Kartagener syndrome is a rare genetic disease that affects the cilia in your lungs and other organs.
What Is Kartagener Syndrome?
Kartagener syndrome is a type of primary ciliary dyskinesia or PCD, that may also cause reversed internal organs. This means your organs are on the opposite side of your body from where they should be.
Primary ciliary dyskinesia is a genetic condition where the cilia aren’t working properly. Cilia are hair-like structures on the surface of your cells and are found in your lungs, airways, and other areas. They move in a wave-like motion to help position organs during a baby’s growth in the womb, and they help move out mucus, bacteria, and debris from your lungs and airways.
In PCD and Kartagener syndrome, these cilia don’t move or they don’t move very well, which causes ongoing lung, sinus, and ear problems. Not all people with PCD have reversed organs, so Kartagener syndrome is a subtype of the disease.
What Causes Kartagener Syndrome?
Kartagener syndrome and PCD are autosomal recessive genetic conditions. Recessive disorders happen when you inherit a mutated gene from both parents. If you get one normal gene and one mutated gene, you will be a carrier but won’t have any symptoms.
You can pass the gene on to your children. If your partner doesn’t have the mutated gene, your children will have a 50% chance of being a carrier.
What Are Kartagener Syndrome Symptoms?
The main symptom of Kartagener syndrome is lung problems. Because the cilia don’t work properly, you have trouble moving debris and fluid from your lungs. The severity of symptoms can vary for each person, but they usually start at birth.
The first sign is a baby who coughs, chokes, gags, and goes into neonatal (newborn) respiratory distress right after birth. This is thought to happen because proper cilia are needed to clear any amniotic fluid from the womb out of a newborn’s lungs.
Other Kartagener syndrome symptoms include:
- Frequent lung infections
- Chronic coughing
- Wet and productive cough
- Too much mucus
- Frequent sinus infections
- Frequent middle ear infections
- Hearing loss
- Scarring in your lungs
- Severe lung damage
- Infertility
- Hydrocephalus, or fluid buildup on your brain
While Kartagener syndrome causes reversed organs, it doesn’t usually lead to other symptoms. Some people with the syndrome are born with heart defects, though.
Cilia are also in other organs like your brain and reproductive tract. As a result, people with Kartagener syndrome may experience problems with fluid on the brain and infertility. In men, infertility is caused by sperm that can’t move very well. Women might have ectopic pregnancies where the egg doesn’t move well and is fertilized in your tubes or elsewhere instead of in the uterus.
How Is Kartagener Syndrome Diagnosed?
A Kartagener syndrome diagnosis starts with a physical exam and history of your symptoms. If your doctor suspects you have a problem with your cilia, they might do different tests. These include:
- Electron microscopy where they take a tissue sample or scrape your nose and look at how the cilia move
- X-rays to look at your lungs and internal organs
- Computed tomography (CT) scan
- Nitric oxide test where they measure how much nitric oxide you breathe out, typically lower in people with ciliary problems
- Hearing tests
Your doctor might use some of these tests to diagnose complications like hearing loss or other problems. Electron microscopy is considered the best way to diagnose the condition itself. If this test is positive, you might have genetic testing done to confirm the results.
What Is the Treatment for Kartagener Syndrome?
There is no cure for Kartagener syndrome. The main treatments focus on keeping airways clear and loosening and getting rid of thick, extra fluid, mucus, and debris. This is called airway clearance therapy and is similar to cystic fibrosis treatment. It helps keep your lungs and tissue as healthy as possible for as long as possible.
Specific Kartagener syndrome treatment includes:
- Regular sinus washes
- Regular ear canal washes
- Steroids
- Mucus thinners, called mucolytics
- Antibiotics
- Bronchodilators to relax lung muscles for easier breathing
- Ear tubes
- Speech therapy
- Hearing aids
- Heart surgery for defects
- Lung transplant in severe cases
It’s also important to get vaccines to prevent serious disease from viruses. These include a yearly flu vaccine along with regular childhood vaccines. You should not smoke, and children with Kartagener syndrome shouldn’t be exposed to smoke.
Kartagener syndrome is a lifelong condition and regular appointments with your doctor are key to managing your symptoms and condition.
How Long Can You Live With Kartagener Syndrome?
The outlook for Kartagener syndrome varies widely. Some people have more severe symptoms than others. Early diagnosis and treatment is important and can help slow the disease and avoid complications.