Joubert Syndrome with Renal and Cerebral Manifestations: A Case Series of Three Siblings

Joubert syndrome is a rare genetic disorder. Marie Joubert made the first official diagnosis of the syndrome in 1969. It is characterised by aberrant neurodevelopment and a complex midbrain-hindbrain malformation which can be seen on the Magnetic Resonance Imaging (MRI) as molar tooth sign. The pres...

Full description

Bibliographic Details
Main Authors: Sushant Kumar, Ashok Bhat
Format: Article
Language:English
Published: JCDR Research and Publications Private Limited 2023-06-01
Series:Journal of Clinical and Diagnostic Research
Subjects:
Online Access:https://jcdr.net/articles/PDF/18046/63675_CE[Ra1]_F(IS)_PF1(AS_SS)_PFA_NC(KM)_PN(KM).pdf
_version_ 1797802339951706112
author Sushant Kumar
Ashok Bhat
author_facet Sushant Kumar
Ashok Bhat
author_sort Sushant Kumar
collection DOAJ
description Joubert syndrome is a rare genetic disorder. Marie Joubert made the first official diagnosis of the syndrome in 1969. It is characterised by aberrant neurodevelopment and a complex midbrain-hindbrain malformation which can be seen on the Magnetic Resonance Imaging (MRI) as molar tooth sign. The present case series reports three siblings from a consanguineous marriage. The first child had delayed developmental milestones, ataxia, mental retardation and presented with advanced renal failure and succumbed to uremic complications. The second and third siblings also had similar clinical findings and the diagnosis of Joubert syndrome was confirmed by the presence of molar tooth sign on MRI. The presence of renal failure in them was detected earlier than the first sibling with favourable outcome in both. The characteristic symptoms of Joubert syndrome include developmental delay, intellectual disability, ocular abnormalities, and lack of control over voluntary movements. Each sibling of an affected individual has a 25% chance of developing the disease, a 50% chance of being an asymptomatic carrier, and a 25% chance of being not affected and not being a carrier. Renal involvement occurs in approximately one third of patients. In the present case series, all the siblings were affected by the syndrome and developed renal failure which is extremely rare. Failure to evaluate the renal function in these patients can result in delayed presentation with adverse outcome as seen in the first sibling. The case series highlights the importance of considering this disorder in the differential diagnosis of chronic kidney disease, especially in cases with a family history and other suggestive symptoms and the need for early recognition and management of the disorder, as early intervention and supportive care can improve the patient’s quality of life and prognosis.
first_indexed 2024-03-13T05:04:12Z
format Article
id doaj.art-d6f099080f144414831e62a15e6d59a7
institution Directory Open Access Journal
issn 2249-782X
0973-709X
language English
last_indexed 2024-03-13T05:04:12Z
publishDate 2023-06-01
publisher JCDR Research and Publications Private Limited
record_format Article
series Journal of Clinical and Diagnostic Research
spelling doaj.art-d6f099080f144414831e62a15e6d59a72023-06-17T05:09:07ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2023-06-01176OR01OR0310.7860/JCDR/2023/63675.18046Joubert Syndrome with Renal and Cerebral Manifestations: A Case Series of Three SiblingsSushant Kumar0Ashok Bhat1Professor, Department of Nephrology, Kasturba Medical College, Manipal Academy of Higher Education, Mangalore, Karnataka, India.Associate Professor, Department of Nephrology, Kasturba Medical College, Manipal Academy of Higher Education, Mangalore, Karnataka, India.Joubert syndrome is a rare genetic disorder. Marie Joubert made the first official diagnosis of the syndrome in 1969. It is characterised by aberrant neurodevelopment and a complex midbrain-hindbrain malformation which can be seen on the Magnetic Resonance Imaging (MRI) as molar tooth sign. The present case series reports three siblings from a consanguineous marriage. The first child had delayed developmental milestones, ataxia, mental retardation and presented with advanced renal failure and succumbed to uremic complications. The second and third siblings also had similar clinical findings and the diagnosis of Joubert syndrome was confirmed by the presence of molar tooth sign on MRI. The presence of renal failure in them was detected earlier than the first sibling with favourable outcome in both. The characteristic symptoms of Joubert syndrome include developmental delay, intellectual disability, ocular abnormalities, and lack of control over voluntary movements. Each sibling of an affected individual has a 25% chance of developing the disease, a 50% chance of being an asymptomatic carrier, and a 25% chance of being not affected and not being a carrier. Renal involvement occurs in approximately one third of patients. In the present case series, all the siblings were affected by the syndrome and developed renal failure which is extremely rare. Failure to evaluate the renal function in these patients can result in delayed presentation with adverse outcome as seen in the first sibling. The case series highlights the importance of considering this disorder in the differential diagnosis of chronic kidney disease, especially in cases with a family history and other suggestive symptoms and the need for early recognition and management of the disorder, as early intervention and supportive care can improve the patient’s quality of life and prognosis.https://jcdr.net/articles/PDF/18046/63675_CE[Ra1]_F(IS)_PF1(AS_SS)_PFA_NC(KM)_PN(KM).pdfdevelopmental delaymental retardationmolar tooth signocular abnormalityrenal failure
spellingShingle Sushant Kumar
Ashok Bhat
Joubert Syndrome with Renal and Cerebral Manifestations: A Case Series of Three Siblings
Journal of Clinical and Diagnostic Research
developmental delay
mental retardation
molar tooth sign
ocular abnormality
renal failure
title Joubert Syndrome with Renal and Cerebral Manifestations: A Case Series of Three Siblings
title_full Joubert Syndrome with Renal and Cerebral Manifestations: A Case Series of Three Siblings
title_fullStr Joubert Syndrome with Renal and Cerebral Manifestations: A Case Series of Three Siblings
title_full_unstemmed Joubert Syndrome with Renal and Cerebral Manifestations: A Case Series of Three Siblings
title_short Joubert Syndrome with Renal and Cerebral Manifestations: A Case Series of Three Siblings
title_sort joubert syndrome with renal and cerebral manifestations a case series of three siblings
topic developmental delay
mental retardation
molar tooth sign
ocular abnormality
renal failure
url https://jcdr.net/articles/PDF/18046/63675_CE[Ra1]_F(IS)_PF1(AS_SS)_PFA_NC(KM)_PN(KM).pdf
work_keys_str_mv AT sushantkumar joubertsyndromewithrenalandcerebralmanifestationsacaseseriesofthreesiblings
AT ashokbhat joubertsyndromewithrenalandcerebralmanifestationsacaseseriesofthreesiblings