ABSTRACT
El síndrome de Sjogren-Larsson se caracteriza por retardo mental, ictiosis congènita y diplejía o cuadriplejía espástica. El defecto primario en este síndrome es la mutación del gen ALDH3A2, que codifica la enzima aldehído deshidrogenasa grasa y causa una deficiencia enzimática que produce una acumulación de alcoholes y aldehídos grasos en los tejidos que comprometen la integridad de la membrana celular, cuyos efectos pueden observarse en la piel, los ojos y el sistema nervioso central. El diagnóstico se realiza por medio de la cuantificación de la actividad de la enzima. Se describe el caso de una paciente con signos clínicos patognomónicos del síndrome de Sjogren-Larsson, cuyo diagnóstico se realizó por medio de la cuantificación de la actividad enzimática en un cultivo de fibroblastos. Además, tomando en cuenta el árbol genealógico de la paciente, se realizó el estudio en los padres y un hermano con signos sugestivos del síndrome de Sjogren-Larsson.
Sjogren-Larsson syndrome is characterized by congenital ichthyosis, mental retardation and spastic diplegia or quadriplegia. The primary defect in this syndrome is mutation of ALDH3A2 gen that codes for the fatty aldehyde dehydrogenase. Deficiency of this enzyme causes an accumulation of fatty alcohols and fatty aldehydes, leading to altered cell-membrane integrity. Skin, eyes, and the central nervous system are affected latter. The diagnosis is carried out through the cuantification of the enzyme activity.
Subject(s)
Humans , Female , Child , Sjogren-Larsson Syndrome/diagnosis , Aldehyde Oxidoreductases/genetics , Sjogren-Larsson Syndrome/genetics , Fibroblasts/enzymology , MutationABSTRACT
Las ictiosis hereditarias son un grupo de desórdenes mendelianos, con manifestaciones clínicas y alteraciones genéticas heterogéneas caracterizadas por la presencia de escamas y/o hiperqueratosis. Las ictiosis sindrómicas son aquellas en las que el defecto genético se manifiesta en la piel y también en otros órganos. Presentamos 7 pacientes con ictiosis sindrómicas: un síndrome IFAP (ictiosis folicular, atriquia, fotofobia), un síndrome de Conradi-Hünermann-Happle (CHH), dos síndromes de Netherton (SN), dos síndromes de Sjögren-Larsson (SSL) y un síndrome KID (queratitis, ictiosis, sordera). Se analizan las características clínicas y diagnósticas de nuestros pacientes (AU)
Inherited ichthyosis are a group of clinical and genetic heterogeneous disorders characterized by the presence of scales, hyperkeratosis or both. In syndromic ichthyosis, the genetic defect involves the skin and other organs. We present 7 patients with syndromic ichthyosis: a case of IFAP syndrome (ichthyosis follicularis with alopecia and photophobia), a case of Conradi-Hünermann-Happle (CHH) syndrome, two cases of Netherton syndrome, two cases of Sjögren-Larsson syndrome and a case of KID syndrome (keratitis, ichthyosis and deafness). We analyze the diagnostic and clinical features of our patients (AU)
Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Ichthyosis/etiology , Ichthyosis/pathology , Alopecia , Ichthyosis, X-Linked , Netherton Syndrome , Photophobia , Sjogren-Larsson SyndromeABSTRACT
Sjogren-Larsson syndrome (SLS) is a rare autosomal recessive neurocutaneous disorder with worldwide incidence of 0.4 per 100,000 people. It is characterized by the triad of congenital ichthyosis, spastic diplegia or quadriplegia, and mental retardation. Herein we report a 2-year-old male child with SLS, asthma, and recurrent pneumonia. SLS was confirmed by a molecular genetics study that revealed a deletion mutation in the ALDH3A2 gene. An ALDH3A2 gene mutation results in dysfunction of the microsomal enzyme fatty aldehyde dehydrogenase and impaired metabolism and accumulation of leukotriene B4, which is a key molecule and a pro-inflammatory mediator in developing allergic diseases, especially asthma. An increased level of leukotriene B4 has been reported in SLS patients. As far as we are aware, this is the first report of SLS associated with asthma and recurrent pneumonia. In conclusion, pediatricians should be aware of and evaluate patients with SLS for possible associated asthma and allergic disorders.
