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Chediak-Higashi syndrome

Chediak-Higashi syndrome is a rare disease of the immune and nervous systems that involves pale-colored hair, eyes, and skin.

Causes, incidence, and risk factors

Chediak-Higashi syndrome is passed down through families (inherited). It is an autosomal recessive disease. This means that both parents are carriers of a non-working copy of the gene, and each parent must pass their non-working gene to the child for them to show symptoms of the disease.

Defects have been found in the CHS1 (also called LYST) gene. The primary defect in this disease is found in certain substances normally present in skin cells and certain white blood cells.

Symptoms

Children with this condition may have:

  • Silver hair, light-colored eyes (albinism)
  • Increased infections in the lungs, skin, and mucous membranes
  • Jerky eye movements (nystagmus )

Infection of affected children with certain viruses, such as Epstein-Barr virus (EBV ), can cause a deadly illness resembling the blood cancer lymphoma .

Other symptoms may include:

  • Decreased vision
  • Intellectual disability
  • Muscle weakness
  • Nerve problems in the limbs (peripheral neuropathy )
  • Nosebleeds or easy bruising
  • Numbness
  • Tremor
  • Seizures
  • Sensitivity to bright light (photophobia)
  • Unsteady walking (ataxia )

Signs and tests

The doctor will perform a physical exam. This may show signs of a swollen spleen or liver or jaundice.

Tests that may be done include:

  • Complete blood count, including white blood cell count
  • Blood platelet count
  • Blood culture and smear
  • Brain MRI or CT
  • EEG
  • EMG
  • Nerve conduction tests

Treatment

There is no specific treatment for Chediak-Higashi syndrome. Bone marrow transplants appear to have been successful in several patients, especially when performed early in the disease.

Antibiotics are used to treat infections. Antiviral drugs such as acyclovir and chemotherapy drugs are often used in the accelerated phase of the disease. Surgery may be needed to drain abscesses in some cases.

Support Groups

Chediak-Higashi Syndrome Association -- www.chediak-higashi.org

Expectations (prognosis)

Death often occurs in the first 10 years of life, from chronic infections or accelerated disease that results in lymphoma-like illness. However, some affected children have survived longer.

Complications

  • Frequent infections especially with Epstein-Barr virus
  • Lymphoma-like cancer
  • Early death

Calling your health care provider

Call your health care provider if you have a family history of this disorder and you are planning to have children.

Call for an appointment with your health care provider if your child shows symptoms of Chediak-Higashi syndrome.

Prevention

Genetic counseling is recommended before becoming pregnant if you have a family history of Chediak-Higashi.

References

Introne WJ, Westbroek W, Golas GA, et al. Chediak-Higashi Syndrome. 2009 Mar 3 [Updated 2012 Feb 16]. In: Pagon RA, Adam MP, Bird TD, et al., editors. GeneReviews™ [Internet]. Seattle (WA): University of Washington, Seattle; 1993-2013.

Updated: 9/8/2013

Chad Haldeman-Englert, MD, FACMG, Wake Forest School of Medicine, Department of Pediatrics, Section on Medical Genetics, Winston-Salem, NC. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.


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