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Causes
By Mayo Clinic staffHunter syndrome occurs when an enzyme that's needed to break down complex sugars called glycosaminoglycans is missing or malfunctioning.
In unaffected people, these enzymes are found in parts of the body's cells known as lysosomes. The lysosomes use enzymes to break down glycosaminoglycans, as part of the body's normal recycling and renewal process. In a person with Hunter syndrome or another form of MPS, these enzymes either are missing or don't work correctly.
Normally, the nutrients that are broken down by lysosomes help your body build bone, cartilage, tendons, corneas, skin and connective tissue, and the fluid that lubricates your joints.
When this enzyme isn't working properly, undigested glycosaminoglycans collect in the cells, blood and connective tissues, causing permanent and progressive damage. Hunter syndrome and other forms of MPS are sometimes called lysosomal storage disorders.
In the case of Hunter syndrome, the missing or malfunctioning enzyme is called iduronate-2-sulfatase.
Hunter syndrome develops when a defective chromosome is inherited from the child's mother.
- Martin R, et al. Recognition and diagnosis of mucopolysaccharidosis II (Hunter syndrome). Pediatrics. 2008;121:e377.
- MPS II (Hunter syndrome). National MPS Society. http://www.mpssociety.org/index.php?option=com_content&view=article&id=129&Itemid=18. Accessed May 6, 2010.
- Mucopolysaccharidoses fact sheet. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/mucopolysaccharidoses/detail_mucopolysaccharidoses.htm. Accessed May 8, 2010.
- Kakkis E, et al. Clinical features and diagnosis of the mucopolysaccharidoses. http://www.uptodate.com/home/index.html. Accessed May 5, 2010.
- Kakkis E, et al. Complications and management of the mucopolysaccharidoses. http://www.uptodate.com/home/index.html. Accessed May 5, 2010.
- Muenzer J, et al. Multidisciplinary management of Hunter syndrome. Pediatrics. 2009;124:e1228.
- Newborn screening. Centers for Disease Control and Prevention. http://www.cdc.gov/nbslabbulletin/bulletin.html. Accessed May 6, 2010.
- Guffon N, et al. Bone marrow transplantation in children with Hunter syndrome: Outcome after 7 to 17 years. Journal of Pediatrics. 2009;154:733.
- Elaprase (prescribing information). Cambridge, Mass.: Shire Human Genetic Therapies; 2007. http://www.elaprase.com/pdf/ElaprasePI40-0120_REV_0_GT4.pdf. Accessed May 5, 2010.
- Safety and clinical outcomes in Hunter syndrome patients 5 years of age and younger receiving idursulfase therapy. ClinicalTrials.gov. http://clinicaltrials.gov/ct2/show/NCT00607386. Accessed May 6, 2010.
- Burrow TA, et al. Review of the use of idursulfase in the treatment of mucopolysaccharidosis II. Biologics: Targets & Therapy. 2008;2:311.
- Friso A, et al. Genistein reduces glycosaminoglycan levels in a mouse model of mucopolysaccharidosis type II. British Journal of Pharmacology. 2010;159:1082.
- Piotrowska E, et al. Genistein-mediated inhibition of glycosaminoglycan synthesis as a basis for gene expression-targeted isoflavone therapy for mucopolysaccharidoses. European Journal of Human Genetics. 2006;14:846.
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