Ochoa syndrome is characterized by the association of severe voiding dysfunction and a characteristic facial expression. Over 100 patients have been described so far. Patients with Ochoa syndrome present with incontinence, urinary tract infection and hydronephrosis (swelling of a kidney due to back up of urine). Voiding dysfunction is the result of an obstructive uropathy (a structural or functional hindrance of normal urine flow). About two-thirds of the patients have moderate to severe constipation. Cryptorchidism (undescended or maldescended testis) has also been reported. The peculiar facial dysmorphism is related to an unusual inversion of facial expression that occurs when the child smiles or cries. The syndrome is inherited as an autosomal recessive trait, and a potential gene has been mapped to chromosome 10q23-q24. Diagnosis may be suspected following recognition of the peculiar facial expression during infancy. Ultrasonography, renal scan, voiding cystourethrogram and urodynamics can be used to evaluate the lower urinary tract dysfunction. Treatment is symptomatic and involves bladder re-education, antibiotic prophylaxis, anticholinergic therapy and alpha-blockers. Intermittent catheterization may be needed. Constipation should be treated. Early diagnosis and treatment are essential in order to prevent upper urinary tract deterioration and renal failure.
Posted on: Sun, 31 Aug 2014 06:47:13 +0000
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