Prader-Willi syndrome

General Information (adopted from Orphanet):

Synonyms, Signs: PRADER-WILLI-LIKE SYNDROME ASSOCIATED WITH CHROMOSOME 6, INCLUDED
PRADER-LABHART-WILLI SYNDROME PRADER-WILLI SYNDROME CHROMOSOME REGION, INCLUDED
PWCR, INCLUDED
PWS
Prader-Labhart-Willi syndrome
Willi-Prader syndrome
Number of Symptoms 123
OrphanetNr: 739
OMIM Id: 176270
ICD-10: Q87.1
UMLs: C0032897
MeSH: D011218
MedDRA: 10036476
Snomed: 89392001

Prevalence, inheritance and age of onset:

Prevalence: 2.8 of 100 000 [Orphanet]
Inheritance: Not applicable
[Orphanet]
Age of onset: Antenatal
Neonatal
[Orphanet]

Disease classification (adopted from Orphanet):

Parent Diseases: Genetic multiple congenital anomalies/dysmorphic syndrome - variable intellectual deficit
 -Rare genetic disease
Multiple congenital anomalies/dysmorphic syndrome - variable intellectual deficit
 -Rare developmental defect during embryogenesis
Rare neurologic disease with psychiatric involvement
 -Rare neurologic disease
Syndrome with hypogonadotropic hypogonadism
 -Rare endocrine disease
 -Rare genetic disease
 -Rare gynecologic or obstetric disease
Syndromic obesity
 -Rare developmental defect during embryogenesis
 -Rare endocrine disease
 -Rare genetic disease

