Nail-Patella Syndrome

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Marijuana and Nail-Patella Syndrome
Nail-patella syndrome (NPS) isn’t a qualifying condition in most of the states where medical marijuana is legal. However, states like Michigan, Illinois and Maine recognize that the symptoms and complications of this rare disorder make those who suffer from it suitable candidates for medical cannabis treatments.

And while there’s no cure for this disorder, medical weed can provide relief. So, if you’re struggling with nail-patella syndrome, read more to find out how medical marijuana could help manage your symptoms.

What Is Nail-Patella Syndrome?

Nail-patella syndrome is a rare, genetic condition. It’s most prominent symptoms are deformed fingernails and toenails, but it also affects the bones, joints, kidneys and eyes. The disorder can result in noticeable skeletal deformities as well.

What is Nail-Patella Syndrome

Other names for this disorder are:

  • Onychoosteodysplasia
  • Hereditary Onychoosteodysplasia (HOOD)
  • Iliac Horn Syndrome
  • Fong Disease
  • Turner-Kieser Syndrome

Some of the first signs of NPS appear in infancy or early childhood. Parents may notice when their child is born, for example, that their fingernails haven’t developed properly. Doctors can make an early diagnosis through a physical examination, x-rays or genetic testing.

What Causes Nail-Patella Syndrome?

Nail-patella syndrome is an inherited genetic condition. Approximately one out of every 50,000 babies bornwill have this disorder. The mutation that causes NPS occurs in a gene called the LIM Homeobox Transcription Factor 1-Beta (LMX1B) located on chromosome nine. This gene codes limb development in embryos.

The mutation is an autosomal dominant trait, meaning only one parent needs to be affected for the mutation to appear in their child. Individuals with a family history of the condition are more likely to develop the severe symptoms associated with it. Rare cases of NPS have developed without the patient having a family history of the condition.

Symptoms and Side Effects of Nail-Patella Syndrome

The symptoms associated with nail-patella syndrome develop because of connective disuse and collagen abnormalities. These changes lead to the visual symptoms, like discolored or missing nails, often associated with the condition.

Signs of NPS vary. Parents could have no apparent symptoms of the disease, for example, while their children have a more severe case. Similar symptoms, like nail abnormalities, occur in most patients. The symptoms themselves, however, range from mild to severe.

One sign that appears in almost every NPS patient is nail abnormalities. Your thumbs’ nails are usually affected the most. Toenail irregularities are rarer than changes in your fingernails. The most common nail features of nail-patella syndrome include:

  • Absent nails
  • Underdeveloped nails
  • Discolored nails
  • Split nails
  • Ridged nails
  • Pitted nails
  • Triangular cuticles versus the usual crescent shape

Although nail irregularities are an annoyance to nail-patella syndrome sufferers, more serious symptoms can also develop. Most of these involve skeletal abnormalities affecting the knees, hips and elbows.

Some of these skeletal symptoms include:

  • Absent or irregularly shaped kneecaps
  • Dislocated kneecaps
  • Deformed elbows
  • Outward angled elbows
  • Inability to fully extend arms
  • Unusual webbing at the bend of the elbow
  • Horn-like growths on the pelvic bones
  • Abnormally shaped pelvic bones
  • Cervical ribs
  • Scoliosis
  • Scapular hypoplasia

The kidneys and eyes can also be affected by NPS. Because of filtration issues, kidney problems develop in thirty to forty percent of reported cases. In extreme instances, kidney problems can lead to high blood pressure and renal failure.

Glaucoma is another major side effect of this disorder and can develop early. Glaucoma develops when there is increased fluid pressure in your eyes because the outflow is blocked. Other eye abnormalities related to nail-patella syndrome include your irises, or the colored portion of your eyes, becoming dark or clover-shaped.

Other rare symptoms associated with NPS include:

  • Numbness, tingling or burning in the hands and feet
  • Poor blood circulation
  • Digestive issues
  • Difficulty gaining weight
  • Reduced muscle mass in the legs and arms
  • Thin bones and tooth enamel
  • Osteoporosis
  • High hairline

Because these symptoms develop or become visible during early childhood, patients can start treatment early. Knowing if your family has a history of NPS also makes you more aware of its signs and to look for them in your children.

Treatments for Nail-Patella Syndrome and Their Side Effects

Since there is no cure for nail-patella syndrome, treatments help patients manage their symptoms and improve their quality of life. NPS patients should seek medical attention at an early age, and if your family has a history of the condition, consider having your child tested to be safe.

Nail-Patella Syndrome Treatment

Treatments recommended by physicians vary from case to case. Each patient presents different symptoms, which range in severity. Thus, not all treatments are necessary or helpful. Patients with nail-patella syndrome should undergo regular screenings for orthopedic issues, kidney problems and glaucoma.

Therapies for NPS are broken into three areas — orthopedic, kidney and glaucoma. Some of the most common treatments for these issues include:

Orthopedic

Because of the nature of this disorder, dislocations and other knee and hip problems are not uncommon. When you dislocate your knee or hip, it can be excruciating. Some of the orthopedic problems caused by nail-patella syndrome become so severe that surgery is required.

