Skip to main content
Journal of Medical Genetics logoLink to Journal of Medical Genetics
. 1997 Nov;34(11):917–923. doi: 10.1136/jmg.34.11.917

Prader-Willi syndrome.

S B Cassidy 1
PMCID: PMC1051120  PMID: 9391886

Abstract

Prader-Willi syndrome is a complex disorder affecting multiple systems with many manifestations relating to hypothalamic insufficiency. Major findings include infantile hypotonia, developmental delay and mental retardation, behaviour disorder, characteristic facial appearance, obesity, hypogonadism, and short stature. Obesity and the behavioural problems are the major causes of morbidity and mortality. Prader-Willi syndrome is caused by abnormalities of the imprinted region of proximal 15q and results from absence of the normally active paternal genes in this region. Such absence results from paternal interstitial deletion, maternal uniparental disomy, or a mutation or other abnormality in the imprinting process. Diagnostic identification of all causes has become available in recent years, permitting early detection and institution of appropriate management. This testing has permitted recent identification of some phenotypic differences among affected subjects of different race and between those with deletions and uniparental disomy as a cause.

Full text

PDF
919

Images in this article

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Angulo M., Castro-Magana M., Mazur B., Canas J. A., Vitollo P. M., Sarrantonio M. Growth hormone secretion and effects of growth hormone therapy on growth velocity and weight gain in children with Prader-Willi syndrome. J Pediatr Endocrinol Metab. 1996 May-Jun;9(3):393–400. doi: 10.1515/JPEM.1996.9.3.393. [DOI] [PubMed] [Google Scholar]
  2. Aughton D. J., Cassidy S. B. Physical features of Prader-Willi syndrome in neonates. Am J Dis Child. 1990 Nov;144(11):1251–1254. doi: 10.1001/archpedi.1990.02150350083032. [DOI] [PubMed] [Google Scholar]
  3. Buiting K., Saitoh S., Gross S., Dittrich B., Schwartz S., Nicholls R. D., Horsthemke B. Inherited microdeletions in the Angelman and Prader-Willi syndromes define an imprinting centre on human chromosome 15. Nat Genet. 1995 Apr;9(4):395–400. doi: 10.1038/ng0495-395. [DOI] [PubMed] [Google Scholar]
  4. Burd L., Vesely B., Martsolf J., Kerbeshian J. Prevalence study of Prader-Willi syndrome in North Dakota. Am J Med Genet. 1990 Sep;37(1):97–99. doi: 10.1002/ajmg.1320370122. [DOI] [PubMed] [Google Scholar]
  5. Butler M. G. Hypopigmentation: a common feature of Prader-Labhart-Willi syndrome. Am J Hum Genet. 1989 Jul;45(1):140–146. [PMC free article] [PubMed] [Google Scholar]
  6. Butler M. G. Molecular diagnosis of Prader-Willi syndrome: comparison of cytogenetic and molecular genetic data including parent of origin dependent methylation DNA patterns. Am J Med Genet. 1996 Jan 11;61(2):188–190. doi: 10.1002/ajmg.1320610202. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Butler M. G. Prader-Willi syndrome: current understanding of cause and diagnosis. Am J Med Genet. 1990 Mar;35(3):319–332. doi: 10.1002/ajmg.1320350306. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Cassidy S. B., Forsythe M., Heeger S., Nicholls R. D., Schork N., Benn P., Schwartz S. Comparison of phenotype between patients with Prader-Willi syndrome due to deletion 15q and uniparental disomy 15. Am J Med Genet. 1997 Feb 11;68(4):433–440. [PubMed] [Google Scholar]
