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Visceral heterotaxy

MedGen UID:
465273
Concept ID:
C3178805
Disease or Syndrome
Synonyms: Heterotaxia; Heterotaxy syndrome
Modes of inheritance:
Autosomal recessive inheritance
MedGen UID:
141025
Concept ID:
C0441748
Intellectual Product
Source: Orphanet
A mode of inheritance that is observed for traits related to a gene encoded on one of the autosomes (i.e., the human chromosomes 1-22) in which a trait manifests in individuals with two pathogenic alleles, either homozygotes (two copies of the same mutant allele) or compound heterozygotes (whereby each copy of a gene has a distinct mutant allele).
Autosomal dominant inheritance
MedGen UID:
141047
Concept ID:
C0443147
Intellectual Product
Source: Orphanet
A mode of inheritance that is observed for traits related to a gene encoded on one of the autosomes (i.e., the human chromosomes 1-22) in which a trait manifests in heterozygotes. In the context of medical genetics, an autosomal dominant disorder is caused when a single copy of the mutant allele is present. Males and females are affected equally, and can both transmit the disorder with a risk of 50% for each child of inheriting the mutant allele.
X-linked recessive inheritance
MedGen UID:
375779
Concept ID:
C1845977
Finding
Source: Orphanet
A mode of inheritance that is observed for recessive traits related to a gene encoded on the X chromosome. In the context of medical genetics, X-linked recessive disorders manifest in males (who have one copy of the X chromosome and are thus hemizygotes), but generally not in female heterozygotes who have one mutant and one normal allele.
 
Monarch Initiative: MONDO:0018677
OMIM® Phenotypic series: PS306955
Orphanet: ORPHA450

Definition

Heterotaxy syndrome is a condition in which the internal organs are abnormally arranged in the chest and abdomen. The term "heterotaxy" is from the Greek words "heteros," meaning "other than," and "taxis," meaning "arrangement." Individuals with this condition have complex birth defects affecting the heart, lungs, liver, spleen, intestines, and other organs.

In the normal body, most of the organs in the chest and abdomen have a particular location on the right or left side. For example, the heart, spleen, and pancreas are on the left side of the body, and most of the liver is on the right. This normal arrangement of the organs is known as "situs solitus." Rarely, the orientation of the internal organs is completely flipped from right to left, a situation known as "situs inversus." This mirror-image orientation usually does not cause any health problems, unless it occurs as part of a syndrome affecting other parts of the body. Heterotaxy syndrome is an arrangement of internal organs somewhere between situs solitus and situs inversus; this condition is also known as "situs ambiguus." Unlike situs inversus, the abnormal arrangement of organs in heterotaxy syndrome often causes serious health problems.

Heterotaxy syndrome can alter the structure of the heart, including the attachment of the large blood vessels that carry blood to and from the rest of the body. It can also affect the structure of the lungs, such as the number of lobes in each lung and the length of the tubes (called bronchi) that lead from the windpipe to the lungs. In the abdomen, the condition can cause a person to have no spleen (asplenia) or multiple small, poorly functioning spleens (polysplenia). The liver may lie across the middle of the body instead of being in its normal position to the right of the stomach. Some affected individuals also have intestinal malrotation, which is an abnormal twisting of the intestines that occurs in the early stages of development before birth.

Depending on the organs involved, signs and symptoms of heterotaxy syndrome can include a bluish appearance of the skin or lips (cyanosis, which is due to a shortage of oxygen), breathing difficulties, an increased risk of infections, and problems with digesting food. The most serious complications are generally caused by critical congenital heart disease, a group of complex heart defects that are present from birth. Biliary atresia, a problem with the bile ducts in the liver, can also cause severe health problems in infancy.

The severity of heterotaxy syndrome varies depending on the specific abnormalities involved. Some affected individuals have only mild health problems related to the condition. At the other end of the spectrum, heterotaxy syndrome can be life-threatening in infancy or childhood, even with treatment. [from MedlinePlus Genetics]

Professional guidelines

PubMed

Babaoğlu K, Doğan Y, Başar EZ, Usta E
J Clin Ultrasound 2022 Jul;50(6):795-802. Epub 2022 Mar 30 doi: 10.1002/jcu.23209. PMID: 35355279
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Sci Transl Med 2012 Oct 3;4(154):154ra135. doi: 10.1126/scitranslmed.3004041. PMID: 23035047Free PMC Article

Recent clinical studies

Etiology

Babaoğlu K, Doğan Y, Başar EZ, Usta E
J Clin Ultrasound 2022 Jul;50(6):795-802. Epub 2022 Mar 30 doi: 10.1002/jcu.23209. PMID: 35355279
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Yurlov IA, Podzolkov VP, Zelenikin MM, Kovalev DV, Babaev GK, Putiato NA, Zaets SB
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Diagnosis

Babaoğlu K, Doğan Y, Başar EZ, Usta E
J Clin Ultrasound 2022 Jul;50(6):795-802. Epub 2022 Mar 30 doi: 10.1002/jcu.23209. PMID: 35355279
von Both I, Pollanen MS
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Therapy

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Changlani DK, Kotecha M, Changlani TD, Varghese R, Kumar RS
Heart Lung Circ 2012 Sep;21(9):598-605. Epub 2012 Jun 20 doi: 10.1016/j.hlc.2012.05.739. PMID: 22726404
Yurlov IA, Podzolkov VP, Zelenikin MM, Kovalev DV, Babaev GK, Putiato NA, Zaets SB
Interact Cardiovasc Thorac Surg 2011 Apr;12(4):563-8. Epub 2011 Jan 13 doi: 10.1510/icvts.2010.253567. PMID: 21233261

Prognosis

Babaoğlu K, Doğan Y, Başar EZ, Usta E
J Clin Ultrasound 2022 Jul;50(6):795-802. Epub 2022 Mar 30 doi: 10.1002/jcu.23209. PMID: 35355279
Bove KE, Thrasher AD, Anders R, Chung CT, Cummings OW, Finegold MJ, Finn L, Ranganathan S, Kim GE, Lovell M, Magid MS, Melin-Aldana H, Russo P, Shehata B, Wang L, White F, Chen Z, Spino C, Magee JC
Am J Surg Pathol 2018 Dec;42(12):1625-1635. doi: 10.1097/PAS.0000000000001146. PMID: 30247160Free PMC Article
Changlani DK, Kotecha M, Changlani TD, Varghese R, Kumar RS
Heart Lung Circ 2012 Sep;21(9):598-605. Epub 2012 Jun 20 doi: 10.1016/j.hlc.2012.05.739. PMID: 22726404
Yurlov IA, Podzolkov VP, Zelenikin MM, Kovalev DV, Babaev GK, Putiato NA, Zaets SB
Interact Cardiovasc Thorac Surg 2011 Apr;12(4):563-8. Epub 2011 Jan 13 doi: 10.1510/icvts.2010.253567. PMID: 21233261
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Clinical prediction guides

Wang D, Marshall D, Veldtman G, Gupta A, Trout AT, Villafane J, Bove K
Pathol Res Pract 2018 Jun;214(6):914-918. Epub 2018 Mar 15 doi: 10.1016/j.prp.2018.03.016. PMID: 29559246
Larsen RL, Eguchi JH, Mulla NF, Johnston JK, Fitts J, Kuhn MA, Razzouk AJ, Chinnock RE, Bailey LL
Am J Cardiol 2002 Jun 1;89(11):1275-9. doi: 10.1016/s0002-9149(02)02325-1. PMID: 12031727
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