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Hereditary endotheliopathy, retinopathy, nephropathy, and stroke

Other Names for this Disease
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Hereditary endotheliopathy with retinopathy, nephropathy, and stroke (HERNS) is a rare genetic condition that affects the vascular endothelium (the inner lining of the arteries and blood vessels). Specifically, the small blood vessels of the brain (microangiopathy); retina (vascular retinopathy); and kidneys are affected. Signs and symptoms may include progressive adult onset vision loss, psychiatric disturbances, stroke-like episodes, neurologic decline, and kidney disease. HERNS is inherited in an autosomal dominant manner.[1][2][3][4]

The term retinal vasculopathy with cerebral leukodystrophy (RVCL) has recently been adopted to include HERNS; cerebroretinal vasculopathy (CRV); and hereditary vascular retinopathy (HVR); historically, these 3 conditions have been considered distinct. Genetic studies have shown that these 3 conditions are likely variations of RVCL and are caused by mutations in the TREX1 gene.[5]
Last updated: 10/9/2013


  1. Dichgans M, Meschia JF. Cerebrovascular disorders. In: Rimoin DL et al. Principle and Practice of Medical Genetics, 5th ed. Philadelphia, PA: Churchill Livingston Elsevier; 2002;
  2. Jen JC, Baloh RW. Herediatry endotheliopathy with retinopathy, nephropathy, and stroke (HERNS). In: Bogousslavsky J, Caplan L., eds. Uncommon Causes of Stroke. 2nd ed. Cambridge University Press; 2001;
  3. Seifried C, Sitzer M, Jen J, Auburer G. HERNS. A rare, hereditary, multisystem disease with cerebral microangiopathy. Nervenartz. 2005;
  4. Cohn AC, Kotschet K, Veitch A, Delatycki MB, McCombe MF. Novel ophthalmological features in hereditary endotheliopathy with retinopathy, nephropathy and stroke syndrome. Clin Experiment Ophthalmol. April 2005; 33(2):181-183.
  5. David Kavanagh et al. New roles for the major human 3'–5' exonuclease TREX1 in human disease. Cell Cycle. June 15, 2008; 7(12):1718-1725.
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In Depth Information

  • The Online Mendelian Inheritance in Man (OMIM) is an catalog of human genes and genetic disorders. Each entry has a summary of related medical articles. It is meant for health care professionals and researchers. OMIM is maintained by Johns Hopkins University School of Medicine. 
  • Orphanet is a European reference portal for information on rare diseases and orphan drugs.  Access to this database is free of charge.
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