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EAST syndrome(SESAMES)

MedGen UID:
411243
Concept ID:
C2748572
Disease or Syndrome
Synonyms: Epilepsy, ataxia, sensorineural deafness and tubulopathy; SEIZURES, SENSORINEURAL DEAFNESS, ATAXIA, IMPAIRED INTELLECTUAL DEVELOPMENT, AND ELECTROLYTE IMBALANCE; Seizures, sensorineural deafness, ataxia, mental retardation and electrolyte imbalance; Seizures, Sensorineural Deafness, Ataxia, Mental Retardation, and Electrolyte Imbalance Syndrome; SeSAME syndrome; SESAMES
SNOMED CT: Seizure, sensorineural deafness, ataxia, intellectual disability, electrolyte imbalance syndrome (721207002); SESAME syndrome (721207002); SESAME (seizures, sensorineural deafness, ataxia, mental retardation, electrolyte imbalance) syndrome (721207002); EAST (epilepsy, ataxia, sensorineural deafness, and tubulopathy) syndrome (721207002)
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).
 
Gene (location): KCNJ10 (1q23.2)
 
Monarch Initiative: MONDO:0013005
OMIM®: 612780
Orphanet: ORPHA199343

Definition

Syndrome with characteristics of seizures, sensorineural deafness, ataxia, intellectual deficit, and electrolyte imbalance. It has been described in five patients from four families. The disease is caused by homozygous or compound heterozygous mutations in the KCNJ10 gene, encoding a potassium channel expressed in the brain, spinal cord, inner ear and kidneys. Transmission is autosomal recessive. [from SNOMEDCT_US]

Clinical features

From HPO
Enuresis
MedGen UID:
8649
Concept ID:
C0014394
Disease or Syndrome
Lack of the ability to control the urinary bladder leading to involuntary urination at an age where control of the bladder should already be possible.
Hypocalciuria
MedGen UID:
9381
Concept ID:
C0020599
Disease or Syndrome
An abnormally decreased calcium concentration in the urine.
Polyuria
MedGen UID:
19404
Concept ID:
C0032617
Sign or Symptom
An increased rate of urine production.
Renal salt wasting
MedGen UID:
375868
Concept ID:
C1846347
Finding
A high concentration of one or more electrolytes in the urine in the presence of low serum concentrations of the electrolyte(s).
Renal potassium wasting
MedGen UID:
339499
Concept ID:
C1846348
Finding
High urine potassium in the presence of hypokalemia.
Renal sodium wasting
MedGen UID:
440580
Concept ID:
C2748576
Finding
An abnormally increased sodium concentration in the urine in the presence of hyponatremia.
Hypertensive disorder
MedGen UID:
6969
Concept ID:
C0020538
Disease or Syndrome
The presence of chronic increased pressure in the systemic arterial system.
Short stature
MedGen UID:
87607
Concept ID:
C0349588
Finding
A height below that which is expected according to age and gender norms. Although there is no universally accepted definition of short stature, many refer to "short stature" as height more than 2 standard deviations below the mean for age and gender (or below the 3rd percentile for age and gender dependent norms).
Sensorineural hearing loss disorder
MedGen UID:
9164
Concept ID:
C0018784
Disease or Syndrome
A type of hearing impairment in one or both ears related to an abnormal functionality of the cochlear nerve.
Cerebellar ataxia
MedGen UID:
849
Concept ID:
C0007758
Disease or Syndrome
Cerebellar ataxia refers to ataxia due to dysfunction of the cerebellum. This causes a variety of elementary neurological deficits including asynergy (lack of coordination between muscles, limbs and joints), dysmetria (lack of ability to judge distances that can lead to under- or overshoot in grasping movements), and dysdiadochokinesia (inability to perform rapid movements requiring antagonizing muscle groups to be switched on and off repeatedly).
Seizure
MedGen UID:
20693
Concept ID:
C0036572
Sign or Symptom
A seizure is an intermittent abnormality of nervous system physiology characterized by a transient occurrence of signs and/or symptoms due to abnormal excessive or synchronous neuronal activity in the brain.
Polydipsia
MedGen UID:
43214
Concept ID:
C0085602
Sign or Symptom
Excessive thirst manifested by excessive fluid intake.
