U.S. flag

An official website of the United States government

Format

Send to:

Choose Destination

Visceral myopathy 1(VSCM1)

MedGen UID:
1785391
Concept ID:
C5542197
Disease or Syndrome
Synonyms: Infantile visceral myopathy; Megaduodenum and/or megacystis; Pseudoobstruction idiopathic intestinal; Visceral myopathy; VSCM1
 
Gene (location): ACTG2 (2p13.1)
 
Monarch Initiative: MONDO:0020754
OMIM®: 155310

Definition

ACTG2 visceral myopathy is a disorder of smooth muscle dysfunction of the bladder and gastrointestinal system with phenotypic spectrum that ranges from mild to severe. Bladder involvement can range from neonatal megacystis and megaureter (with its most extreme form of prune belly syndrome) at the more severe end, to recurrent urinary tract infections and bladder dysfunction at the milder end. Intestinal involvement can range from malrotation, neonatal manifestations of microcolon, megacystis microcolon intestinal hypoperistalsis syndrome, and chronic intestinal pseudoobstruction (CIPO) in neonates at the more severe end to intermittent abdominal distention and functional intestinal obstruction at the milder end. Affected infants (with or without evidence of intestinal malrotation) often present with feeding intolerance and findings of non-mechanical bowel obstruction that persist after successful surgical correction of malrotation. Individuals who develop manifestations of CIPO in later childhood or adulthood often experience episodic waxing and waning of bowel motility. They may undergo frequent abdominal surgeries (perhaps related to malrotation or adhesions causing mechanical obstruction) resulting in resection of dilated segments of bowel, often becoming dependent on total parenteral nutrition (TPN). [from GeneReviews]

Additional description

From OMIM
Familial visceral myopathy (VSCM) is a rare inherited form of myopathic pseudoobstruction, characterized by impaired function of enteric smooth muscle cells resulting in abnormal intestinal mobility, severe abdominal pain, malnutrition, and even death (Lehtonen et al., 2012). Visceral myopathy represents a phenotypic spectrum of disease characterized by inter- and intrafamilial variability, in which the most severely affected patients exhibit prenatal bladder enlargement, intestinal malrotation, neonatal functional gastrointestinal obstruction, and chronic dependence on total parenteral nutrition (TPN) and urinary catheterization (summary by Wangler et al., 2014). Another form of visceral myopathy with functional gastrointestinal obstruction is associated with external ophthalmoplegia (277320). Functional gastrointestinal obstruction also occurs in association with other abnormalities, such as 'prune belly' syndrome (100100) and Barrett esophagus (Mungan syndrome; 611376). Chronic intestinal pseudoobstruction can also be neuropathic in origin (see 609629). Genetic Heterogeneity of Visceral Myopathy VSCM2 (619350) is caused by mutation in the MYH11 gene (160745) on chromosome 16p13.  http://www.omim.org/entry/155310