Treatments for orthopedic symptoms include:

  • Painkillers: Bringing relief to chronic pain is important in improving your quality of life. However, long-term use of painkillers, like oxycodone, should be avoided as they can lead to kidney issues. Other side effects include nausea, weakness and more.
  • Physical Therapy: Although this is an effective treatment, patients can risk aggravating their joint issues. Physical therapy often complements other orthopedic treatments.
  • Splinting and Bracing: To prevent further injuries or complications, physicians may use splints and braces to keep the affected areas from moving out of place or in such a way that would cause pain.
  • Surgery: In some cases, patients need surgical stabilization or replacement of their knee caps with prosthetics. Bone fractures can also lead to surgery.

Orthopedic treatments often rely on a combination of the above therapies. Many patients, for example, may use pain medicine and physical therapy to combat their daily discomfort.

  • Kidney

All nail-patella syndrome patients should get regular screenings for renal disease. If caught early, you can begin treatment and restore function to your kidney. Kidney disease treatments are the same whether the disease results from NPS or another issue:

  • Lifestyle Choices: Some foods, beverages and activities can aggravate kidney conditions. Patients should discuss lifestyle changes with their physician. Sodium, for example, is an ingredient those with kidney disease need to avoid.
  • ACE Inhibitors: This medicine treats high blood pressure and excessive proteins in the urine. ACE inhibitor side effects include a dry cough, fatigue, dizziness, headaches and even a loss of taste.
  • Dialysis or Renal Transplant: If your kidney loses 85 to 90 percent of its function, you’ll need to begin dialysis. In some cases, your kidney’s performance can improve, but many patients require a kidney transplant.

Scheduling appointments to check for kidney disease are essential to managing NPS and ensuring you receive prompt treatment should the condition begin to affect your kidneys.

  • Glaucoma

If not treated, glaucoma can lead to narrowed visual perception and blindness. If you lose your vision, it’s irreversible. Regular appointments with an optometrist can catch this symptom early.

A few options are available for reducing eye pressure and opening blockages to improve fluid drainage. The most common treatments are:

  • Eye Drops: Side effects of eye drops can include stinging or itching, blurred vision, eye redness, low blood pressure, fatigue, headache, dry mouth and nose, nausea and memory problems.
  • Laser Treatment: Potential side effects of laser procedures include excessive scar tissue, increase in eye pressure, inflammation of the iris, clouding of the cornea, pain, fluid drainage issues and decreased vision.
  • Surgery: Possible side effects of glaucoma surgery include eye scarring, blurred vision, bleeding, loss of central vision, infection and high eye pressure.

In some cases, surgery or laser treatments are unavoidable if you want to preserve your vision. If you do proceed with these more aggressive treatments, it’s crucial you select an experienced doctor to perform the procedure.

While these traditional treatments are all that is available to some patients across the U.S., those in states where medical marijuana is legal can use it to alleviate their day-to-day symptoms.

How Is Medical Marijuana an Effective Treatment?

Medical marijuana for nail-patella syndrome is an excellent treatment option for individuals who greatly suffer from the disorder. The best thing about medical cannabis for nail-patella syndrome is it can help with several of the associated complications, such as pain, glaucoma and kidney disease.

Pain management is a major concern for NPS patients. Prescription opioids pose a significant risk to those with nail-patella syndrome. Long-term use of painkillers can damage kidneys and cause renal failure — patients with NPS are already at risk of kidney failure, making for a high-risk combination.

Marijuana as a treatment

When medical marijuana is used to treat nail-patella syndrome, patients experience reduced bouts of pain with none of the dangerous side effects of prescription opioids. They also report feeling more active, letting them live their lives to its fullest extent. For patients, that makes medical marijuana an effective, low-risk treatment.

What Symptoms of Nail-Patella Syndrome Can Marijuana Treat

Many of the ailments caused by nail-patella syndrome are treatable with medical marijuana. It’s a safe alternative to prescription drug use, and NPS patients across the U.S. are finding relief with it.

Medical cannabis treats the following symptoms of nail-patella syndrome:

Knee and Joint Pain

Joint abnormalities can cause severe pain. Medical marijuana is well-documented as an effective pain reliever. It targets pain located in the bones, ligaments and tendons. Cannabis even treats aches from scoliosis, another potential symptom of NPS.

Nail-patella syndrome also makes joints swollen or inflamed. The cannabinoidstetrahydrocannabinol (THC)and beta-caryophyllene (E-BCP) are compounds in cannabis with anti-inflammatory properties.

If you wish to avoid the psychoactive high often associated with medical weed, a strain with low THC and high cannabidiol (CBD) amounts can give you a break from chronic discomfort while still maintaining a clear mind.

Kidney Disease

Medical marijuana is shown to lower the risk of kidney disease. It helps kidney health with the same anti-inflammatory properties mentioned above. These properties fight off disease and promote tissue repair. CBD also acts as a detoxifier for the body by reducing oxidative stress. This type of stress is known to increase the likelihood of pathophysiological conditions, like kidney disease.

