An inherited disorders that affect many tissues and systems in the body, characterized by the presence of multiple symptoms such as telangiectases, ataxic gait, proneness to infection, and defective humoral/ cellular immunity and increased risk of malignancies.
Causes, incidence, and risk factors
Ataxia-telangiectasia is transmitted as an autosomal recessive trait. The disease results from mutations in a gene called ATM. The most obvious symptoms of the disease are multiple telangiectases that are easily visible in the white of the eye and certain skin areas such as the ear and nose, graying of the hair, and irregular pigmentation of the skin in areas exposed to sunlight. In addition there is decreased coordination of movements, ataxia, in late childhood.
Signs and tests
mask-like face decreased to absent deep tendon reflexes multiple skin changes including pigmentary, eczematoid and atrophic growth failure absence of pubertal development hypoplastic tonsils, lymph nodes, and spleen Tests:
serum immunoglobulin levels (IgE, IgA ) - especially decreased IgA and IgE levels
decreased B and T cell screen
elevated alpha fetoprotein (AFP)
carcinoembryonic antigen ( CEA )
increased tendency of chromosomes to break on exposure to radiation genetic testing may be available for mutations in the ATM gene. X-rays may show underdeveloped, small thymus in childhood abnormal glucose tolerance test
Treatment
There is no specific treatment for ataxia-telangiectasia. Treatment is directed at specific associated problems.
Support groups
Ataxia Telangiectasia Children's Project; 800-543-5728
Expectations (prognosis)
An early death is expected, commonly in early adolescence.
Complications
severe recurrent pulmonary infections
progressive movement disorder with confinement to a wheelchair malignant disease, especially lymphoma , that can result in death
diabetes progressive scoliosis and kyphosis
Calling your health care provider
Call your health care provider if signs or symptoms of the disease are present.
Prevention
Because these patients are very sensitive to radiation they should never be exposed to radiation therapy and no unnecessary X-rays should be done. Genetic counseling is of benefit to prospective parents with a family history of ataxia-telangiectasia. Even parents of a child with this disorder may have a slight increased risk of cancer. They should have genetic counseling and more intensive screening for cancer.