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Osteoporosis-pseudoglioma syndrome

Reviewed January 2013

What is osteoporosis-pseudoglioma syndrome?

Osteoporosis-pseudoglioma syndrome is a rare condition characterized by severe thinning of the bones (osteoporosis) and eye abnormalities that lead to vision loss. In people with this condition, osteoporosis is usually recognized in early childhood. It is caused by a shortage of minerals, such as calcium, in bones (decreased bone mineral density), which makes the bones brittle and prone to fracture. Affected individuals often have multiple bone fractures, including in the bones that form the spine (vertebrae). Multiple fractures can cause collapse of the affected vertebrae (compressed vertebrae), abnormal side-to-side curvature of the spine (scoliosis), short stature, and limb deformities. Decreased bone mineral density can also cause softening or thinning of the skull (craniotabes).

Most affected individuals have impaired vision at birth or by early infancy and are blind by young adulthood. Vision problems are usually caused by one of several eye conditions, grouped together as pseudoglioma, that affect the light-sensitive tissue at the back of the eye (the retina), although other eye conditions have been identified in affected individuals. Pseudogliomas are so named because, on examination, the conditions resemble an eye tumor known as a retinal glioma.

Rarely, people with osteoporosis-pseudoglioma syndrome have additional signs or symptoms such as mild intellectual disability, weak muscle tone (hypotonia), abnormally flexible joints, or seizures.

How common is osteoporosis-pseudoglioma syndrome?

Osteoporosis-pseudoglioma syndrome is a rare disorder that occurs in approximately 1 in 2 million people.

What genes are related to osteoporosis-pseudoglioma syndrome?

Osteoporosis-pseudoglioma syndrome is caused by mutations in the LRP5 gene. This gene provides instructions for making a protein that participates in a chemical signaling pathway that affects the way cells and tissues develop. In particular, the LRP5 protein helps regulate bone mineral density and plays a critical role in development of the retina.

LRP5 gene mutations that cause osteoporosis-pseudoglioma syndrome prevent cells from making any LRP5 protein or lead to a protein that cannot function. Loss of this protein's function disrupts the chemical signaling pathways that are needed for the formation of bone and for normal retinal development, leading to the bone and eye abnormalities characteristic of osteoporosis-pseudoglioma syndrome.

Related Gene(s)

Changes in this gene are associated with osteoporosis-pseudoglioma syndrome.

  • LRP5

How do people inherit osteoporosis-pseudoglioma syndrome?

Osteoporosis-pseudoglioma syndrome is inherited in an autosomal recessive pattern, which means both copies of the LRP5 gene in each cell have mutations. The parents of an individual with an autosomal recessive condition each carry one copy of the mutated gene, but they typically do not show signs and symptoms of the condition. However, some carriers may have decreased bone mineral density.

Where can I find information about diagnosis or management of osteoporosis-pseudoglioma syndrome?

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

  • Fitbones: Arizona Osteoporosis Coalition: Screening (http://www.fitbones.org/OsteoporosisInformation/Treatment/Screening.aspx)
  • Genetic Testing Registry: Osteoporosis with pseudoglioma (http://www.ncbi.nlm.nih.gov/gtr/conditions/C0432252)
  • Lucile Packard Children's Hospital at Stanford: Juvenile Osteoporosis (http://www.lpch.org/DiseaseHealthInfo/HealthLibrary/diabetes/josteo.html)
  • MedlinePlus Encyclopedia: Bone Mineral Density Test (http://www.nlm.nih.gov/medlineplus/ency/article/007197.htm)
  • Merck Manual Home Health Edition: Osteoporosis (http://www.merckmanuals.com/home/bone_joint_and_muscle_disorders/osteoporosis/osteoporosis.html)

You might also find information on the diagnosis or management of osteoporosis-pseudoglioma syndrome in Educational resources (http://www.ghr.nlm.nih.gov/condition/osteoporosis-pseudoglioma-syndrome/show/Educational+resources) and Patient support (http://www.ghr.nlm.nih.gov/condition/osteoporosis-pseudoglioma-syndrome/show/Patient+support).

General information about the diagnosis (http://ghr.nlm.nih.gov/handbook/consult/diagnosis) and management (http://ghr.nlm.nih.gov/handbook/consult/treatment) of genetic conditions is available in the Handbook. Read more about genetic testing (http://ghr.nlm.nih.gov/handbook/testing), particularly the difference between clinical tests and research tests (http://ghr.nlm.nih.gov/handbook/testing/researchtesting).

