Handigodu Syndrome
Encyclopedia
Handigodu Syndrome is a rare and painful osteoarthritic
disorder endemic
to the Malnad
region in the state of Karnataka
, India
. Also known as Handigodu Joint Disease, it derives its name from the village of Handigodu in the Sagara
taluk of the Shimoga district
of Karnataka
where it was first noticed. This disease currently has no cure. Scientifically it is termed as Endemic Familial Arthritis
of Malnad
. Since the day it was discovered, it has claimed over 1000 lives and has left many people crippled. Apart from Sagara taluk, the disease has also been reported from the Koppa, Narasimharajapura
and Sringeri taluks of Chikkamagaluru district.
. The doctors who could not diagnose the problem attributed the pain to some neurological disorder. Seeking advice on this disease, a team of experts led by K. S. Mani, a neurologist
from NIMHANS
, Bangalore
visited the region. After examining the patients, they ruled out any neurological disorder and implied that the pain was due to a bone and joint disorder.
conducted research in the affected regions and found out that the disease was confined to a dalit
colony. They also found out that the disease was affecting people of all age groups and it was non-contagious
and non-infectious
. This research was further followed by research conducted over four years (1984–88) by the Indian Council of Medical Research
(ICMR). Study groups involving experts from different medical fields were formed and these groups visited the affected places to conduct experiments. They were also helped by the Health Department of Karnataka who also provided a team to assist them. Despite undertaking extensive research, the team could not come into any conclusion on the cause of the disease. The team wound up in 1988 and this was the first phase of their research. The second phase of the research by ICMR was started in the year 2001 under the leadership of S. S. Agarwal of the Sanjay Gandhi
Post-graduate centre in Lucknow
. Some of the activities in the second phase were to x-ray
the patients and also study their family history
to see if the disease was related to genetics
. The study reported that Handigodu syndrome is a syndrome of familial spondyloepi(meta)physeal dysplasia
. It is inherited as an autosomal dominant trait. All the presentations of the varied manifestation of the disease could be explained as being caused by defective development of bones as a result of monogenic disorder.
from birth, deformation
of the limbs after age seven and death as early as between 25 and 30 years or even younger. Depending on the mobility of the affected patients, the disease has been identified with three severities: in mild to moderate cases, the patient is able to walk with difficulty, in severe cases mobility is very restricted, whereas in acute cases the limbs are bent and badly crippled making the patients crawl.
from the fund reserved for the physically challenged. Assistance has also been provided to construct houses for them. A special treatment unit has been set up in the Government Hospital at Sagar with an ambulance
provided to shift the affected patients to the hospital. H. D. Kumaraswamy
, then Chief Minister
of Karnataka
spent a night at Handigodu village and has assured the Government's assistance in eradicating this disease.
Osteoarthritis
Osteoarthritis also known as degenerative arthritis or degenerative joint disease, is a group of mechanical abnormalities involving degradation of joints, including articular cartilage and subchondral bone. Symptoms may include joint pain, tenderness, stiffness, locking, and sometimes an effusion...
disorder endemic
Endemic (epidemiology)
In epidemiology, an infection is said to be endemic in a population when that infection is maintained in the population without the need for external inputs. For example, chickenpox is endemic in the UK, but malaria is not...
to the Malnad
Malnad
Malenadu is a region of Karnataka state in South India. Malenadu covers the western and eastern slopes of the Western Ghats, roughly 100 kilometers in width. Malenadu covers portions of the Shimoga, Chikmagalur, Uttara Kannada, Kodagu and Hassan districts....
region in the state of Karnataka
Karnataka
Karnataka , the land of the Kannadigas, is a state in South West India. It was created on 1 November 1956, with the passing of the States Reorganisation Act and this day is annually celebrated as Karnataka Rajyotsava...
, India
India
India , officially the Republic of India , is a country in South Asia. It is the seventh-largest country by geographical area, the second-most populous country with over 1.2 billion people, and the most populous democracy in the world...
