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Clinical characterisation and molecular analysis of Wagner syndrome
  1. Sarah P Meredith1,
  2. Allan J Richards1,
  3. Declan W Flanagan2,
  4. John D Scott2,
  5. Arabella V Poulson2,
  6. Martin P Snead2
  1. 1Department of Pathology, University of Cambridge, Cambridge, UK
  2. 2Vitreoretinal Service, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
  1. Correspondence to: M P Snead Vitreoretinal Service, Box 41, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge CB2 2QQ, UK; mps34{at}cam.ac.uk

Abstract

Aim: To detail the clinical findings in a British family with molecularly characterised Wagner syndrome.

Background: Only in the last year has the specific genetic defect in Wagner syndrome been identified, and the background literature of the molecular genetics is outlined. Clinical and laboratory findings in a second case of Wagner syndrome are included to highlight difficulties that can be encountered when identifying pathogenic mutations for disorders arising in complex genes.

Methods: Mutation screening was performed using PCR and RT-PCR.

Results: A heterozygous mutation was found converting the donor splice site of exon 8 of the chondroitin sulphate proteoglycan 2 (CSPG2). This is the same mutation that has been reported in the original Wagner pedigree. The main clinical features of Wagner syndrome are vitreous syneresis, thickening and incomplete separation of the posterior hyaloid membrane, chorioretinal changes accompanied by subnormal electroretinographic responses, an ectopic fovea and early-onset cataract. A clinical feature present in this family, but previously undescribed, is anterior uveitis without formation of synechiae. Wagner syndrome has a progressive course, resulting in loss of vision even in the absence of retinal detachment.

Conclusion: On a background of considerable confusion regarding the distinction between Wagner syndrome and predominantly ocular Stickler syndrome, it is now apparent the that two conditions are both clinically and genetically distinct. This report summarises the clinical findings in Wagner syndrome and extends the phenotypic characteristics.

  • cDNA, complementary DNA
  • COL2A1, collagen, type II, alpha 1
  • CSPG2, chondroitin sulphate proteoglycan 2
  • ERG, electroretinogram
  • OMIM, Online Mendelian Inheritance in Man

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Footnotes

  • Published Online First 11 October 2006

  • Funding: Action Medical Research (ref S/P/3937), The Evelyn Trust.

  • Competing interests: None.

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