Clinical features

From HPO
Abdominal pain
MedGen UID:
7803
Concept ID:
C0000737
Sign or Symptom
An unpleasant sensation characterized by physical discomfort (such as pricking, throbbing, or aching) and perceived to originate in the abdomen.
Hydronephrosis
MedGen UID:
42531
Concept ID:
C0020295
Disease or Syndrome
Severe distention of the kidney with dilation of the renal pelvis and calices.
Vesicoureteral reflux
MedGen UID:
21852
Concept ID:
C0042580
Disease or Syndrome
Vesicoureteral reflux (VUR) is characterized by the reflux of urine from the bladder into the ureters and sometimes into the kidneys. It is a risk factor for urinary tract infections. Primary VUR results from a developmental defect of the ureterovesical junction (UVJ). In combination with intrarenal reflux, the resulting inflammatory reaction may result in renal injury or scarring, also called reflux nephropathy (RN). Extensive renal scarring impairs renal function and may predispose patients to hypertension, proteinuria, and renal insufficiency (summary by Lu et al., 2007). Genetic Heterogeneity of Vesicoureteral Reflux A locus designated VUR1 maps to chromosome 1p13. VUR2 (610878) is caused by mutation in the ROBO2 gene (602431) on chromosome 3p12; VUR3 (613674) is caused by mutation in the SOX17 gene (610928) on chromosome 8q11; VUR4 (614317) maps to chromosome 5; VUR5 (614318) maps to chromosome 13; VUR6 (614319) maps to chromosome 18; VUR7 (615390) maps to chromosome 12; and VUR8 (615963) is caused by mutation in the TNXB gene (600985) on chromosome 6p21. A possible X-linked form has been reported (VURX; 314550).
Urinary retention
MedGen UID:
38289
Concept ID:
C0080274
Functional Concept
Inability to completely empty the urinary bladder during the process of urination.
Megacystis
MedGen UID:
343318
Concept ID:
C1855311
Finding
Dilatation of the bladder postnatally.
Abdominal distention
MedGen UID:
34
Concept ID:
C0000731
Finding
Distention of the abdomen.
Constipation
MedGen UID:
1101
Concept ID:
C0009806
Sign or Symptom
Infrequent or difficult evacuation of feces.
Dysphagia
MedGen UID:
41440
Concept ID:
C0011168
Disease or Syndrome
Difficulty in swallowing.
Diarrhea
MedGen UID:
8360
Concept ID:
C0011991
Sign or Symptom
Abnormally increased frequency (usually defined as three or more) loose or watery bowel movements a day.
Intestinal pseudo-obstruction
MedGen UID:
5864
Concept ID:
C0021847
Disease or Syndrome
A functional rather than mechanical obstruction of the intestines, associated with manifestations that resemble those caused by an intestinal obstruction, including distension, abdominal pain, nausea, vomiting, constipation or diarrhea, in an individual in whom a mechanical blockage has been excluded.
Vomiting
MedGen UID:
12124
Concept ID:
C0042963
Sign or Symptom
Forceful ejection of the contents of the stomach through the mouth by means of a series of involuntary spasmic contractions.
Gastroparesis
MedGen UID:
101809
Concept ID:
C0152020
Disease or Syndrome
Decreased strength of the muscle layer of stomach, which leads to a decreased ability to empty the contents of the stomach despite the absence of obstruction.
Malnutrition
MedGen UID:
56429
Concept ID:
C0162429
Disease or Syndrome
A deficiency in the intake of energy and nutrients.
Megaduodenum
MedGen UID:
75604
Concept ID:
C0266177
Congenital Abnormality
Dilation and elongation of the duodenum with hypertrophy of all layers of the duodenum.
Microcolon
MedGen UID:
82734
Concept ID:
C0266200
Congenital Abnormality
A colon of abnormally small caliber.
Thinning of outer muscular layer of small bowel
MedGen UID:
860148
Concept ID:
C4011711
Finding
The depth of the outer muscular layer of the small bowel is below the lower limit of normal.
Aganglionic megacolon
MedGen UID:
5559
Concept ID:
C0019569
Disease or Syndrome
The disorder described by Hirschsprung (1888) and known as Hirschsprung disease or aganglionic megacolon is characterized by congenital absence of intrinsic ganglion cells in the myenteric (Auerbach) and submucosal (Meissner) plexuses of the gastrointestinal tract. Patients are diagnosed with the short-segment form (S-HSCR, approximately 80% of cases) when the aganglionic segment does not extend beyond the upper sigmoid, and with the long-segment form (L-HSCR) when aganglionosis extends proximal to the sigmoid (Amiel et al., 2008). Total colonic aganglionosis and total intestinal HSCR also occur. Genetic Heterogeneity of Hirschsprung Disease Several additional loci for isolated Hirschsprung disease have been mapped. HSCR2 (600155) is associated with variation in the EDNRB gene (131244) on 13q22; HSCR3 (613711) is associated with variation in the GDNF gene (600837) on 5p13; HSCR4 (613712) is associated with variation in the EDN3 gene (131242) on 20q13; HSCR5 (600156) maps to 9q31; HSCR6 (606874) maps to 3p21; HSCR7 (606875) maps to 19q12; HSCR8 (608462) maps to 16q23; and HSCR9 (611644) maps to 4q31-q32. HSCR also occurs as a feature of several syndromes including the Waardenburg-Shah syndrome (277580), Mowat-Wilson syndrome (235730), Goldberg-Shprintzen syndrome (609460), and congenital central hypoventilation syndrome (CCHS; 209880). Whereas mendelian modes of inheritance have been described for syndromic HSCR, isolated HSCR stands as a model for genetic disorders with complex patterns of inheritance. Isolated HSCR appears to be of complex nonmendelian inheritance with low sex-dependent penetrance and variable expression according to the length of the aganglionic segment, suggestive of the involvement of one or more genes with low penetrance. The development of surgical procedures decreased mortality and morbidity, which allowed the emergence of familial cases. HSCR occurs as an isolated trait in 70% of patients, is associated with chromosomal anomaly in 12% of cases, and occurs with additional congenital anomalies in 18% of cases (summary by Amiel et al., 2008).
Pancreatitis
MedGen UID:
14586
Concept ID:
C0030305
Disease or Syndrome
The presence of inflammation in the pancreas.
Polyhydramnios
MedGen UID:
6936
Concept ID:
C0020224
Pathologic Function
The presence of excess amniotic fluid in the uterus during pregnancy.