  9. Cassidy S. B., Lai L. W., Erickson R. P., Magnuson L., Thomas E., Gendron R., Herrmann J. Trisomy 15 with loss of the paternal 15 as a cause of Prader-Willi syndrome due to maternal disomy. Am J Hum Genet. 1992 Oct;51(4):701–708. [PMC free article] [PubMed] [Google Scholar]
  10. Cassidy S. B. Prader-Willi syndrome. Curr Probl Pediatr. 1984 Jan;14(1):1–55. doi: 10.1016/0045-9380(84)90043-4. [DOI] [PubMed] [Google Scholar]
  11. Christian S. L., Smith A. C., Macha M., Black S. H., Elder F. F., Johnson J. M., Resta R. G., Surti U., Suslak L., Verp M. S. Prenatal diagnosis of uniparental disomy 15 following trisomy 15 mosaicism. Prenat Diagn. 1996 Apr;16(4):323–332. doi: 10.1002/(SICI)1097-0223(199604)16:4<323::AID-PD856>3.0.CO;2-5. [DOI] [PubMed] [Google Scholar]
  12. Christian S. L., Smith A. C., Macha M., Black S. H., Elder F. F., Johnson J. M., Resta R. G., Surti U., Suslak L., Verp M. S. Prenatal diagnosis of uniparental disomy 15 following trisomy 15 mosaicism. Prenat Diagn. 1996 Apr;16(4):323–332. doi: 10.1002/(SICI)1097-0223(199604)16:4<323::AID-PD856>3.0.CO;2-5. [DOI] [PubMed] [Google Scholar]
  13. Clayton-Smith J., Pembrey M. E. Angelman syndrome. J Med Genet. 1992 Jun;29(6):412–415. doi: 10.1136/jmg.29.6.412. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Delach J. A., Rosengren S. S., Kaplan L., Greenstein R. M., Cassidy S. B., Benn P. A. Comparison of high resolution chromosome banding and fluorescence in situ hybridization (FISH) for the laboratory evaluation of Prader-Willi syndrome and Angelman syndrome. Am J Med Genet. 1994 Aug 1;52(1):85–91. doi: 10.1002/ajmg.1320520117. [DOI] [PubMed] [Google Scholar]
  15. Dykens E. M., Cassidy S. B. Correlates of maladaptive behavior in children and adults with Prader-Willi syndrome. Am J Med Genet. 1995 Dec 18;60(6):546–549. doi: 10.1002/ajmg.1320600612. [DOI] [PubMed] [Google Scholar]
  16. Dykens E. M., Hodapp R. M., Walsh K., Nash L. J. Profiles, correlates, and trajectories of intelligence in Prader-Willi syndrome. J Am Acad Child Adolesc Psychiatry. 1992 Nov;31(6):1125–1130. doi: 10.1097/00004583-199211000-00022. [DOI] [PubMed] [Google Scholar]
  17. Gillessen-Kaesbach G., Gross S., Kaya-Westerloh S., Passarge E., Horsthemke B. DNA methylation based testing of 450 patients suspected of having Prader-Willi syndrome. J Med Genet. 1995 Feb;32(2):88–92. doi: 10.1136/jmg.32.2.88. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Gillessen-Kaesbach G., Robinson W., Lohmann D., Kaya-Westerloh S., Passarge E., Horsthemke B. Genotype-phenotype correlation in a series of 167 deletion and non-deletion patients with Prader-Willi syndrome. Hum Genet. 1995 Dec;96(6):638–643. doi: 10.1007/BF00210291. [DOI] [PubMed] [Google Scholar]
  19. Glenn C. C., Porter K. A., Jong M. T., Nicholls R. D., Driscoll D. J. Functional imprinting and epigenetic modification of the human SNRPN gene. Hum Mol Genet. 1993 Dec;2(12):2001–2005. doi: 10.1093/hmg/2.12.2001. [DOI] [PubMed] [Google Scholar]
