Waardenburg's syndrome
🦻🎨 Waardenburg Syndrome is a rare congenital auditory–pigmentary disorder characterised by varying degrees of hearing loss and distinctive pigmentation abnormalities.
📌 About
- Waardenburg syndrome is an auditory-pigmentary syndrome.
- There are four clinical subtypes (Types I–IV) with overlapping features.
📊 Epidemiology
- Annual incidence: ~1 in 212,000 births.
- Prevalence: ~1 in 42,000 worldwide.
- Accounts for about 3% of congenital deafness.
🧬 Aetiology
- Sometimes associated with Hirschsprung disease.
🧪 Genetics
- Mutations in EDN3, EDNRB, MITF, PAX3, SNAI2, and SOX10.
- Usually inherited in an autosomal dominant pattern (with variable penetrance).
🖼️ Waardenburg's Syndrome
🧑⚕️ Clinical Features
- ⚪ White forelock and premature greying (before age 30).
- 👁️ Heterochromia irides or strikingly brilliant blue eyes.
- 🦻 Congenital sensorineural hearing loss (variable).
- 🦴 Some patients have musculoskeletal anomalies of the upper limbs.
- 👨👩👧 Family history: at least one affected immediate relative.
- 👁️ Dystopia canthorum (increased distance between inner eye corners).
- ⚪ Leukoderma – patches of light or white skin.
- 🪞 Medial eyebrow extension (“meeting in the middle”).
- 👃 Distinctive nasal abnormalities.
🔍 Investigations
- Pure tone audiometry (hearing assessment).
- Genetic testing to confirm mutations.
🛠️ Management
- 🔊 Hearing management → audiology referral, hearing aids or cochlear implant if indicated.
- 👨👩👧 Genetic counselling for family planning.
- ☀️ Skin protection advised for patients with leukoderma (risk of sun sensitivity).
- 💩 Treat associated Hirschsprung’s disease if present.
📚 References