To locate a healthcare provider, see How can I find a genetics professional in my area? (http://ghr.nlm.nih.gov/handbook/consult/findingprofessional) in the Handbook.

Where can I find additional information about osteoporosis-pseudoglioma syndrome?

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

  • MedlinePlus - Health information

    • Encyclopedia: Bone Mineral Density Test (http://www.nlm.nih.gov/medlineplus/ency/article/007197.htm)
    • Health Topic: Bone Density (http://www.nlm.nih.gov/medlineplus/bonedensity.html)
    • Health Topic: Bone Diseases (http://www.nlm.nih.gov/medlineplus/bonediseases.html)
    • Health Topic: Osteoporosis (http://www.nlm.nih.gov/medlineplus/osteoporosis.html)
    • Health Topic: Vision Impairment and Blindness (http://www.nlm.nih.gov/medlineplus/visionimpairmentandblindness.html)
  • Additional NIH Resources - National Institutes of Health
    National Institute of Arthritis and Muskuloskeletal and Skin Diseases: Juvenile Osteoporosis (http://www.niams.nih.gov/Health_Info/Bone/Bone_Health/Juvenile/juvenile_osteoporosis.asp)

  • Educational resources - Information pages

    • Boston Children's Hospital: Juvenile Osteoporosis (http://www.childrenshospital.org/az/Site1195/mainpageS1195P0.html)
    • Boston Children's Hospital Center for the Study of Genetic Skeletal Disorders (http://www.childrenshospital.org/cfapps/research/data_admin/Site2253/mainpageS2253P16.html)
    • Fitbones: Arizona Osteoporosis Coalition: What is Osteoporosis? (http://www.fitbones.org/OsteoporosisInformation/Learn/WhatisOsteo.aspx)
    • KidsHealth from Nemours: Osteoporosis (http://kidshealth.org/kid/grownup/conditions/osteoporosis.html)
    • Lucile Packard Children's Hospital at Stanford: Juvenile Osteoporosis (http://www.lpch.org/DiseaseHealthInfo/HealthLibrary/diabetes/josteo.html)
    • Merck Manual Home Health Edition: Osteoporosis (http://www.merckmanuals.com/home/bone_joint_and_muscle_disorders/osteoporosis/osteoporosis.html)
    • Orphanet (http://www.orpha.net/consor/cgi-bin/Disease_Search.php?lng=EN&data_id=2536&Disease_Disease_Search_diseaseGroup=osteoporosis-pseudoglioma&Disease_Disease_Search_diseaseType=Pat&Disease%28s%29/group%20of%20diseases=Osteoporosis---pseudoglioma&title=Osteoporosis---pseudoglioma&search=Disease_Search_Simple)
    • University of Arizona (http://disorders.eyes.arizona.edu/disorders/osteoporosis-pseudoglioma-syndrome)

  • Patient support - For patients and families

    • American Foundation for the Blind (http://www.afb.org/default.aspx)
    • Fitbones: Arizona Osteoporosis Coalition: Living with Osteoporosis (http://www.fitbones.org/OsteoporosisInformation/Learn/Living.aspx)
    • National Osteoporosis Foundation (http://www.nof.org/)
    • The Foundation Fighting Blindness (http://www.ffb.ca/index.html)

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

  • Genetic Testing Registry - Repository of genetic test information

    • Genetic Testing Registry: Osteoporosis with pseudoglioma (http://www.ncbi.nlm.nih.gov/gtr/conditions/C0432252)
  • ClinicalTrials.gov - Linking patients to medical research (http://clinicaltrials.gov/ct2/results?cond=%22osteoporosis-pseudoglioma%20syndrome%22%20OR%20%22juvenile%20osteoporosis%22)
  • PubMed - Recent literature (http://www.ncbi.nlm.nih.gov/pubmed?term=(osteoporosis-pseudoglioma%20syndrome%5BTIAB%5D)%20AND%20english%5Bla%5D%20AND%20human%5Bmh%5D%20AND%20%22last%202520%20days%22%5Bdp%5D)
  • OMIM - Genetic disorder catalog (http://omim.org/entry/259770)

What other names do people use for osteoporosis-pseudoglioma syndrome?