  20. Glenn C. C., Saitoh S., Jong M. T., Filbrandt M. M., Surti U., Driscoll D. J., Nicholls R. D. Gene structure, DNA methylation, and imprinted expression of the human SNRPN gene. Am J Hum Genet. 1996 Feb;58(2):335–346. [PMC free article] [PubMed] [Google Scholar]
  21. Greenswag L. R. Adults with Prader-Willi syndrome: a survey of 232 cases. Dev Med Child Neurol. 1987 Apr;29(2):145–152. doi: 10.1111/j.1469-8749.1987.tb02129.x. [DOI] [PubMed] [Google Scholar]
  22. Gunay-Aygun M., Cassidy S. B., Nicholls R. D. Prader-Willi and other syndromes associated with obesity and mental retardation. Behav Genet. 1997 Jul;27(4):307–324. doi: 10.1023/a:1025683829856. [DOI] [PubMed] [Google Scholar]
  23. Gunay-Aygun M., Heeger S., Schwartz S., Cassidy S. B. Delayed diagnosis in patients with Prader-Willi syndrome due to maternal uniparental disomy 15. Am J Med Genet. 1997 Jul 11;71(1):106–110. [PubMed] [Google Scholar]
  24. Hertz G., Cataletto M., Feinsilver S. H., Angulo M. Developmental trends of sleep-disordered breathing in Prader-Willi syndrome: the role of obesity. Am J Med Genet. 1995 Mar 27;56(2):188–190. doi: 10.1002/ajmg.1320560215. [DOI] [PubMed] [Google Scholar]
  25. Holm V. A., Cassidy S. B., Butler M. G., Hanchett J. M., Greenswag L. R., Whitman B. Y., Greenberg F. Prader-Willi syndrome: consensus diagnostic criteria. Pediatrics. 1993 Feb;91(2):398–402. [PMC free article] [PubMed] [Google Scholar]
  26. Holm V. A., Pipes P. L. Food and children with Prader-Willi syndrome. Am J Dis Child. 1976 Oct;130(10):1063–1067. doi: 10.1001/archpedi.1976.02120110025003. [DOI] [PubMed] [Google Scholar]
  27. Kennerknecht I. Differentiated recurrence risk estimations in the Prader-Willi syndrome. Clin Genet. 1992 Jun;41(6):303–308. doi: 10.1111/j.1399-0004.1992.tb03403.x. [DOI] [PubMed] [Google Scholar]
  28. Kishino T., Lalande M., Wagstaff J. UBE3A/E6-AP mutations cause Angelman syndrome. Nat Genet. 1997 Jan;15(1):70–73. doi: 10.1038/ng0197-70. [DOI] [PubMed] [Google Scholar]
  29. Kubota T., Aradhya S., Macha M., Smith A. C., Surh L. C., Satish J., Verp M. S., Nee H. L., Johnson A., Christan S. L. Analysis of parent of origin specific DNA methylation at SNRPN and PW71 in tissues: implication for prenatal diagnosis. J Med Genet. 1996 Dec;33(12):1011–1014. doi: 10.1136/jmg.33.12.1011. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. Kubota T., Das S., Christian S. L., Baylin S. B., Herman J. G., Ledbetter D. H. Methylation-specific PCR simplifies imprinting analysis. Nat Genet. 1997 May;16(1):16–17. doi: 10.1038/ng0597-15. [DOI] [PubMed] [Google Scholar]
  31. Kubota T., Sutcliffe J. S., Aradhya S., Gillessen-Kaesbach G., Christian S. L., Horsthemke B., Beaudet A. L., Ledbetter D. H. Validation studies of SNRPN methylation as a diagnostic test for Prader-Willi syndrome. Am J Med Genet. 1996 Dec 2;66(1):77–80. doi: 10.1002/(SICI)1096-8628(19961202)66:1<77::AID-AJMG18>3.0.CO;2-N. [DOI] [PubMed] [Google Scholar]
  32. Ledbetter D. H., Engel E. Uniparental disomy in humans: development of an imprinting map and its implications for prenatal diagnosis. Hum Mol Genet. 1995;4(Spec No):1757–1764. doi: 10.1093/hmg/4.suppl_1.1757. [DOI] [PubMed] [Google Scholar]