Professional guidelines

PubMed

Stubblefield MD
Phys Med Rehabil Clin N Am 2017 Feb;28(1):89-100. doi: 10.1016/j.pmr.2016.08.003. PMID: 27913002
Di Lorenzo C, Youssef NN
Semin Pediatr Surg 2010 Feb;19(1):50-8. doi: 10.1053/j.sempedsurg.2009.11.006. PMID: 20123274
Sutton DH, Harrell SP, Wo JM
Nutr Clin Pract 2006 Feb;21(1):16-22. doi: 10.1177/011542650602100116. PMID: 16439766

Recent clinical studies

Etiology

Nham S, Nguyen ATM, Holland AJA
Eur J Pediatr 2022 Jul;181(7):2619-2632. Epub 2022 Apr 28 doi: 10.1007/s00431-021-04365-9. PMID: 35482095Free PMC Article
Colomba C, La Placa S, Saporito L, Corsello G, Ciccia F, Medaglia A, Romanin B, Serra N, Di Carlo P, Cascio A
J Pediatr 2018 Nov;202:186-193. Epub 2018 Jul 17 doi: 10.1016/j.jpeds.2018.06.034. PMID: 30029859
Li Z, Xu D, Wang Z, Wang Y, Zhang S, Li M, Zeng X
Lupus 2017 Oct;26(11):1127-1138. Epub 2017 May 19 doi: 10.1177/0961203317707825. PMID: 28523968
Puri P
J Pediatr Surg 1997 Feb;32(2):149-57. doi: 10.1016/s0022-3468(97)90170-6. PMID: 9044113
Stanghellini V, Corinaldesi R, Barbara L
Baillieres Clin Gastroenterol 1988 Jan;2(1):225-54. doi: 10.1016/0950-3528(88)90029-2. PMID: 3289641Free PMC Article

Diagnosis

Westfall KM, Cleary RK
Dis Colon Rectum 2022 Dec 1;65(12):1431-1434. Epub 2022 Oct 4 doi: 10.1097/DCR.0000000000002642. PMID: 36194654
Nham S, Nguyen ATM, Holland AJA
Eur J Pediatr 2022 Jul;181(7):2619-2632. Epub 2022 Apr 28 doi: 10.1007/s00431-021-04365-9. PMID: 35482095Free PMC Article
Sakakibara R
Neurol Sci 2021 Apr;42(4):1355-1365. Epub 2021 Feb 4 doi: 10.1007/s10072-021-05041-4. PMID: 33538914
Brewer BN, Kamen DL
Rheum Dis Clin North Am 2018 Feb;44(1):165-175. doi: 10.1016/j.rdc.2017.09.011. PMID: 29149925Free PMC Article
Li Z, Xu D, Wang Z, Wang Y, Zhang S, Li M, Zeng X
Lupus 2017 Oct;26(11):1127-1138. Epub 2017 May 19 doi: 10.1177/0961203317707825. PMID: 28523968

Therapy

Aboelezz AF, Othman MO
Gastrointest Endosc Clin N Am 2024 Jan;34(1):141-153. Epub 2023 Oct 13 doi: 10.1016/j.giec.2023.09.011. PMID: 37973225
Nham S, Nguyen ATM, Holland AJA
Eur J Pediatr 2022 Jul;181(7):2619-2632. Epub 2022 Apr 28 doi: 10.1007/s00431-021-04365-9. PMID: 35482095Free PMC Article
Colomba C, La Placa S, Saporito L, Corsello G, Ciccia F, Medaglia A, Romanin B, Serra N, Di Carlo P, Cascio A
J Pediatr 2018 Nov;202:186-193. Epub 2018 Jul 17 doi: 10.1016/j.jpeds.2018.06.034. PMID: 30029859
Li Z, Xu D, Wang Z, Wang Y, Zhang S, Li M, Zeng X
Lupus 2017 Oct;26(11):1127-1138. Epub 2017 May 19 doi: 10.1177/0961203317707825. PMID: 28523968
Caraceni P, Fagiuoli S, Wright HI, Nadir A, Van Thiel DH
Ital J Gastroenterol 1995 Jan-Feb;27(1):29-39. PMID: 7795285

