Diagnosing Bardet-Biedl syndrome (BBS)

Diagnosing patients with BBS, a rare genetic disease.

The diagnosis of BBS is based on clinical findings. Consider the complete presentation and use your clinical judgment to diagnose BBS.2-7,9,13,14

Clinical features

The presence of clinical features associated with BBS may vary, but can often include hyperphagia and early-onset, severe obesity, among others, such as visual impairment, cognitive impairment, renal anomalies, polydactyly, and hypogonadism.4,5,9,13,14

Most Common clinical features5,7,12

Other clinical features5,7

BBS, Bardet-Biedl syndrome.

BBS has a variable phenotype with clinical features that can vary greatly across individuals and evolve over time.2-6,8,10-12,16

Evolution of clinical features of BBS1-6,8,10-12,15,16

aPediatric patients with CKD stages 4 and 5 were diagnosed before age 5 years; patients either developed CKD in childhood or maintained normal or near-normal renal function into adulthood.
bIf polyuria is absent or overlooked, ESRD, which occurs at various ages from birth, may be the first renal manifestation.9
BBS, Bardet-Biedl syndrome; CKD, chronic kidney disease; ESRD, end-stage renal disease.11

Genetics

BBS is diagnosed clinically. Genetic testing can help provide additional evidence to support the diagnosis of BBS. BBS is clinically and genetically diverse; clinical features, genetics, patient history, and family findings should all be considered.4,5,7,9,13,14

Patient history and family findings

It’s important to review patients’ complete medical history. Some clinical features associated with BBS may have been previously treated and/or not considered as a symptom of BBS. Family members have an increased risk of inheriting a pathogenic gene associated with BBS, and clinical features may vary between siblings of patients with BBS. Genetic testing for parents and siblings may provide additional diagnostic information.4,7

Discover BBS

Discover more about BBS, a rare genetic disease.

Access resources

Download the BBS handout for an overview of the disease. 

Explore the MC4R pathway

Refresh your knowledge of the MC4R pathway.

Contact us

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BBS, Bardet-Biedl syndrome; MC4R, melanocortin-4 receptor

References

  1. Agrawal H et al. Pediatr Rev. 2018;39(5):e21-e23.
  2. Beales PL, et al. J Med Genet. 1999;36(6):437-446.
  3. Castro-Sánchez S et al. J Med Genet. 2015;52(8):503-513.
  4. Forsyth R, Gunay-Aygun M. GeneReviews. Accessed February 21, 2024. https://www. ncbi.nlm.nih.gov/books/NBK1363
  5. Forsythe E, Beales PL. Eur J Hum Genet. 2013;21(1):8-13.
  6. Forsythe E, et al. J Am Soc Nephrol. 2017;28(3):963-970.
  7. Forsythe E, et al. Front Pediatr. 2018;6(23):1-8.
  8. Hooda AK, et al. Indian J Nephrol. 2009;19(3):112-114.
  9. Milani D, et al. Ital J Pediatr. 2014;40(1):33.
  10. Pomeroy J, et al. Pediatr Obes. 2021;16(2):e12703.
  11. Putoux A, et al. Pediatr Nephrol. 2012;27(1):7-15.
  12. Sherafat-Kazemzadeh R, et al. Pediatr Obes. 2013;8(5):e64-e67.
  13. Styne DM, et al. J Clin Endocrinol Metab. 2017;102(3):709-757.
  14. van der Valk ES, et al. Obes Rev. 2019;20(6):795-804.
  15. Vlahovic AM, Haxhija EQ. Pediatric and Adolescent Plastic Surgery for the Clinician. Springer; 2017:89-105.
  16. Weihbrecht K, et al. Med Res Arch. 2017;5(9):10.18103/mra.v5i9.1526.