  33. Ledbetter D. H., Riccardi V. M., Airhart S. D., Strobel R. J., Keenan B. S., Crawford J. D. Deletions of chromosome 15 as a cause of the Prader-Willi syndrome. N Engl J Med. 1981 Feb 5;304(6):325–329. doi: 10.1056/NEJM198102053040604. [DOI] [PubMed] [Google Scholar]
  34. Mascari M. J., Gottlieb W., Rogan P. K., Butler M. G., Waller D. A., Armour J. A., Jeffreys A. J., Ladda R. L., Nicholls R. D. The frequency of uniparental disomy in Prader-Willi syndrome. Implications for molecular diagnosis. N Engl J Med. 1992 Jun 11;326(24):1599–1607. doi: 10.1056/NEJM199206113262404. [DOI] [PMC free article] [PubMed] [Google Scholar]
  35. Matsuura T., Sutcliffe J. S., Fang P., Galjaard R. J., Jiang Y. H., Benton C. S., Rommens J. M., Beaudet A. L. De novo truncating mutations in E6-AP ubiquitin-protein ligase gene (UBE3A) in Angelman syndrome. Nat Genet. 1997 Jan;15(1):74–77. doi: 10.1038/ng0197-74. [DOI] [PubMed] [Google Scholar]
  36. Mitchell J., Schinzel A., Langlois S., Gillessen-Kaesbach G., Schuffenhauer S., Michaelis R., Abeliovich D., Lerer I., Christian S., Guitart M. Comparison of phenotype in uniparental disomy and deletion Prader-Willi syndrome: sex specific differences. Am J Med Genet. 1996 Oct 16;65(2):133–136. doi: 10.1002/(SICI)1096-8628(19961016)65:2<133::AID-AJMG10>3.0.CO;2-R. [DOI] [PubMed] [Google Scholar]
  37. Nicholls R. D. Genomic imprinting and uniparental disomy in Angelman and Prader-Willi syndromes: a review. Am J Med Genet. 1993 Apr 1;46(1):16–25. doi: 10.1002/ajmg.1320460106. [DOI] [PubMed] [Google Scholar]
  38. Nicholls R. D., Knoll J. H., Butler M. G., Karam S., Lalande M. Genetic imprinting suggested by maternal heterodisomy in nondeletion Prader-Willi syndrome. Nature. 1989 Nov 16;342(6247):281–285. doi: 10.1038/342281a0. [DOI] [PMC free article] [PubMed] [Google Scholar]
  39. Ozçelik T., Leff S., Robinson W., Donlon T., Lalande M., Sanjines E., Schinzel A., Francke U. Small nuclear ribonucleoprotein polypeptide N (SNRPN), an expressed gene in the Prader-Willi syndrome critical region. Nat Genet. 1992 Dec;2(4):265–269. doi: 10.1038/ng1292-265. [DOI] [PubMed] [Google Scholar]
  40. Purvis-Smith S. G., Saville T., Manass S., Yip M. Y., Lam-Po-Tang P. R., Duffy B., Johnston H., Leigh D., McDonald B. Uniparental disomy 15 resulting from "correction" of an initial trisomy 15. Am J Hum Genet. 1992 Jun;50(6):1348–1350. [PMC free article] [PubMed] [Google Scholar]
  41. Reis A., Dittrich B., Greger V., Buiting K., Lalande M., Gillessen-Kaesbach G., Anvret M., Horsthemke B. Imprinting mutations suggested by abnormal DNA methylation patterns in familial Angelman and Prader-Willi syndromes. Am J Hum Genet. 1994 May;54(5):741–747. [PMC free article] [PubMed] [Google Scholar]
  42. Robinson W. P., Bottani A., Xie Y. G., Balakrishman J., Binkert F., Mächler M., Prader A., Schinzel A. Molecular, cytogenetic, and clinical investigations of Prader-Willi syndrome patients. Am J Hum Genet. 1991 Dec;49(6):1219–1234. [PMC free article] [PubMed] [Google Scholar]
