content ln"><ul><li><a href="http://www.diseaseinfosearch.org/Alkaptonuria/304" target="_blank">Genetic Alliance</a></li><li><a href="https://www.malacards.org/card/alkaptonuria" target="_blank">MalaCards</a></li><li><a href="https://vsearch.nlm.nih.gov/vivisimo/cgi-bin/query-meta?v:project=medlineplus&amp;query=Alkaptonuria" target="_blank">MedlinePlus</a></li><li><a href="https://medlineplus.gov/genetics/condition/alkaptonuria" target="_blank">MedlinePlusGenetics (GHR)</a></li><li><a href="https://rarediseases.info.nih.gov/diseases/5775/disease" target="_blank">NCATS Office of Rare Diseases Research (GARD)</a></li></ul></div>
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<a href="/pubmed/clinical?term=Alkaptonuria" ref="ncbi_uid=&amp;discoId=gtr_reviews&amp;linkpos=2&amp;linkpostotal=3" target="_blank">PubMed Clinical Queries</a>
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<a href="/pubmed?term=Alkaptonuria%20AND%20humans[mesh]%20AND%20review[publication%20type]" ref="ncbi_uid=&amp;discoId=gtr_reviews&amp;linkpos=3&amp;linkpostotal=3" target="_blank">Reviews in PubMed</a>
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<a class="brieflinkpopperctrl" href="/clinvar?LinkName=medgen_clinvar&amp;from_uid=1413" ref="log$=recordlinks">ClinVar</a>
<div class="brieflinkpop offscreen_noflow">Related medical variations</div>
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<a class="brieflinkpopperctrl" href="/gene?LinkName=medgen_gene_diseases&amp;from_uid=1413" ref="log$=recordlinks">Gene</a>
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<a class="brieflinkpopperctrl" href="/gtr/tests?term=C0002066[DISCUI]" ref="log$=recordlinks">GTR</a>
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<a class="brieflinkpopperctrl" href="/pubmed?LinkName=medgen_pubmed_bookshelf_cited&amp;from_uid=1413" ref="log$=recordlinks">PubMed (Bookshelf cited)</a>
<div class="brieflinkpop offscreen_noflow">Links to PubMed based on citations in GeneReviews and Medical Genetics Summaries</div>
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<a class="brieflinkpopperctrl" href="/pubmed?LinkName=medgen_pubmed_genereviews&amp;from_uid=1413" ref="log$=recordlinks">PubMed (GeneReviews)</a>
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<a class="htb ralinkpopperctrl" ref="log$=activity&amp;linkpos=1" href="/portal/utils/pageresolver.fcgi?recordid=67ca6a7eb15b832ebcf7e98a">Alkaptonuria</a>
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