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Symptoms
By Mayo Clinic staffHunter syndrome is one type of a group of inherited metabolic disorders called mucopolysaccharidosis (MPS), and Hunter syndrome is referred to as MPS II. Hunter syndrome symptoms vary from person to person. Some people have mild symptoms, while others have severe problems. Symptoms aren't present at birth. If symptoms begin early — around ages 2 to 4 — the syndrome is usually more severe.
Signs and symptoms may include:
- Delayed development, such as late walking or talking
- Changing facial features, including thickening of the lips, tongue and nostrils
- A broad nose and flared nostrils
- Claw-like hands
- A protruding tongue
- Abnormal bone size or shape and other skeletal irregularities
- Enlarged internal organs, such as the liver and spleen, resulting in a distended abdomen
- Respiratory difficulties including sleep apnea, a condition in which breathing intermittently stops during sleep
- Cardiovascular disorders, such as progressive thickening of heart valves, high blood pressure (hypertension) and obstruction of blood vessels
- Vision damage or loss from degeneration of cells that capture light and buildup of cellular debris in the brain causing pressure on the optic nerve and eye
- Progressive loss of hearing
- Aggressive behavior
- Stunted growth
- Joint stiffness
- Diarrhea
- Carpal tunnel syndrome
- Sleep apnea
When to see a doctor
Hunter syndrome isn't common, but if you notice changes in your child's facial appearance, a loss of previously acquired skills, or other signs or symptoms listed above, talk to your child's primary care doctor. He or she can help you decide if you need to see a specialist or seek out further testing.
- Scarpa, et al. Mucopolysaccharidosis type II: European recommendations for the diagnosis and multidisciplinary management of a rare disease. Orphanet Journal of Rare Diseases. 2011;6:1.
- Martin R, et al. Recognition and diagnosis of mucopolysaccharidosis II (Hunter syndrome). Pediatrics. 2008;121:e377.
- Mucopolysaccharidoses fact sheet. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/mucopolysaccharidoses/detail_mucopolysaccharidoses.htm. Accessed Oct. 11, 2012.
- Kakkis E, et al. Complications and management of the mucopolysaccharidoses. http://www.uptodate.com/ index. Accessed Sept. 21, 2012.
- Muenzer J, et al. Multidisciplinary management of Hunter syndrome. Pediatrics. 2009;124:e1228.
- Da Silva EMK, et al. Enzyme replacement therapy with idursulfase for mucopolysaccharidosis type II (Hunter syndrome). Cochrane Database of Systematic Reviews. 2011; 9:CD008185. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD008185.pub2/abstract. Accessed Oct. 1, 2012.
- Valayannopoulos V, et al. Therapy for the mucopolysaccharidoses. Rheumatology. 2011;50:v49.
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