Symptom Information: Sort by abundance 

1
(HPO:0000064) Hypoplastic labia minora typical [HPO] 7 / 7739
2
(HPO:0000786) Primary amenorrhea 56% [HPO] 61 / 7739
3
(HPO:0000054) Micropenis Frequent [Orphanet] typical [HPO] 257 / 7739
4
(HPO:0000044) Hypogonadotrophic hypogonadism hallmark [HPO] 56 / 7739
5
(HPO:0000028) Cryptorchidism 85% [HPO] 347 / 7739
6
(HPO:0000876) Oligomenorrhea frequent [HPO] 13 / 7739
7
(HPO:0000789) Infertility hallmark [HPO] 74 / 7739
8
(HPO:0000046) Scrotal hypoplasia 69% [HPO] 54 / 7739
9
(HPO:0000060) Clitoral hypoplasia typical [HPO] 9 / 7739
10
(HPO:0100820) Glomerulopathy Frequent [Orphanet] 46 / 7739
11
(HPO:0000141) Amenorrhea 16 / 7739
12
(HPO:0000035) Abnormality of the testis Frequent [Orphanet] 296 / 7739
13
(HPO:0000670) Carious teeth occasional [HPO] 145 / 7739
14
(HPO:0000506) Telecanthus Frequent [Orphanet] 156 / 7739
15
(HPO:0000341) Narrow forehead typical [HPO] 96 / 7739
16
(HPO:0000219) Thin upper lip vermilion typical [HPO] 112 / 7739
17
(HPO:0000252) Microcephaly Frequent [Orphanet] 832 / 7739
18
(HPO:0000494) Downslanted palpebral fissures Frequent [Orphanet] 328 / 7739
19
(HPO:0002714) Downturned corners of mouth Frequent [Orphanet] typical [HPO] 98 / 7739
20
(HPO:0000268) Dolichocephaly 144 / 7739
21
(HPO:0002705) High, narrow palate Frequent [Orphanet] 308 / 7739
22
(HPO:0007874) Almond-shaped palpebral fissure typical [HPO] 4 / 7739
23
(HPO:0009553) Abnormality of the hairline Frequent [Orphanet] 30 / 7739
24
(HPO:0000682) Abnormality of dental enamel Frequent [Orphanet] 102 / 7739
25
(HPO:0000446) Narrow nasal bridge typical [HPO] 29 / 7739
26
(HPO:0000582) Upslanted palpebral fissure occasional [HPO] 185 / 7739
27
(HPO:0000486) Strabismus Frequent [Orphanet] 576 / 7739
28
(HPO:0000545) Myopia occasional [HPO] 286 / 7739
29
(HPO:0000565) Esotropia occasional [HPO] 58 / 7739
30
(HPO:0007730) Iris hypopigmentation 33% [HPO] 4 / 7739
31
(HPO:0000540) Hypermetropia 99 / 7739
32
(HPO:0100720) Hypoplasia of the ear cartilage Frequent [Orphanet] 12 / 7739
33
(HPO:0002066) Gait ataxia Frequent [Orphanet] 327 / 7739
34
(HPO:0001263) Global developmental delay hallmark [HPO] 853 / 7739
35
(HPO:0007010) Poor fine motor coordination occasional [HPO] 4 / 7739
36
(HPO:0007328) Impaired pain sensation frequent [HPO] 10 / 7739
37
(HPO:0001270) Motor delay hallmark [HPO] 322 / 7739
38
(HPO:0000709) Psychosis 15% [HPO] 61 / 7739
39
(HPO:0007018) Attention deficit hyperactivity disorder common [HPO] 56 / 7739
40
(HPO:0002360) Sleep disturbance 113 / 7739
41
(HPO:0010535) Sleep apnea typical [HPO] 24 / 7739
42
(HPO:0002591) Polyphagia hallmark [HPO] 25 / 7739
43
(HPO:0000750) Delayed speech and language development hallmark [HPO] 197 / 7739
44
(HPO:0007015) Poor gross motor coordination 2 / 7739
45
(HPO:0001328) Specific learning disability hallmark [HPO] 114 / 7739
46
(HPO:0001250) Seizures Frequent [Orphanet] 15% [HPO] 1245 / 7739
47
(HPO:0000717) Autism 19% [HPO] 108 / 7739
48
(HPO:0000708) Behavioral abnormality Frequent [Orphanet] 212 / 7739
49
(HPO:0100651) Type I diabetes mellitus Frequent [Orphanet] 44 / 7739
50
(HPO:0005978) Type II diabetes mellitus 25% [HPO] 68 / 7739
51
(HPO:0000824) Growth hormone deficiency hallmark [HPO] 56 / 7739
52
(HPO:0000826) Precocious puberty 4% [HPO] 42 / 7739
53
(HPO:0000846) Adrenal insufficiency 60% [HPO] 24 / 7739
54
(HPO:0000823) Delayed puberty typical [HPO] 65 / 7739
55
(HPO:0000842) Hyperinsulinemia 39 / 7739
56
(HPO:0008373) Puberty and gonadal disorders Frequent [Orphanet] 156 / 7739
57
(HPO:0002650) Scoliosis Frequent [Orphanet] typical [HPO] 705 / 7739
58
(HPO:0004209) Clinodactyly of the 5th finger Frequent [Orphanet] 288 / 7739
59
(HPO:0001385) Hip dysplasia 10% [HPO] 242 / 7739
60
(HPO:0001159) Syndactyly occasional [HPO] 140 / 7739
61
(HPO:0002808) Kyphosis typical [HPO] 289 / 7739
62
(HPO:0001786) Narrow foot 11 / 7739
63
(HPO:0000938) Osteopenia occasional [HPO] 138 / 7739
64
(HPO:0000954) Single transverse palmar crease Frequent [Orphanet] 162 / 7739
65
(HPO:0002750) Delayed skeletal maturation Frequent [Orphanet] 250 / 7739
66
(HPO:0004283) Narrow palm hallmark [HPO] 8 / 7739
67
(HPO:0001773) Short foot hallmark [HPO] 86 / 7739
68
(HPO:0009466) Radial deviation of finger occasional [HPO] 101 / 7739
69
(HPO:0004279) Short palm Frequent [Orphanet] hallmark [HPO] 323 / 7739
70
(HPO:0000939) Osteoporosis occasional [HPO] 129 / 7739
71
(HPO:0200055) Small hand 71 / 7739
72
(HPO:0001558) Decreased fetal movement 74 / 7739
73
(HPO:0002033) Poor suck hallmark [HPO] 37 / 7739
74
(HPO:0004322) Short stature Frequent [Orphanet] hallmark [HPO] 1232 / 7739
75
(HPO:0001511) Intrauterine growth retardation Frequent [Orphanet] 358 / 7739
76
(HPO:0001956) Truncal obesity 39 / 7739
77
(HPO:0001531) Failure to thrive in infancy hallmark [HPO] 26 / 7739
78
(HPO:0001513) Obesity Frequent [Orphanet] hallmark [HPO] 172 / 7739
79
(HPO:0002236) Frontal upsweep of hair occasional [HPO] 8 / 7739
80
(HPO:0001010) Hypopigmentation of the skin 33% [HPO] 46 / 7739
81
(HPO:0007513) Generalized hypopigmentation 12 / 7739
82
(HPO:0000992) Cutaneous photosensitivity typical [HPO] 75 / 7739
83
(HPO:0005599) Hypopigmentation of hair 33% [HPO] 38 / 7739
84
(HPO:0003220) Abnormality of chromosome stability Frequent [Orphanet] 98 / 7739
85
(HPO:0005968) Temperature instability occasional [HPO] 5 / 7739
86
(HPO:0001611) Nasal speech typical [HPO] 48 / 7739
87
(HPO:0002791) Hypoventilation 10 / 7739
88
(HPO:0002205) Recurrent respiratory infections typical [HPO] 254 / 7739
89
(HPO:0001290) Generalized hypotonia hallmark [HPO:probinson] 51 / 7739
90
(HPO:0001252) Muscular hypotonia Frequent [Orphanet] 990 / 7739
91
(HPO:0003199) Decreased muscle mass typical [HPO] 27 / 7739
92
(HPO:0012758) Neurodevelopmental delay Frequent [Orphanet] 949 / 7739
93
(OMIM) Birth length normal 15 / 7739
94
(OMIM) Down-turned corners of mouth 1 / 7739
95
(OMIM) Mean adult female height, 147 cm 1 / 7739
96
(OMIM) Almond-shaped eyes 12 / 7739
97
(HPO:0030084) Clinodactyly 90 / 7739
98
(OMIM) Weak or squeaky cry in infancy 1 / 7739
99
(MedDRA:10058668) Clinodactyly 91 / 7739
100
(OMIM) Thick, viscous saliva 1 / 7739
101
(OMIM) Decreased vomiting 1 / 7739
102
(HPO:0003745) Sporadic 131 / 7739
103
(OMIM) Poor neonatal suck and swallow reflexes 1 / 7739
104
(HPO:0001428) Somatic mutation Frequent [Orphanet] 100 / 7739
105
(OMIM) High pain threshold 1 / 7739
106
(OMIM) Feeding problems in infancy requiring gavage feeds 1 / 7739
107
(OMIM) Steady childhood growth 1 / 7739
108
(OMIM) Fall-off in adolescent growth 1 / 7739
109
(OMIM) Small-appearing mouth 1 / 7739
110
(OMIM) Narrow hands with straight ulnar border 1 / 7739
111
(OMIM) Length deceleration in first few months 1 / 7739
112
(OMIM) Frontal hair upsweep 2 / 7739
113
(OMIM) Mental retardation, mild to moderate 33 / 7739
114
(MedDRA:10021143) [DEL] Hypoxia 5 / 7739
115
(OMIM) Blonde to light brown hair 1 / 7739
116
(OMIM) Childhood polyphagia 1 / 7739
117
(OMIM) Severe neonatal hypotonia improving with age 1 / 7739
118
(HPO:0002119) Ventriculomegaly frequent [HPO] 253 / 7739
119
(HPO:0012743) Abdominal obesity 6 / 7739
120
(OMIM) Mean adult male height, 155 cm 1 / 7739
121
(OMIM) Speech articulation problems 1 / 7739
122
(OMIM) Normal neuromuscular studies 1 / 7739
123
(OMIM) Onset of obesity from 6 months to 6 years 1 / 7739

