Skip to main content
Log in

Congenital central hypoventilation syndrome: four families

  • Original Article
  • Published:
Sleep and Breathing Aims and scope Submit manuscript

Abstract

Background

Congenital central hypoventilation syndrome (CCHS) is a rare condition that usually presents soon after birth and is potentially life-shortening if not treated. The defining abnormality is hypoventilation during sleep which requires life-long treatment with artificial ventilation. This syndrome may also be associated with generalised dysfunction of the autonomic nervous system and a sub-group with associated Hirschsprung’s disease. The genetic basis of CCHS has been identified as mutations in the PHOX2B gene.

Methods

We present four families, three with autosomal dominant inheritance and familial clustering, and one with a de novo mutation resulting in CCHS.

Conclusions

We demonstrate that nasal mask ventilation from birth can provide adequate treatment and improved quality of life for these children. Phenotypic variability in expression of disease is seen in families with the same mutations in PHOX2B gene. The psychosocial costs of the disease and the unrecognised ‘morbidity barter’ that is part of current management needs to be factored into in all stages of management from childhood to adolescence to adulthood.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Vanderlaan M, Holbrok CR, Wang M, Tuell A, Gozal D (2004) Epidemiologic survey of 196 patients with congenital central hypoventilation syndrome. Pediatr Pulmonol 37:217–229

    Article  PubMed  Google Scholar 

  2. Autonomic control, congenital failure of. MIM#209880. http://www.ncbi.nlm.nih.gov/omim/209880, accessed on 08/05/2010

  3. Gaultier C, Amiel J, Dauger S, Trang H, Lyonnet S, Gallego J, Simonneau M (2004) Genetics and early disturbances of breathing control. Pediatr Res 55:729–733

    Article  PubMed  Google Scholar 

  4. Berry-Kravis EM, Zhou L, Rand CM, Weese-Mayer DE (2006) Congenital central hypoventilation syndrome: PHOX2B mutations and phenotype. Am J Respir Crit Care Med 74:1139–1144

    Article  Google Scholar 

  5. Hamilton J, Bodurtha JN (1989) Congenital central hypoventilation syndrome and Hirschsprung's disease in half sibs. J Med Genet 26:272–274

    Article  PubMed  CAS  Google Scholar 

  6. Weese-Mayer DE, Berry-Kravis EM (2004) Genetics of congenital central hypoventilation syndrome: lessons from a seemingly orphan disease. Am J Respir Crit Care Med 170:16–21

    Article  PubMed  Google Scholar 

  7. Antic NA, Malow BA, Lange N, McEvoy RD, Olson AL, Turkington P, Windisch W, Samuels M, Stevens CA, Berry-Kravis EM, Weese-Mayer DE (2006) PHOX2B mutation—confirmed congenital central hypoventilation syndrome presentation in adulthood. Am J Respir Crit Care Med 174:923–927

    Article  PubMed  CAS  Google Scholar 

  8. Silvestri JM, Weese-Mayer DE, Nelson MN (1992) Neuropsychologic abnormalities in children with congenital central hypoventilation syndrome. J Pediatr 120:388–393

    Article  PubMed  CAS  Google Scholar 

  9. Bachetti T, Matera I, Borghini S, Di Duca M, Ravazzolo R, Ceccherini I (2005) Distinct pathogenic mechanisms for PHOX2B associated polyalanine expansions and frameshift mutations in congenital central hypoventilation syndrome. Hum Mol Genet 14:1815–1824

    Article  PubMed  CAS  Google Scholar 

  10. Matera I, Bachetti T, Puppo F, Di Duca M, Morandi F, Casiraghi GM, Cilio MR, Hennekam R, Hofstra R, Schober JG, Ravazzolo R, Ottonello G, Ceccherini I (2004) PHOX2B mutations and polyalanine expansions correlate with the severity of the respiratory phenotype and associated symptoms in both congenital and late onset central hypoventilation syndrome. J Med Genet 41:373–380

    Article  PubMed  CAS  Google Scholar 

  11. Chen ML, Keens TG (2004) Congenital central hypoventilation syndrome: not just another rare disorder. Paediatr Respir Rev 5:182–189

    Article  PubMed  Google Scholar 

  12. Villa MP, Dotta A, Castello D, Piro S, Pagani J, Palamides S, Ronchetti R (1997) Bi-level positive airway pressure (BiPAP) ventilation in an infant with central hypoventilation syndrome. Pediatr Pulmonol 24:66–69

    Article  PubMed  CAS  Google Scholar 

  13. Ramesh P, Boit P, Samuels M (2008) Mask ventilation in the early management of congenital central hypoventilation syndrome. Arch Dis Child Fetal Neonatal Ed 3:F400–F403

    Article  Google Scholar 

  14. Li KK, Riley RW, Guilleminault C (2000) An unreported risk in the use of home nasal continuous positive airway pressure and home nasal ventilation in children. Chest 117:916–918

    Article  PubMed  CAS  Google Scholar 

  15. Todd ES, Weinberg SM, Berry-Kravis EM, Silvestri JM, Kenny AS, Rand CM, Zhou L, Maher BS, Marazita ML, Weese-Mayer DE (2006) Facial phenotype in children and young adults with PHOX2B-determined congenital central hypoventilation syndrome: quantitative pattern of dysmorphology. Pediatr Res 59:39–45

    Article  PubMed  Google Scholar 

  16. Hennewig U, Hadzik B, Vogel M, Meissner T, Goecke T, Peters H, Selzer G, Mayatepek E, Hoehn T (2008) Congenital central hypoventilation syndrome with hyperinsulinism in a preterm infant. J Hum Genet 53:573–577

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Karen Waters.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Trivedi, A., Waters, K., Suresh, S. et al. Congenital central hypoventilation syndrome: four families. Sleep Breath 15, 785–789 (2011). https://doi.org/10.1007/s11325-010-0439-z

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11325-010-0439-z

Keywords

Navigation