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Lesch-Nyhan syndrome

Lesch-Nyhan syndrome

Reviewed February 2013

What is Lesch-Nyhan syndrome?

Lesch-Nyhan syndrome is a condition that occurs almost exclusively in males. It is characterized by neurological and behavioral abnormalities and the overproduction of uric acid. Uric acid is a waste product of normal chemical processes and is found in blood and urine. Excess uric acid can be released from the blood and build up under the skin and cause gouty arthritis (arthritis caused by an accumulation of uric acid in the joints). Uric acid accumulation can also cause kidney and bladder stones.

The nervous system and behavioral disturbances experienced by people with Lesch-Nyhan syndrome include abnormal involuntary muscle movements, such as tensing of various muscles (dystonia), jerking movements (chorea), and flailing of the limbs (ballismus). People with Lesch-Nyhan syndrome usually cannot walk, require assistance sitting, and generally use a wheelchair. Self-injury (including biting and head banging) is the most common and distinctive behavioral problem in individuals with Lesch-Nyhan syndrome.

How common is Lesch-Nyhan syndrome?

The prevalence of Lesch-Nyhan syndrome is approximately 1 in 380,000 individuals. This condition occurs with a similar frequency in all populations.

What genes are related to Lesch-Nyhan syndrome?

Mutations in the HPRT1 gene cause Lesch-Nyhan syndrome. The HPRT1 gene provides instructions for making an enzyme called hypoxanthine phosphoribosyltransferase 1. This enzyme is responsible for recycling purines, a type of building block of DNA and its chemical cousin RNA. Recycling purines ensures that cells have a plentiful supply of building blocks for the production of DNA and RNA.

HPRT1 gene mutations that cause Lesch-Nyhan syndrome result in a severe shortage (deficiency) or complete absence of hypoxanthine phosphoribosyltransferase 1. When this enzyme is lacking, purines are broken down but not recycled, producing abnormally high levels of uric acid. For unknown reasons, a deficiency of hypoxanthine phosphoribosyltransferase 1 is associated with low levels of a chemical messenger in the brain called dopamine. Dopamine transmits messages that help the brain control physical movement and emotional behavior, and its shortage may play a role in the movement problems and other features of this disorder. However, it is unclear how a shortage of hypoxanthine phosphoribosyltransferase 1 causes the neurological and behavioral problems characteristic of Lesch-Nyhan syndrome.

Some people with HPRT1 gene mutations produce some functional enzyme. These individuals are said to have Lesch-Nyhan variant. The signs and symptoms of Lesch-Nyhan variant are often milder than those of Lesch-Nyhan syndrome and do not include self-injury.

Read more about the HPRT1 gene.

How do people inherit Lesch-Nyhan syndrome?

This condition is inherited in an X-linked recessive pattern. The gene associated with this condition is located on the X chromosome, which is one of the two sex chromosomes. In males (who have only one X chromosome), one altered copy of the gene in each cell is sufficient to cause the condition. In females (who have two X chromosomes), a mutation would have to occur in both copies of the gene to cause the disorder. Because it is unlikely that females will have two altered copies of this gene, males are affected by X-linked recessive disorders much more frequently than females. A characteristic of X-linked inheritance is that fathers cannot pass X-linked traits to their sons.

Where can I find information about diagnosis or management of Lesch-Nyhan syndrome?

These resources address the diagnosis or management of Lesch-Nyhan syndrome and may include treatment providers.

You might also find information on the diagnosis or management of Lesch-Nyhan syndrome in Educational resources and Patient support.

General information about the diagnosis and management of genetic conditions is available in the Handbook. Read more about genetic testing, particularly the difference between clinical tests and research tests.

To locate a healthcare provider, see How can I find a genetics professional in my area? in the Handbook.

Where can I find additional information about Lesch-Nyhan syndrome?

You may find the following resources about Lesch-Nyhan syndrome helpful. These materials are written for the general public.

You may also be interested in these resources, which are designed for healthcare professionals and researchers.

What other names do people use for Lesch-Nyhan syndrome?

  • choreoathetosis self-mutilation syndrome
  • complete HPRT deficiency
  • complete hypoxanthine-guanine phosphoribosyltransferase deficiency
  • deficiency of guanine phosphoribosyltransferase
  • deficiency of hypoxanthine phosphoribosyltransferase
  • HGPRT deficiency
  • hypoxanthine guanine phosphoribosyltransferase deficiency
  • hypoxanthine phosphoribosyltransferase deficiency
  • juvenile gout, choreoathetosis, mental retardation syndrome
  • juvenile hyperuricemia syndrome
  • Lesch-Nyhan disease
  • LND
  • LNS
  • primary hyperuricemia syndrome
  • total HPRT deficiency
  • total hypoxanthine-guanine phosphoribosyl transferase deficiency
  • X-linked hyperuricemia
  • X-linked primary hyperuricemia
  • X-linked uric aciduria enzyme defect

For more information about naming genetic conditions, see the Genetics Home Reference Condition Naming Guidelines and How are genetic conditions and genes named? in the Handbook.

What if I still have specific questions about Lesch-Nyhan syndrome?

Where can I find general information about genetic conditions?

What glossary definitions help with understanding Lesch-Nyhan syndrome?

aciduria ; arthritis ; cell ; chorea ; chromosome ; deficiency ; DNA ; dopamine ; dystonia ; enzyme ; gene ; gout ; guanine ; inheritance ; injury ; involuntary ; juvenile ; kidney ; mental retardation ; mutation ; nervous system ; neurological ; prevalence ; purines ; recessive ; RNA ; sex chromosomes ; syndrome ; transferase ; uric acid ; X-linked recessive

You may find definitions for these and many other terms in the Genetics Home Reference Glossary.

See also Understanding Medical Terminology.

References (11 links)

 

The resources on this site should not be used as a substitute for professional medical care or advice. Users seeking information about a personal genetic disease, syndrome, or condition should consult with a qualified healthcare professional. See How can I find a genetics professional in my area? in the Handbook.

 
Reviewed: February 2013
Published: April 17, 2014