Associated genes:

ClinVar (via SNiPA)

Gene symbol Variation Clinical significance Reference

Additional Information:

Description: (OMIM) Prader-Willi syndrome is characterized by diminished fetal activity, obesity, muscular hypotonia, mental retardation, short stature, hypogonadotropic hypogonadism, and small hands and feet. It can be considered to be an autosomal dominant disorder and is caused by deletion or ...
Diagnosis OMIM Seven clinicians experienced with PWS, in consultation with national and international experts, proposed 2 scoring systems as diagnostic criteria: one for children aged 0-36 months and another for children aged 3 years to adults (Holm et al., 1993). ...
Clinical Description OMIM The original paper by Prader et al. (1956) described the full clinical picture.

- Prenatal

Mothers with prior experience of normal pregnancies almost without exception report distinctly delayed onset and reduced fetal activity during ...

Molecular genetics OMIM Latt et al. (1987) isolated probes from the proximal region of the long arm of chromosome 15 that are useful in the study of PWS.

Buiting et al. (1992) isolated a putative gene family and candidate ...

Population genetics OMIM In a review, Butler (1990) estimated the frequency of PWS at about 1 in 25,000 and suggested that it is the most common syndromal cause of human obesity. In a comprehensive survey of PWS in North Dakota, Burd ...
Diagnosis GeneReviews Consensus diagnostic criteria for Prader-Willi syndrome (PWS) developed in 1993 [Holm et al 1993] have proven to be accurate [Gunay-Aygun et al 2001] and continue to be useful for the clinician. However, confirmation of the diagnosis requires molecular genetic testing, which was not widely available when the criteria were developed. ...
Clinical Description GeneReviews Fetal size is generally normal. Prenatal hypotonia usually results in decreased fetal movement, abnormal fetal position at delivery, and increased incidence of assisted delivery or cesarean section....
Genotype-Phenotype Correlations GeneReviews No phenotypic feature is known to correlate exclusively with any one of the molecular classes of mutation that result in PWS. However, there are some statistical differences in the frequency or severity of some features between the two largest molecular classes (deletion and UPD). ...
Differential Diagnosis GeneReviews Many disorders can mimic parts of the PWS phenotype....
Management GeneReviews Management of the manifestations of PWS is age-dependent and should include both addressing the consequences of the syndrome and anticipatory guidance. It is recommended that a team approach be used, if possible. Several approaches to management have been published recently [McCandless 2011, Cassidy & McCandless 2010, Eiholzer & Whitman 2004, Butler et al 2006, Goldstone et al 2008, Cassidy & Driscoll 2009, Cassidy et al 2012]....
Molecular genetics GeneReviews Information in the Molecular Genetics and OMIM tables may differ from that elsewhere in the GeneReview: tables may contain more recent information. —ED....