Prognosis

Boybeyi Türer Ö, Soyer T, Özen H, Arslan UE, Karnak İ, Tanyel FC
Turk J Gastroenterol 2020 Aug;31(8):596-602. doi: 10.5152/tjg.2020.19233. PMID: 32915148Free PMC Article
Li Z, Xu D, Wang Z, Wang Y, Zhang S, Li M, Zeng X
Lupus 2017 Oct;26(11):1127-1138. Epub 2017 May 19 doi: 10.1177/0961203317707825. PMID: 28523968
Nasir GA, Rahma S, Kadim AH
East Mediterr Health J 2000 Jan;6(1):187-93. PMID: 11370333
Basilisco G
Am J Gastroenterol 1997 Jan;92(1):150-3. PMID: 8995957
Caraceni P, Fagiuoli S, Wright HI, Nadir A, Van Thiel DH
Ital J Gastroenterol 1995 Jan-Feb;27(1):29-39. PMID: 7795285

Clinical prediction guides

Kapur RP, Goldstein AM, Loeff DS, Myers CT, Paschal CR
Pediatr Dev Pathol 2022 Nov-Dec;25(6):581-597. Epub 2022 Jun 12 doi: 10.1177/10935266221107449. PMID: 35695198
Piché J, Van Vliet PP, Pucéat M, Andelfinger G
Cell Cycle 2019 Nov;18(21):2828-2848. Epub 2019 Sep 13 doi: 10.1080/15384101.2019.1658476. PMID: 31516082Free PMC Article
Colomba C, La Placa S, Saporito L, Corsello G, Ciccia F, Medaglia A, Romanin B, Serra N, Di Carlo P, Cascio A
J Pediatr 2018 Nov;202:186-193. Epub 2018 Jul 17 doi: 10.1016/j.jpeds.2018.06.034. PMID: 30029859
Carod-Artal FJ
Clin Auton Res 2018 Feb;28(1):67-81. Epub 2017 Jul 20 doi: 10.1007/s10286-017-0452-4. PMID: 28730326
Li Z, Xu D, Wang Z, Wang Y, Zhang S, Li M, Zeng X
Lupus 2017 Oct;26(11):1127-1138. Epub 2017 May 19 doi: 10.1177/0961203317707825. PMID: 28523968

Recent systematic reviews

Sakakibara R, Sawai S, Ogata T
Auton Neurosci 2022 Nov;242:103018. Epub 2022 Jul 8 doi: 10.1016/j.autneu.2022.103018. PMID: 35863181
Bazerbachi F, Haffar S, Szarka LA, Wang Z, Prokop LJ, Murad MH, Camilleri M
Neurogastroenterol Motil 2017 Nov;29(11) Epub 2017 Jun 5 doi: 10.1111/nmo.13120. PMID: 28580600
Li Z, Xu D, Wang Z, Wang Y, Zhang S, Li M, Zeng X
Lupus 2017 Oct;26(11):1127-1138. Epub 2017 May 19 doi: 10.1177/0961203317707825. PMID: 28523968
Bellini M, Gambaccini D, Bassotti G
Tech Coloproctol 2016 Jul;20(7):433-6. Epub 2016 May 12 doi: 10.1007/s10151-016-1477-8. PMID: 27174045
Noble EJ, Harris R, Hosie KB, Thomas S, Lewis SJ
Int J Surg 2009 Apr;7(2):100-5. Epub 2009 Jan 31 doi: 10.1016/j.ijsu.2009.01.006. PMID: 19261555

Supplemental Content

Table of contents

    Clinical resources

    Practice guidelines

    • PubMed
      See practice and clinical guidelines in PubMed. The search results may include broader topics and may not capture all published guidelines. See the FAQ for details.

    Recent activity

    Your browsing activity is empty.

    Activity recording is turned off.

    Turn recording back on

    See more...