Blepharophimosis Ptosis Epicanthus Inversus Syndrome (BPES) Type 1 in an Indian Family
Keywords:
blepharophimosis ptosis epicanthus inversus syndrome (BPES), secondary amenorrhea, primary ovarian failureAbstract
Blepharophimosis ptosis epicanthus inversus (BPES) is a relatively rare congenital disorder, which usually presents with classical eye manifestations. In some cases, it is associated with premature ovarian failure (POF). BPES is of two types, type I and type II. Type I is associated with POF along with eyelid malformations, while Type 2 has only eyelid malformations.
Here, we report a family of BPES, in whom two sisters presented with secondary amenorrhea. On eye examination, they have blepharophimosis, ptosis, epicanthus inversus and telecanthus. Investigations revealed hypergonadotropic hypogonadism. Their father also has similar eye manifestations. Diagnosis of BPES type I was made and both were started on hormone replacement therapy.
To make timely diagnosis of BPES, every patient with POF should specifically be checked for eye manifestations.
Downloads
References
Chawla B, Bhadange Y, Dada R, Kumar M, Sharma S, et al. Clinical, radiologic, and genetic features in blepharophimosis, ptosis, and epicanthus inversus syndrome in the Indian population. Invest Ophthalmol Vis Sci. 2013;54(4):2985-91. PMID: 23513057. https://doi.org/10.1167/iovs.13-11794.
Kamath M, Dabke S, Kamath G, Nayak R, et al. Sporadic blepharophimosis syndrome: A case report. IJSR;5.
Zlotogora J, Sagi M, Cohen T. The blepharophimosis, ptosis, and epicanthus inversus syndrome: Delineation of two types. Am J Hum Genet. 1983;35(5):1020-7. PMID: 6613996. PMCID: PMC1685801.
De Baere E, Copelli S, Caburet S, Laissue P, et al. Premature ovarian failure and forkhead transcription factor FOXL2: Blepharophimosis-ptosis-epicanthus inversus syndrome and ovarian dysfunction. Pediatric Endocrinol Rev. 2005;2(4):653-60. PMID: 16208278.
Patil SB, Kale SM, Math M, Khare N, Sumeet J. Anthropometry of the eyelid and palpebral fissure in an Indian population. Aesthet Surg J. 2011;31(3):290-4. PMID: 21385738. https://doi.org/10.1177/1090820X11398475.
Verdin H, De Baere E. Blepharophimosis, ptosis, and epicanthus inversus. Pagon RA, Adam MP, Ardinger HH, et al., editors. Seattle (WA): University of Washington, Seattle; 1993-2017. Bookshelf ID: NBK1441. PMID: 20301614.
Corrêa FJ, Tavares AB, Pereira RW, Abrão MS. A new FOXL2 gene mutation in a woman with premature ovarian failure and sporadic blepharophimosis-ptosis-epicanthus inversus syndrome. Fertil Steril. 2010;93(3):3-6. https://doi.org/10.1016/j.fertnstert.2009.08.034.
Townes PL, Muechler EK. Blepharophimosis, ptosis, epicanthus inversus, and primary amenorrhea: A dominant trait. Arch Ophthalmol. 1979;97(9):1664-6. PMID: 475637.
Fraser IS, Shearman RP, Smith A, Russell P. An association among blepharophimosis, resistant ovary syndrome, and true premature menopause. Fertil Steril. 1988;50(5):747-51. PMID: 3141218.
Panidis D, Rousso D, Vavilis D, Skiadopoulos S, Kalogeropoulos A. Familial blepharophimosis with ovarian dysfunction. Hum Reprod. 1994;9(11):2034-7. PMID: 7868670.
Amati P, Gasparini P, Zlotogora J, Zelante L, et al. A gene for premature ovarian failure associated with eyelid malformation maps to chromosome 3q22-q23. Am J Hum Gen. 1996;58(5):1089-92. PMID: 8651270. PMCID: PMC1914611.
Crisponi L, Deiana M, Loi A, Chiappe F, et al. The putative forkhead transcription factor FOXL2 is mutated in blepharophimosis/ptosis/epicanthus inversus syndrome. Nat Gen. 2001;27(2):159-66. PMID: 11175783. https://doi.org/ 10.1038/84781.
Published
How to Cite
Issue
Section
License
Journal of the ASEAN Federation of Endocrine Societies is licensed under a Creative Commons Attribution-NonCommercial 4.0 International. (full license at this link: http://creativecommons.org/licenses/by-nc/3.0/legalcode).
To obtain permission to translate/reproduce or download articles or use images FOR COMMERCIAL REUSE/BUSINESS PURPOSES from the Journal of the ASEAN Federation of Endocrine Societies, kindly fill in the Permission Request for Use of Copyrighted Material and return as PDF file to jafes@asia.com or jafes.editor@gmail.com.
A written agreement shall be emailed to the requester should permission be granted.