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2016 ; 2
(4
): 270-275
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Anterior Chamber Pathology in Alagille Syndrome
#MMPMID27843908
Ho DK
; Levin AV
; Anninger WV
; Piccoli DA
; Eagle RC Jr
Ocul Oncol Pathol
2016[Oct]; 2
(4
): 270-275
PMID27843908
show ga
BACKGROUND: Alagille syndrome is an autosomal dominant disorder characterized by
neonatal cholestasis, characteristic facies, and cardiac abnormalities. Ocular
abnormalities include posterior embryotoxon, mosaic pattern of iris stromal
hypoplasia, microcornea, optic disc drusen, and pigmentary retinopathy. We
present the second report of ocular pathology in two cases of Alagille syndrome.
METHODS: Gross and histologic preparations of four eyes of two patients. RESULTS:
Posterior embryotoxon is seen in both cases, with iris processes extending to the
embryotoxon in case 1. Case 1 exhibited distinctly abnormal iris stroma with a
prominent cleft separating the anterior and posterior stroma. Lacy vacuolization
of the iris pigment epithelium was seen in case 2. CONCLUSIONS: Alagille syndrome
is primarily a hepatic disorder but presents with several distinct ocular
pathologic features, most specifically posterior embryotoxon. This and the
unusual iris stroma may be caused by improper migration of neural crest cells due
to mutation in the Jagged 1 gene that causes Alagille syndrome. Patients with
Alagille syndrome rarely present to ocular autopsy. Pathology findings may help
us better understand the pathophysiology of the ocular abnormalities in this
disorder.