. Also known as Handigodu Joint Disease, it derives its name from the village of Handigodu in the Sagara
Sagara, India
Sâgara is a city located in Shimoga district in the Indian state of Karnataka. Located within the Western Ghats range, it is known for its proximity to Jog Falls and to the historical places of Ikkeri and Keladi. Varadamoola, the origin of the river Varada, is also near Sagara...
taluk of the Shimoga district
Shimoga District
Shimoga District is a district in the Karnataka state of India. A major part of Shimoga District lies in the Malnad region of the Western Ghats, a hilly area known for its green forests, plentiful rainfall, and as the source of many of the area's rivers. Shimoga City is the administrative centre...
of Karnataka
Karnataka
Karnataka , the land of the Kannadigas, is a state in South West India. It was created on 1 November 1956, with the passing of the States Reorganisation Act and this day is annually celebrated as Karnataka Rajyotsava...
where it was first noticed. This disease currently has no cure. Scientifically it is termed as Endemic Familial Arthritis
Arthritis
Arthritis is a form of joint disorder that involves inflammation of one or more joints....
of Malnad
Malnad
Malenadu is a region of Karnataka state in South India. Malenadu covers the western and eastern slopes of the Western Ghats, roughly 100 kilometers in width. Malenadu covers portions of the Shimoga, Chikmagalur, Uttara Kannada, Kodagu and Hassan districts....
. Since the day it was discovered, it has claimed over 1000 lives and has left many people crippled. Apart from Sagara taluk, the disease has also been reported from the Koppa, Narasimharajapura
Narasimharajapura
Narasimharajapura is a panchayat town in Chikmagalur district in the Indian state of Karnataka.-Geography:Narasimharajapura is located at . It has an average elevation of 643 metres...
and Sringeri taluks of Chikkamagaluru district.
Discovery
Handigodu syndrome was first noticed by H M Chandrashekhar in the village of Handigodu during the years 1974-75. Four patients who complained of severe joint and hip pain were admitted to the General Hospital at SagarSagara, India
Sâgara is a city located in Shimoga district in the Indian state of Karnataka. Located within the Western Ghats range, it is known for its proximity to Jog Falls and to the historical places of Ikkeri and Keladi. Varadamoola, the origin of the river Varada, is also near Sagara...
. The doctors who could not diagnose the problem attributed the pain to some neurological disorder. Seeking advice on this disease, a team of experts led by K. S. Mani, a neurologist
Neurologist
A neurologist is a physician who specializes in neurology, and is trained to investigate, or diagnose and treat neurological disorders.Neurology is the medical specialty related to the human nervous system. The nervous system encompasses the brain, spinal cord, and peripheral nerves. A specialist...
from NIMHANS
NIMHANS
The National Institute of Mental Health and Neurosciences is located in Bangalore, and is the premier neuroscience institute of India. It is recognised by the Government of India as a 'medical institute of national importance'...
, Bangalore
Bangalore
Bengaluru , formerly called Bengaluru is the capital of the Indian state of Karnataka. Bangalore is nicknamed the Garden City and was once called a pensioner's paradise. Located on the Deccan Plateau in the south-eastern part of Karnataka, Bangalore is India's third most populous city and...
visited the region. After examining the patients, they ruled out any neurological disorder and implied that the pain was due to a bone and joint disorder.
Research
A team from the National Institute of Nutrition, HyderabadNational Institute of Nutrition, Hyderabad
The National Institute of Nutrition is an Indian education and research facility located at Osmania University in Hyderabad. The institute operates under the Indian Council of Medical Research for India's Ministry of Health and Family Welfare...
conducted research in the affected regions and found out that the disease was confined to a dalit
Dalit
Dalit is a designation for a group of people traditionally regarded as Untouchable. Dalits are a mixed population, consisting of numerous castes from all over South Asia; they speak a variety of languages and practice a multitude of religions...
colony. They also found out that the disease was affecting people of all age groups and it was non-contagious
Contagious disease
A contagious disease is a subset category of infectious diseases , which are easily transmitted by physical contact with the person suffering the disease, or by their secretions or objects touched by them....
and non-infectious
Infection
An infection is the colonization of a host organism by parasite species. Infecting parasites seek to use the host's resources to reproduce, often resulting in disease...
. This research was further followed by research conducted over four years (1984–88) by the Indian Council of Medical Research
Indian council of medical research
The Indian Council of Medical Research , New Delhi, the apex body in India for the formulation, coordination and promotion of biomedical research, is one of the oldest medical research bodies in the world.-History:...
(ICMR). Study groups involving experts from different medical fields were formed and these groups visited the affected places to conduct experiments. They were also helped by the Health Department of Karnataka who also provided a team to assist them. Despite undertaking extensive research, the team could not come into any conclusion on the cause of the disease. The team wound up in 1988 and this was the first phase of their research. The second phase of the research by ICMR was started in the year 2001 under the leadership of S. S. Agarwal of the Sanjay Gandhi
Sanjay Gandhi
Sanjay Gandhi was an Indian politician. The younger son of Prime Minister Indira Gandhi and Feroze Gandhi, he was a member of the Nehru-Gandhi family...