Subject(s)
Child , Child, Preschool , Humans , Male , Aldehyde Dehydrogenase , Asthma , Cerebral Palsy , Ichthyosis , Incidence , Intellectual Disability , Leukotriene B4 , Metabolism , Molecular Biology , Neurocutaneous Syndromes , Pneumonia , Quadriplegia , Sequence Deletion , Sjogren-Larsson SyndromeABSTRACT
Sjogren Larsson Syndrome [SLS; OMIM: 270200] is an autosomal recessive neurocutaneous disorder characterized by mental retardation, congenital ichthyosis and spastic paraplegia. SLS is caused by mutations in aldehyde dehydrogenase 3A2 isoform 2 [ALDH3A2], which encodes fatty aldehyde dehydrogenase [FALDH]. This enzyme metabolizes the NAD-dependent oxidation of long chain aldehyde derived from lipid metabolism. Up to now, more than 72 mutations have been reported in SLS patients. DNA was extracted from peripheral blood of all the five patients, one healthy sibling and their parents using standard procedures. SNP genotyping was performed using the GeneChip [registered sign]. Multipoint linkage analyses and non-parametric linkage analysis was performed too. Results: Here, we report an interesting family with five affected individuals with a novel splice site mutation [c.1107+1delGTA] in ALDH3A2. In absence of capability to measure FALDH activity in Iran, DNA sequencing of the ALDH3A2 gene could lead to the identification of causative mutation and confirm the diagnosis
Subject(s)
Humans , Female , Male , Sjogren-Larsson Syndrome/genetics , Skin Diseases , Ichthyosis , Consanguinity , MutationABSTRACT
Relatam-se os casos de dois irmãos consanguíneos com síndrome de Sjögren- Larsson, enfatizando a importância clínica do exame oftalmológico. BPLS, masculino, 11 anos e MBLS, feminino, 10 anos, irmãos de pais não-consanguíneos, apresentando ictiose congênita, diplegia espástica e retardo mental. Ao exame oftalmológico, apresentavam miopia, fotofobia, baixa acuidade visual. A fundoscopia, presença de cristais branco-amarelados em área foveal e parafoveal em ambos os olhos. Aconselhamento genético foi realizado. O manejo foi de suporte. A Síndrome de Sjögren-Larsson é uma rara doença autossômica recessiva em que há 100 por cento de penetrância. Síndrome de Sjögren-Larsson é classicamente caracterizada por ictiose, espasticidade e deficiência mental. A doença é causada por mutações no gene aldeído desidrogenase. As alterações oculares observadas são geralmente bilaterais, cristais branco-amarelados em área retiniana, que aparecem nos dois primeiros anos de vida e que vão aumentando em número com a idade. As anormalidades oculares não têm relação com a severidade da ictiose ou com as anormalidades neurológicas. Acredita-se que as lesões oftalmológicas sejam um sinal patognomônico da síndrome. É necessário enfatizar a importância do diagnóstico precoce e possibilidades de tratamento dietético.
Sjogren - Larsson syndrome is a rare autosomal recessively inherited neurocutaneous disorder which occurs with 100 percent penetrance and is classically characterized by ichthyosis, spasticity and mental handicap. The disease is caused by mutations in the aldehyde dehydrogenase gene. The ocular manifestations are highly characteristic bilateral, glistening yellow-white retinal dots from the age of 1 to 2 years onward. The number of dots increases whit age. The extent of the macular abnormality does not correlate with the severity of the ichthyosis or with the severity of the neurological abnormalities. We report the clinical characteristics and ocular manifestations associated with the Sjögren-Larsson syndrome in two siblings, emphasizing the clinical importance of the ophthalmological examination of the Sjögren-Larsson syndrome. BPLS, a eleven year old boy and MPLS, a ten year old girl from non-consanguinous parents, presenting congenital ichthyosis, spastic diplegia and mental retardation. Miopia, fotofobia, subnormal visual acuity and glistening yellow-white crystalline deposits that were located in the foveal and parafoveal area were found in the ophthalmologic examination.
Subject(s)
Humans , Male , Female , Child , Sjogren-Larsson Syndrome/complications , Sjogren-Larsson Syndrome/diagnosis , Sjogren-Larsson Syndrome/genetics , Macula Lutea/pathology , Macular Degeneration/etiology , Cerebral Palsy , Ichthyosis , Macular Degeneration/diagnostic imaging , Intellectual Disability , Muscle SpasticityABSTRACT
Apresentação de um caso de distrofia macular cristalina em paciente do sexo feminino com síndrome de Sjögren-Larsson. A doença caracteriza-se pela tríade: ictiose congênita, diplegia ou tetraplegia espástica e retardo mental. Os olhos são acometidos em até 100% dos casos sendo característica a presença de maculopatia cristalina como observado na paciente relatada. À fundoscopia observou-se a presença de depósitos esbranquiçados perifoveais. A tomografia de coerência óptica evidenciou pontos hiper-reflexivos correspondentes aos depósitos intrarretinianos, atrofia macular com redução na espessura macular em ambos os olhos. Os achados relacionados à síndrome, à tomografia de coerência óptica foram apresentados de maneira inédita em nosso meio.
