Hutchinson Gilford Progeria

  • AD, 1824C>T in LMNA gene (encodes lamin A)
    • Mutation introduces a splice site that results in the protein being abnormally farnesylated → there is a new treatment that prevents the farnesylation and can increase the lifespan of these patients
    • Lamin A protein contributes to the structure/function of the nuclear envelope
  • Localized sclerodermatous changes of lower trunk/thigh & dyspigmentation
  • Premature aging
  • Markedly premature aging (median lifespan 12 years), large appearing
  • Cranium, frontal bossing, priminent scalp veins, beaked nose, micrgnathia
  • “Plucked bird” appearance, loss of subcutaneous tissue, sclerodermoid
  • Skin: alopecia, high pitched voice, average intelligence, severe premature
  • Coronary atherosclerosis
  • Overtime, patiens show signs of premature aging
    • Early skin wrinkling and xerosis
    • Hair loss (scalp, eyebrows, eyelashes)
    • Skin atrophy with prominent veins
    • Atherosclerosis and angina
    • Bone density loss/osteoporosis (with susceptibility to fractures), coxa valga and osteolysis of distl phalanges)
  • Rapid and progressive features of premature aging develop - complications include crebrovascular and cardiovascular events (CHF and MI), limited mobility and exercise tolerance, and poor growth
  • Complications of cardiovascular disease are the most common cause of mortality (mean age of death = 13 years)