Post-graduate centre in Lucknow
Lucknow
Lucknow is the capital city of Uttar Pradesh in India. Lucknow is the administrative headquarters of Lucknow District and Lucknow Division....
. Some of the activities in the second phase were to x-ray
X-ray
X-radiation is a form of electromagnetic radiation. X-rays have a wavelength in the range of 0.01 to 10 nanometers, corresponding to frequencies in the range 30 petahertz to 30 exahertz and energies in the range 120 eV to 120 keV. They are shorter in wavelength than UV rays and longer than gamma...
the patients and also study their family history
Family history
Family history is the systematic narrative and research of past events relating to a specific family, or specific families.- Introduction :...
to see if the disease was related to genetics
Genetics
Genetics , a discipline of biology, is the science of genes, heredity, and variation in living organisms....
. The study reported that Handigodu syndrome is a syndrome of familial spondyloepi(meta)physeal dysplasia
Spondyloepimetaphyseal dysplasia, Strudwick type
Spondyloepimetaphyseal dysplasia, Strudwick type is an inherited disorder of bone growth that results in dwarfism, characteristic skeletal abnormalities, and problems with vision. The name of the condition indicates that it affects the bones of the spine and two regions near the ends of bones...
. It is inherited as an autosomal dominant trait. All the presentations of the varied manifestation of the disease could be explained as being caused by defective development of bones as a result of monogenic disorder.
Symptoms
Symptoms of the disease are an acute pain and swelling in the hips and knee joints. Some of the other characteristics of this disease are dwarfismDwarfism
Dwarfism is short stature resulting from a medical condition. It is sometimes defined as an adult height of less than 4 feet 10 inches , although this definition is problematic because short stature in itself is not a disorder....
from birth, deformation
Deformity
A deformity, dysmorphism, or dysmorphic feature is a major difference in the shape of body part or organ compared to the average shape of that part.Deformity may arise from numerous causes:*A Genetic mutation*Damage to the fetus or uterus...
of the limbs after age seven and death as early as between 25 and 30 years or even younger. Depending on the mobility of the affected patients, the disease has been identified with three severities: in mild to moderate cases, the patient is able to walk with difficulty, in severe cases mobility is very restricted, whereas in acute cases the limbs are bent and badly crippled making the patients crawl.
Possible causes
Many theories have been put forth as possible causes of this disease:- The disease may be because the patients consumed pesticides intoxicated crabCrabTrue crabs are decapod crustaceans of the infraorder Brachyura, which typically have a very short projecting "tail" , or where the reduced abdomen is entirely hidden under the thorax...
s as food. - The disease may be because there were quite a few cases where marriages had taken place between close family members.
Assistance
A subsistence allowance is provided to the patients by the Government of KarnatakaGovernment of Karnataka
The Government of Karnataka is a democratically elected body with the Governor as the constitutional head. The Governor who is appointed for a period of five years appoints the Chief Minister and his council of ministers...
from the fund reserved for the physically challenged. Assistance has also been provided to construct houses for them. A special treatment unit has been set up in the Government Hospital at Sagar with an ambulance
Ambulance
An ambulance is a vehicle for transportation of sick or injured people to, from or between places of treatment for an illness or injury, and in some instances will also provide out of hospital medical care to the patient...
provided to shift the affected patients to the hospital. H. D. Kumaraswamy
H. D. Kumaraswamy
Hardanahalli Deve Gowda Kumaraswamy was Chief Minister of the state of Karnataka, India from February 4, 2006 to October 9, 2007. He is one of the sons of former Prime Minister of India H. D. Deve Gowda...
, then Chief Minister
Chief Minister
A Chief Minister is the elected head of government of a sub-national state, provinces of Sri Lanka, Pakistan, notably a state of India, a territory of Australia or a British Overseas Territory that has attained self-government...
of Karnataka
Karnataka
Karnataka , the land of the Kannadigas, is a state in South West India. It was created on 1 November 1956, with the passing of the States Reorganisation Act and this day is annually celebrated as Karnataka Rajyotsava...
spent a night at Handigodu village and has assured the Government's assistance in eradicating this disease.