Dysdiadochokinesis
MedGen UID:
115975
Concept ID:
C0234979
Sign or Symptom
A type of ataxia characterized by the impairment of the ability to perform rapidly alternating movements, such as pronating and supinating his or her hand on the dorsum of the other hand as rapidly as possible.
Salt craving
MedGen UID:
116112
Concept ID:
C0240928
Finding
Hypersalivation, also known as salt craving, refers to an excessive desire to consume salt (sodium chloride) or salty foods.
Delayed speech and language development
MedGen UID:
105318
Concept ID:
C0454644
Finding
A degree of language development that is significantly below the norm for a child of a specified age.
Global developmental delay
MedGen UID:
107838
Concept ID:
C0557874
Finding
A delay in the achievement of motor or mental milestones in the domains of development of a child, including motor skills, speech and language, cognitive skills, and social and emotional skills. This term should only be used to describe children younger than five years of age.
Cerebellar atrophy
MedGen UID:
196624
Concept ID:
C0740279
Disease or Syndrome
Cerebellar atrophy is defined as a cerebellum with initially normal structures, in a posterior fossa with normal size, which displays enlarged fissures (interfolial spaces) in comparison to the foliae secondary to loss of tissue. Cerebellar atrophy implies irreversible loss of tissue and result from an ongoing progressive disease until a final stage is reached or a single injury, e.g. an intoxication or infectious event.
Intellectual disability
MedGen UID:
811461
Concept ID:
C3714756
Mental or Behavioral Dysfunction
Intellectual disability, previously referred to as mental retardation, is characterized by subnormal intellectual functioning that occurs during the developmental period. It is defined by an IQ score below 70.
Chronic axonal neuropathy
MedGen UID:
867220
Concept ID:
C4021578
Disease or Syndrome
An abnormality characterized by chronic impairment of the normal functioning of the axons.
Peripheral hypomyelination
MedGen UID:
870480
Concept ID:
C4024927
Finding
Reduced amount of myelin in the nervous system resulting from defective myelinogenesis in the peripheral nervous system.
Intention tremor
MedGen UID:
1642960
Concept ID:
C4551520
Sign or Symptom
A type of kinetic tremor that occurs during target directed movement is called intention tremor. That is, an oscillatory cerebellar ataxia that tends to be absent when the limbs are inactive and during the first part of voluntary movement but worsening as the movement continues and greater precision is required (e.g., in touching a target such as the patient's nose or a physician's finger).
Hypotonia
MedGen UID:
10133
Concept ID:
C0026827
Finding
Hypotonia is an abnormally low muscle tone (the amount of tension or resistance to movement in a muscle). Even when relaxed, muscles have a continuous and passive partial contraction which provides some resistance to passive stretching. Hypotonia thus manifests as diminished resistance to passive stretching. Hypotonia is not the same as muscle weakness, although the two conditions can co-exist.
Generalized hypotonia
MedGen UID:
346841
Concept ID:
C1858120
Finding
Generalized muscular hypotonia (abnormally low muscle tone).
Hypokalemia
MedGen UID:
5712
Concept ID:
C0020621
Finding
An abnormally decreased potassium concentration in the blood.
Hypomagnesemia
MedGen UID:
57481
Concept ID:
C0151723
Disease or Syndrome
An abnormally decreased magnesium concentration in the blood.
Hypokalemic metabolic alkalosis
MedGen UID:
152852
Concept ID:
C0740898
Disease or Syndrome
Elevated serum bicarbonate concentration
MedGen UID:
1671049
Concept ID:
C4732834
Finding
An abnormal increase in the concentration of bicarbonate, HCO3[-], in the circulation.
Hyperaldosteronism
MedGen UID:
6960
Concept ID:
C0020428
Disease or Syndrome
Overproduction of the mineralocorticoid aldosterone by the adrenal cortex.
Increased circulating renin level
MedGen UID:
66818
Concept ID:
C0240783
Finding
An increased level of renin in the blood.