  43. Saitoh S., Buiting K., Cassidy S. B., Conroy J. M., Driscoll D. J., Gabriel J. M., Gillessen-Kaesbach G., Glenn C. C., Greenswag L. R., Horsthemke B. Clinical spectrum and molecular diagnosis of Angelman and Prader-Willi syndrome patients with an imprinting mutation. Am J Med Genet. 1997 Jan 20;68(2):195–206. [PubMed] [Google Scholar]
  44. Saitoh S., Buiting K., Rogan P. K., Buxton J. L., Driscoll D. J., Arnemann J., König R., Malcolm S., Horsthemke B., Nicholls R. D. Minimal definition of the imprinting center and fixation of chromosome 15q11-q13 epigenotype by imprinting mutations. Proc Natl Acad Sci U S A. 1996 Jul 23;93(15):7811–7815. doi: 10.1073/pnas.93.15.7811. [DOI] [PMC free article] [PubMed] [Google Scholar]
  45. Schoeller D. A., Levitsky L. L., Bandini L. G., Dietz W. W., Walczak A. Energy expenditure and body composition in Prader-Willi syndrome. Metabolism. 1988 Feb;37(2):115–120. doi: 10.1016/s0026-0495(98)90003-8. [DOI] [PubMed] [Google Scholar]
  46. Smith A., Prasad M., Deng Z. M., Robson L., Woodage T., Trent R. J. Comparison of high resolution cytogenetics, fluorescence in situ hybridisation, and DNA studies to validate the diagnosis of Prader-Willi and Angelman's syndromes. Arch Dis Child. 1995 May;72(5):397–402. doi: 10.1136/adc.72.5.397. [DOI] [PMC free article] [PubMed] [Google Scholar]
  47. Spritz R. A., Bailin T., Nicholls R. D., Lee S. T., Park S. K., Mascari M. J., Butler M. G. Hypopigmentation in the Prader-Willi syndrome correlates with P gene deletion but not with haplotype of the hemizygous P allele. Am J Med Genet. 1997 Jul 11;71(1):57–62. doi: 10.1002/(sici)1096-8628(19970711)71:1<57::aid-ajmg11>3.0.co;2-u. [DOI] [PMC free article] [PubMed] [Google Scholar]
  48. Sutcliffe J. S., Nakao M., Christian S., Orstavik K. H., Tommerup N., Ledbetter D. H., Beaudet A. L. Deletions of a differentially methylated CpG island at the SNRPN gene define a putative imprinting control region. Nat Genet. 1994 Sep;8(1):52–58. doi: 10.1038/ng0994-52. [DOI] [PubMed] [Google Scholar]
  49. Wevrick R., Francke U. Diagnostic test for the Prader-Willi syndrome by SNRPN expression in blood. Lancet. 1996 Oct 19;348(9034):1068–1069. doi: 10.1016/S0140-6736(96)04342-5. [DOI] [PubMed] [Google Scholar]
  50. Wiesner G. L., Bendel C. M., Olds D. P., White J. G., Arthur D. C., Ball D. W., King R. A. Hypopigmentation in the Prader-Willi syndrome. Am J Hum Genet. 1987 May;40(5):431–442. [PMC free article] [PubMed] [Google Scholar]
  51. Williams C. A., Angelman H., Clayton-Smith J., Driscoll D. J., Hendrickson J. E., Knoll J. H., Magenis R. E., Schinzel A., Wagstaff J., Whidden E. M. Angelman syndrome: consensus for diagnostic criteria. Angelman Syndrome Foundation. Am J Med Genet. 1995 Mar 27;56(2):237–238. doi: 10.1002/ajmg.1320560224. [DOI] [PubMed] [Google Scholar]
  52. Zipf W. B., Berntson G. G. Characteristics of abnormal food-intake patterns in children with Prader-Willi syndrome and study of effects of naloxone. Am J Clin Nutr. 1987 Aug;46(2):277–281. doi: 10.1093/ajcn/46.2.277. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Medical Genetics are provided here courtesy of BMJ Publishing Group

RESOURCES