  • OPPG
  • osteogenesis imperfecta, ocular form

For more information about naming genetic conditions, see the Genetics Home Reference Condition Naming Guidelines (http://ghr.nlm.nih.gov/ConditionNameGuide) and How are genetic conditions and genes named? (http://ghr.nlm.nih.gov/handbook/mutationsanddisorders/naming) in the Handbook.

What if I still have specific questions about osteoporosis-pseudoglioma syndrome?

Ask the Genetic and Rare Diseases Information Center (http://rarediseases.info.nih.gov/GARD/).

What glossary definitions help with understanding osteoporosis-pseudoglioma syndrome?

autosomal ; autosomal recessive ; bone mineral density ; calcium ; cell ; gene ; glioma ; hypotonia ; juvenile ; mineral ; muscle tone ; osteogenesis ; osteoporosis ; protein ; pseudoglioma ; recessive ; retina ; scoliosis ; short stature ; stature ; syndrome ; tissue ; tumor

You may find definitions for these and many other terms in the Genetics Home Reference Glossary (http://www.ghr.nlm.nih.gov/glossary).

References

  • Ai M, Heeger S, Bartels CF, Schelling DK; Osteoporosis-Pseudoglioma Collaborative Group. Clinical and molecular findings in osteoporosis-pseudoglioma syndrome. Am J Hum Genet. 2005 Nov;77(5):741-53. Epub 2005 Sep 27. (http://www.ncbi.nlm.nih.gov/pubmed/16252235?dopt=Abstract)
  • Gong Y, Slee RB, Fukai N, Rawadi G, Roman-Roman S, Reginato AM, Wang H, Cundy T, Glorieux FH, Lev D, Zacharin M, Oexle K, Marcelino J, Suwairi W, Heeger S, Sabatakos G, Apte S, Adkins WN, Allgrove J, Arslan-Kirchner M, Batch JA, Beighton P, Black GC, Boles RG, Boon LM, Borrone C, Brunner HG, Carle GF, Dallapiccola B, De Paepe A, Floege B, Halfhide ML, Hall B, Hennekam RC, Hirose T, Jans A, Jüppner H, Kim CA, Keppler-Noreuil K, Kohlschuetter A, LaCombe D, Lambert M, Lemyre E, Letteboer T, Peltonen L, Ramesar RS, Romanengo M, Somer H, Steichen-Gersdorf E, Steinmann B, Sullivan B, Superti-Furga A, Swoboda W, van den Boogaard MJ, Van Hul W, Vikkula M, Votruba M, Zabel B, Garcia T, Baron R, Olsen BR, Warman ML; Osteoporosis-Pseudoglioma Syndrome Collaborative Group. LDL receptor-related protein 5 (LRP5) affects bone accrual and eye development. Cell. 2001 Nov 16;107(4):513-23. (http://www.ncbi.nlm.nih.gov/pubmed/11719191?dopt=Abstract)
  • Levasseur R, Lacombe D, de Vernejoul MC. LRP5 mutations in osteoporosis-pseudoglioma syndrome and high-bone-mass disorders. Joint Bone Spine. 2005 May;72(3):207-14. Review. (http://www.ncbi.nlm.nih.gov/pubmed/15850991?dopt=Abstract)
  • Narumi S, Numakura C, Shiihara T, Seiwa C, Nozaki Y, Yamagata T, Momoi MY, Watanabe Y, Yoshino M, Matsuishi T, Nishi E, Kawame H, Akahane T, Nishimura G, Emi M, Hasegawa T. Various types of LRP5 mutations in four patients with osteoporosis-pseudoglioma syndrome: identification of a 7.2-kb microdeletion using oligonucleotide tiling microarray. Am J Med Genet A. 2010 Jan;152A(1):133-40. doi: 10.1002/ajmg.a.33177. (http://www.ncbi.nlm.nih.gov/pubmed/20034086?dopt=Abstract)
  • Tüysüz B, Bursalı A, Alp Z, Suyugül N, Laine CM, Mäkitie O. Osteoporosis-pseudoglioma syndrome: three novel mutations in the LRP5 gene and response to bisphosphonate treatment. Horm Res Paediatr. 2012;77(2):115-20. doi: 10.1159/000336193. Epub 2012 Mar 23. (http://www.ncbi.nlm.nih.gov/pubmed/22456437?dopt=Abstract)

 

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? (http://ghr.nlm.nih.gov/handbook/consult/findingprofessional) in the Handbook.

 
Reviewed: January 2013
Published: May 20, 2013