Tay Sachs disease
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Clinical signs
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Tay Sachs disease is a metabolic disorder transmitted by autosomal recessive inheritance
that causes the destruction of the infant's nervous system. The infant appears completely
healthy at birth and develops normally until about six months of age. Then the first
signs of the disease appear, marked by rapid general deterioration. The infant loses
the developmental achievements acquired up to that time, stops crawling or turning,
and loses his sight and the ability to grab and hold things with his hands. Mental retardation develops a short time after
the onset of the disease. As the disease progresses, the infant also loses his ability
to eat and sometimes his ability to smile. Death usually occurs at about the age
of two years.
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Types
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There is only one type.
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Is the disease treatable?
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No. Today, an infant with Tay Sachs disease cannot be treated effectively. Therefore,
the only way of coping with the disease is by prevention. It is therefore important
to know how the disease is caused.
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Inheritance pattern
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Autosomal recessive |
Penetrance
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Full |
What is the risk of recurrence in a subsequent pregnancy?
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For a couple who has already had an affected child, the risk is 25% in every subsequent
pregnancy. This also applies to a couple where both partners have been found to
carry mutations for Tay Sachs disease. When only one parent carries the abnormal
gene, there is no risk that any of their offspring will have the disease; however,
in such families there is a 50% chance that the infant will be a carrier, but he
himself will be healthy, like the carrier parent.
The risk for more distant relatives depends on the number of affected individuals
in the family, the degree of relationship between the relatives and the affected
individuals, consanguinity
between the parents, if present, etc. This risk is established within genetic counseling.
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Associated features that can be demonstrated in tests performed during pregnancy
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There are no specific ultrasound signs and no associated defects. The chorionic
villus or amniotic fluid cells can be tested to measure the level of the enzyme
(hexosaminidase A) that is deficient in Tay Sachs disease - this enzyme test is
exact. It can be carried out in addition to the molecular test (described below).
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Molecular genetic information
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The gene for the disease
The gene responsible for producing hexosaminidase A.
Location
15q23.
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Genetic testing
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Diagnostic testing
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A direct test can be performed to identify the mutation in the gene by testing for
the common mutations. See: Testing the disease-causing
gene for mutations that are common in a specific ethnic group - autosomal recessive
diseases.
In addition, the level of the enzyme deficient in Tay Sachs disease patients can
be measured, thus unequivocally diagnosing patients.
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Carrier testing
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Is the risk of being a carrier greater among Ashkenazi Jews?
Yes. Tay Sachs disease carriers are usually Jews of Ashkenazi origin. Other communities
are at lower risk. The carrier frequency in the healthy Ashkenazi Jewish population
is 1:30 and in one out of 900 Ashkenazi couples, both partners are carriers.
Do couples who already have healthy children need to be tested?
Yes, if they have not been tested previously, and are planning further pregnancies.
If they have been tested previously, the test need not be repeated.
Is it necessary to book an appointment or pay for the test?
There is no need to book an appointment in advance. The test is free of charge or
financial undertaking.
What must a young couple do?
The first step is to carry out a test to determine whether the partners carry an
abnormal gene for Tay Sachs disease. For this, one of them must undergo a specific
blood test. If the woman is pregnant, the father is tested.
If the results of the blood test show beyond doubt that the subject does not carry
an abnormal gene for Tay Sachs disease, there is no risk that any of the couple's
children will be affected. However, if the test results are unclear, or the subject
is found to be a carrier, the couple is invited to come for a further test at the
same center where the first test was performed, and the partner is also tested.
If this shows that the partner is also a carrier, there is a 25% risk in every pregnancy
of having a child with Tay Sachs disease.
Couples where both partners are carriers are invited to come for genetic counseling
in which they will receive an explanation about the disease and can discuss what
options are available.
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Fetal testing
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As for diagnostic testing. |
Can the disease be detected in pregnancy?
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Yes, an affected fetus can be identified in the first trimester of pregnancy by
performing prenatal diagnosis (chorionic
villus sampling or
amniocentesis).
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What should be done if it is found that both partners are carriers and that there
is a risk that they may have a child with the disease?
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Prenatal diagnosis carried out in every pregnancy will allow carrier parents to
have only healthy children who do not have Tay Sachs disease. When prenatal diagnosis
indicates that the fetus is affected, the pregnancy can be terminated using medical
methods. In cases where both parents are carriers, therefore, it is very important
that the mother undergoes prenatal diagnosis in every pregnancy in order to identify
an affected fetus in the early stages of gestation, even if the couple already has
healthy children. |
Blood testing centers:
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Ask your physician for the local screening center.
Details are available at all family health clinics and regional health bureaus.
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