Presentation of a case of crystalline macular distrophy diagnosed in a female patient with Sjögren-Larsson syndrome. The disease consists of clinical findings of spastic diplegia or tetraplegia, mental retardation, and congential ichthyosis. The eyes are affected in up to 100% of cases, and crystalline maculopathy is the main finding as described in this case report. On fundus examination multiple white dots were observed at ophthalmoscopy. The optical coherence tomography has shown not only the hipereflexive intraretinal spots but also macular atrophy with macular thickness reduction. The tomographic findings were first described in our country.
Subject(s)
Adolescent , Female , Humans , Macula Lutea/pathology , Macular Degeneration/etiology , Sjogren-Larsson Syndrome/complications , Macular Degeneration/diagnosis , Tomography, Optical CoherenceABSTRACT
We report a case of an incidental finding of intrathyroid lymph node tissue in a 40-year-old Egyptian female presenting with multinodular goiter. Collections of lymphoid tissue surrounded by capsule and mature fat cells were seen enclosed by normal thyroid follicles. Heteroplasia or deviation of the normal anatomy of the cervical lymph node groups may explain the presence of this lymphoid tissue
Subject(s)
Humans , Female , Lymph Nodes , Lymphoid Tissue/abnormalities , Lymphoid Tissue/embryology , Thyroid Gland , Hashimoto Disease , Sjogren-Larsson Syndrome , Myasthenia Gravis , Immunohistochemistry , Thyroid NeoplasmsABSTRACT
A síndrome de Sjögren-Larsson (SJL) é distúrbio raro, autossômico recessivo, caracterizado pela tríade clássica de ictiose congênita, retardo mental e tetraplegia ou diplegia espástica. Trata-se de um erro inato do metabolismo dos lipídios, causado pela deficiência da enzima microssômica aldeído graxo desidrogenase. Os achados de imagem do encéfalo na SJL demonstram atrofia cerebral e alteração da substância branca. A espectroscopia de prótons, com poucos casos relatados, caracteriza-se pelo elevado pico de lipídios e redução de N-acetil-aspartato. Apresentamos três casos de SJL, com ênfase nos achados da ressonância magnética e da espectroscopia de prótons.
Subject(s)
Adolescent , Child , Child, Preschool , Female , Humans , Male , Aspartic Acid/analogs & derivatives , Brain/pathology , Lipid Metabolism , Sjogren-Larsson Syndrome/pathology , Aspartic Acid/metabolism , Brain/metabolism , Magnetic Resonance Imaging , Magnetic Resonance SpectroscopyABSTRACT
Aprocechando el caso de una niña que se presento en el Hospital Daniel Bracamonte de la ciudad de Potosi, se describe la enfermedad que engloba a un grupo de enfermedades que pertenecen al grupo de las colagenosis. La esclerodermia (del griego esclero.dura y dermia-piel) es uan enfermedad rara de naturaleza autoinmune y todas ellas tienen como sintomas comunes el endurecimiento de la piel y adelgazamiento cutaneo: La esclerosis sistemica no solo afecta al sistema autoinmune sino a la pared de los vasos sanguineos y el tejido conectivo
Subject(s)
Humans , Female , Adolescent , Scleroderma, Systemic/classification , Scleroderma, Systemic/complications , Scleroderma, Systemic/diagnosis , Collagen/administration & dosage , Extremities , Sjogren-Larsson Syndrome , Sjogren-Larsson Syndrome/classification , Sjogren-Larsson Syndrome/complications , Sjogren-Larsson Syndrome/diagnosisABSTRACT
Two male siblings aged 8 and 11 years, born of non-consanguineous parents, presented with classical triad of congenital ichthyosis, mental retardation and spastic diplegia. They had no eye, hair, nails and teeth changes. MRI showed diffuse dysmyelination.