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVEAST syndrome
Follow this link to review classifications for EAST syndrome in Orphanet.

Professional guidelines

PubMed

Guo W, Ji P, Xie Y
J Nephrol 2023 Mar;36(2):575-591. Epub 2022 Aug 22 doi: 10.1007/s40620-022-01428-4. PMID: 35994232

Recent clinical studies

Etiology

Mir A, Chaudhary M, Alkhaldi H, Alhazmi R, Albaradie R, Housawi Y
Brain Dev 2019 Sep;41(8):706-715. Epub 2019 Apr 2 doi: 10.1016/j.braindev.2019.03.009. PMID: 30952461
Cross JH, Arora R, Heckemann RA, Gunny R, Chong K, Carr L, Baldeweg T, Differ AM, Lench N, Varadkar S, Sirimanna T, Wassmer E, Hulton SA, Ognjanovic M, Ramesh V, Feather S, Kleta R, Hammers A, Bockenhauer D
Dev Med Child Neurol 2013 Sep;55(9):846-56. doi: 10.1111/dmcn.12171. PMID: 23924083Free PMC Article

Diagnosis

Vanhaesebrouck A, Van Poucke M, Stee K, Granger N, Ives E, Van Soens I, Cornelis I, Bossens K, Peelman L, Van Ham L, Bhatti SFM
J Vet Intern Med 2023 Nov-Dec;37(6):2310-2314. Epub 2023 Oct 31 doi: 10.1111/jvim.16892. PMID: 37905444Free PMC Article
Guo W, Ji P, Xie Y
J Nephrol 2023 Mar;36(2):575-591. Epub 2022 Aug 22 doi: 10.1007/s40620-022-01428-4. PMID: 35994232
Bockenhauer D, Kleta R
Pediatr Nephrol 2021 Aug;36(8):2553-2561. Epub 2021 Jun 18 doi: 10.1007/s00467-021-05098-5. PMID: 34143300Free PMC Article
Celmina M, Micule I, Inashkina I, Audere M, Kuske S, Pereca J, Stavusis J, Pelnena D, Strautmanis J
Clin Genet 2019 Jan;95(1):63-78. Epub 2018 Jul 8 doi: 10.1111/cge.13374. PMID: 29722015
McCormick JA, Ellison DH
Compr Physiol 2015 Jan;5(1):45-98. doi: 10.1002/cphy.c140002. PMID: 25589264Free PMC Article

Therapy

Pillaiyar T, Laufer S
J Med Chem 2022 Jan 27;65(2):955-982. Epub 2021 Jun 3 doi: 10.1021/acs.jmedchem.1c00335. PMID: 34081439
Mir A, Chaudhary M, Alkhaldi H, Alhazmi R, Albaradie R, Housawi Y
Brain Dev 2019 Sep;41(8):706-715. Epub 2019 Apr 2 doi: 10.1016/j.braindev.2019.03.009. PMID: 30952461

Prognosis

Mir A, Chaudhary M, Alkhaldi H, Alhazmi R, Albaradie R, Housawi Y
Brain Dev 2019 Sep;41(8):706-715. Epub 2019 Apr 2 doi: 10.1016/j.braindev.2019.03.009. PMID: 30952461
Celmina M, Micule I, Inashkina I, Audere M, Kuske S, Pereca J, Stavusis J, Pelnena D, Strautmanis J
Clin Genet 2019 Jan;95(1):63-78. Epub 2018 Jul 8 doi: 10.1111/cge.13374. PMID: 29722015
Kandeel M, Elaiziz MA, Kandeel A, Altaher AA, Kitade Y
Acta Virol 2014;58(4):359-63. doi: 10.4149/av_2014_04_359. PMID: 25518718
Cross JH, Arora R, Heckemann RA, Gunny R, Chong K, Carr L, Baldeweg T, Differ AM, Lench N, Varadkar S, Sirimanna T, Wassmer E, Hulton SA, Ognjanovic M, Ramesh V, Feather S, Kleta R, Hammers A, Bockenhauer D
Dev Med Child Neurol 2013 Sep;55(9):846-56. doi: 10.1111/dmcn.12171. PMID: 23924083Free PMC Article
Scholl UI, Dave HB, Lu M, Farhi A, Nelson-Williams C, Listman JA, Lifton RP
Pediatr Nephrol 2012 Nov;27(11):2081-2090. Epub 2012 Aug 21 doi: 10.1007/s00467-012-2219-4. PMID: 22907601

Clinical prediction guides

Scholl UI, Dave HB, Lu M, Farhi A, Nelson-Williams C, Listman JA, Lifton RP
Pediatr Nephrol 2012 Nov;27(11):2081-2090. Epub 2012 Aug 21 doi: 10.1007/s00467-012-2219-4. PMID: 22907601
Paulais M, Bloch-Faure M, Picard N, Jacques T, Ramakrishnan SK, Keck M, Sohet F, Eladari D, Houillier P, Lourdel S, Teulon J, Tucker SJ
Proc Natl Acad Sci U S A 2011 Jun 21;108(25):10361-6. Epub 2011 Jun 1 doi: 10.1073/pnas.1101400108. PMID: 21633011Free PMC Article
Williams DM, Lopes CM, Rosenhouse-Dantsker A, Connelly HL, Matavel A, O-Uchi J, McBeath E, Gray DA
J Am Soc Nephrol 2010 Dec;21(12):2117-29. Epub 2010 Nov 18 doi: 10.1681/ASN.2009121227. PMID: 21088294Free PMC Article
Reichold M, Zdebik AA, Lieberer E, Rapedius M, Schmidt K, Bandulik S, Sterner C, Tegtmeier I, Penton D, Baukrowitz T, Hulton SA, Witzgall R, Ben-Zeev B, Howie AJ, Kleta R, Bockenhauer D, Warth R
Proc Natl Acad Sci U S A 2010 Aug 10;107(32):14490-5. Epub 2010 Jul 22 doi: 10.1073/pnas.1003072107. PMID: 20651251Free PMC Article
Bockenhauer D, Feather S, Stanescu HC, Bandulik S, Zdebik AA, Reichold M, Tobin J, Lieberer E, Sterner C, Landoure G, Arora R, Sirimanna T, Thompson D, Cross JH, van't Hoff W, Al Masri O, Tullus K, Yeung S, Anikster Y, Klootwijk E, Hubank M, Dillon MJ, Heitzmann D, Arcos-Burgos M, Knepper MA, Dobbie A, Gahl WA, Warth R, Sheridan E, Kleta R
N Engl J Med 2009 May 7;360(19):1960-70. doi: 10.1056/NEJMoa0810276. PMID: 19420365Free PMC Article

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