For NPS patients with renal failure, medical marijuana can also help. It works by reducing spasms, as well as increasing your appetite, as kidney disease can lead to weight loss and a lack of hunger.

Glaucoma

Medical cannabis significantly slows the progression of glaucoma by relieving ocular pressure. Marijuana’s neuroprotection and vasodilation properties, which decrease blood pressure, also assist in the treatment of glaucoma.

Marijuana reduces eye pressure

In one study, researchers found that medical marijuana reduced eye pressure for eight to 12 hours when the cannabis was administered as a topical. Another study, which tested animals, found the effects lasted for around six hours.

As medical marijuana becomes legalized in more states, additional studies can give us more insight into its benefits for different diseases and conditions, including nail-patella syndrome. Patients agree though — the natural treatment helps them.

Best Strains of Cannabis to Use for Nail-Patella Syndrome

The number of medical marijuana strains available is incredible. No longer do patients choose between one or two options. They can now select designer strains, tailor-made to treat a plethora of symptoms. If you need help finding the perfect strain for you, a medical marijuana doctor or local budtenders at your dispensary will have recommendations.

Here is a short list of recommendations for managing symptoms from nail-patella syndrome:

Best Strains for Pain

If your main discomfort from NPS is chronic pain, you have a wide selection of strains available. Two of the most helpful ones include:

  • Banana Kush: This West Coast invention is an Indica-dominant hybrid strain. It’s well-known for its pain-relieving and anti-inflammatory properties.
  • Harlequin: A sativa strain with a healthy presence of CBD. It has amplified pain-killing properties, yet allows users to maintain a clear head.

Dispensaries in your area may have these two strains available or similar ones that you can try.

Anti-Inflammatory Strains

You can also alleviate chronic pain from NPS by using anti-inflammatory strains, like:

  • Cannatonic: This well-known anti-inflammatory strain is a pure hybrid, with equal amounts of sativa and Indica. It’s high in CBD, which doesn’t produce psychoactive effects.
  • AC/DC: This strain is best known for supplying the anti-inflammatory relief of cannabis without psychoactive effects. It’s a sativa-dominant strain with high levels of CBD.

If your local dispensary doesn’t offer these strains, they’ll be able to recommend an alternative with similar effects and CBD and THC content.

Best Strains for Glaucoma

People have treated glaucoma with medical marijuana since at least the 1970s. Helpful strains for glaucoma include:

  • Maui Waui: This sativa strain is the most popular for treating glaucoma. With a low THC content, it provides immediate relief without the fear of getting stoned.
  • Blueberry: Few strains can surpass the pain-killing qualities of this Indica strain. It’s been a popular pain-reliever since the ‘70s and helps glaucoma patients lower their ocular pressure.

While your dispensary may not have these strains in stock, they likely have comparable strains available.

One of the reasons why dispensary selections vary is because medical marijuana isn’t something growers can import or export. As medical marijuana becomes more accepted as a part of the medical field, laws could change and allow growers to ship medical weed to different states.

Methods of Medical Marijuana Treatment

The most common way of taking medical cannabis for nail-patella syndrome is by smoking or vaporization. While these methods provide quick relief, you may want to try some alternative modes:

  • Edibles: This form of administration can be done on the go. You can purchase precise doses at a local dispensary. Although it may take longer to feel the medical marijuana’s effects, they last longer.
  • Tincture and sprays: Both methods are applied under the tongue. Tastes vary from mild to strong. The medicine diffuses into your bloodstream and bypasses your digestive system.
  • Topicals and transdermal patches: This mode of administration allows cannabis treatments to be applied directly to the area with the most pain. Topicals and patches help you treat your most painful areas directly.

State laws determine what administration modes are legal. Some don’t allow the smoking of medical marijuana, though most approve topicals and tinctures. Your medical cannabis doctor can talk to you about your state’s laws.

How to Get Medical Marijuana for Nail-Patella Syndrome

Many states approve medical marijuana for patients with debilitating conditions. If you would like to apply for one of these programs, you must prove that you have a qualifying condition. Even though NPS isn’t eligible in every state, it’s symptoms, like glaucoma and chronic pain could qualify you.

If you’re ready to take the next step in treating your nail-patella syndrome with medical marijuana, you need to make an appointment with a local marijuana doctor. These medical professionals are qualified to diagnose and recommend this all-natural treatment option. Meet with one of these compassionate physicians by searching for a medical cannabis doctor near you.

Information about Medical Marijuana & Nail-Patella Syndrome

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Resources:

  1. https://www.midwestcompassion.org/2015/05/18/treating-nail-patella-syndrome-with-cannabis/
  2. http://www.webmd.com/children/nail-patella-syndrome-10752
  3. https://www.kidney.org/atoz/content/dialysisinfo
  4. https://www.medicaljane.com/2015/01/06/cannabis-for-the-treatment-of-glaucoma/