Nail Patella Syndrome

A Guide to Understanding This Rare Genetic Condition

Dermatology

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Last updated: Mar 24, 2025

What is Nail Patella Syndrome?

Nail Patella Syndrome (NPS) is a rare genetic disorder that affects multiple parts of the body, primarily the nails, knees, elbows, and pelvis. It's also known as hereditary onycho-osteodysplasia (HOOD syndrome).

Key Features

  • Nail abnormalities: Missing or underdeveloped fingernails and toenails
  • Skeletal changes: Small or absent kneecaps (patellae)
  • Joint involvement: Limited mobility in elbows and knees
  • Kidney involvement: Possible kidney problems in some cases

Common Symptoms

Nail Changes

  • Missing or underdeveloped nails, especially thumbnails
  • Triangle-shaped lunulae (white crescents)
  • Split or ridged nails

Skeletal/Joint Issues

  • Small or absent kneecaps
  • Limited elbow extension
  • Hip abnormalities
  • Lower back problems

Other Features

  • Eye problems (increased pressure)
  • Kidney abnormalities
  • Decreased bone density

Diagnosis

  • Physical examination
  • Family history evaluation
  • Genetic testing
  • X-rays of joints
  • Kidney function tests

Treatment and Management

Physical Support

  • Physical therapy
  • Occupational therapy
  • Orthopedic devices when needed

Medical Monitoring

  • Regular kidney function tests
  • Eye pressure monitoring
  • Orthopedic evaluations

Living with NPS

  • Regular medical check-ups
  • Lifestyle modifications
  • Support group participation
  • Genetic counseling for family planning

When to See a Doctor

  • Joint pain or mobility issues
  • Signs of kidney problems
  • Vision changes
  • Before planning pregnancy

Inheritance Pattern

  • Autosomal dominant inheritance
  • 50% chance of passing to children
  • Caused by mutations in LMX1B gene

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