Subject(s)
Child , Humans , Magnetic Resonance Imaging , Male , Intellectual Disability/pathology , Siblings , Sjogren-Larsson Syndrome/pathologyABSTRACT
Sjogren-Larsson Syndrome is a rare autosomal disorder which occurs with 100% penetrance and is classically characterized by ichthyosis, spasticity and mental handicap. This has rarely been described in people of Indian origin, case reports mainly being restricted to Caucasians. We have described a 6-year-old girl with classical features of this syndrome, the symptoms having started in infancy. The spasticity is mainly diplegic in nature. Skin changes of ichthyosis are generalized and more in the flexural areas. Mental retardation is severe. Management is supportive.
Subject(s)
Child, Preschool , Female , Follow-Up Studies , Humans , Sjogren-Larsson Syndrome/diagnosisABSTRACT
A Síndrome de Sjögren-Larsson é uma doença autossômica recessiva rara com distribuiçäo universal. Consiste em ictiose, displegia espástica e retardo mental causado por um defeito enzimático na oxidaçäo do álcool-graxo. Nós relatamos dois casos e fazemos uma revisäo da literatura respectiva. As duas crianças tinham atividade deficiente da NAD oxidorredutase. Foram estudados os lípides de membrana das células plasmáticas e eritrócitos. Bons resultados foram obtidos em um dos pacientes quando submetido a dieta na infância precoce o que se correlacionou com diminuiçäo do álcool-graxo no plasma. Entretanto näo obtivemos melhora clínica no outro paciente cujo tratamento teve início tardio.Terapia com etretinato foi necessária para controlar os sintomas cutâneos neste segundo paciente.
Subject(s)
Humans , Infant , Child, Preschool , Infant, Newborn , Female , Male , Lipids/analysis , Alcohol Oxidoreductases/metabolism , Sjogren-Larsson Syndrome/diet therapy , Fatty Alcohols/metabolism , Fatty Acids, Essential , Fibroblasts/enzymology , Hospitalization , Ichthyosis/pathology , Intellectual Disability/pathology , Muscle Spasticity/pathology , SkinABSTRACT
Sjogren-Larsson syndrome is a rare autosomal recessive neurocutaneous disorder due to a deficiency of the fatty aldehyde dehydrogenase. It consists of ichthyosis, spastic di- or quardriplegia and mental retardation. We report a case of a 9-year-old boy who was suspected to have Sjogren-Larsson syndrome. He had congenital ichthyosis, spastic diplegia and mental retardation. In addition, there was macular degeneration on the fundus. His neurological symptoms were improved after selective posterior rhizotomy and rehabilitation therapy. However, the dermatological problem did not subside with conservative treatment.
Subject(s)
Child , Humans , Male , Aldehyde Dehydrogenase , Cerebral Palsy , Ichthyosis , Intellectual Disability , Macular Degeneration , Muscle Spasticity , Neurocutaneous Syndromes , Rehabilitation , Rhizotomy , Sjogren-Larsson SyndromeABSTRACT
A 9-year-old boy with classical features of Sjogren-Larsson syndrome was reported. He had had diffuse dry skin with ichthyotic scales since birth. The skin biopsy was compatible with ichthyosis. At the age of two he was unable to walk normally and also had learning problems. Neurological examination revealed spastic paraparesis, macular degeneration and mild mental retardation. MRI of the brain and spinal cord revealed subcortical white matter and corpus callosal lesions as well as focal cerebral atrophy and diffuse spinal cord atrophy.
Subject(s)
Biopsy , Child , Gait , Humans , Magnetic Resonance Imaging , Male , Neurologic Examination , Pedigree , Sjogren-Larsson Syndrome/diagnosisABSTRACT
Sjögren-Larsson syndrome(SLS) is a rare hereditable disease characterized by congenital ichthyosis, spastic diplegia and mental retardation. Along with the typical triad of symptoms, many patients with this disease have short stature, kyphosis and glistening dots in the retina of the eye. The pathogenesism is unknown but recent studies suggest that SLS might be, at least in part, a disorder of fatty acid metabolism. We describe a patient with a pathognomonic finding in the fundus and with the classic features of SLS.
Subject(s)
Humans , Cerebral Palsy , Ichthyosis , Intellectual Disability , Kyphosis , Metabolism , Retina , Sjogren-Larsson SyndromeABSTRACT
The Sjogren-Larsson syndrome is genetically determined syndrome with autosomal recessive inheritence and characterized by the three cardinal signs: congenital ichthyosis, spastic di/tetraplegia, and mental retardation. Ocular signs include ectropion, blepharitis, conjunctivitis, keratitis, and macular glistening spot. The authors have experienced a case of Sjogren-Larsson syndrome that showed classical triad and macular glistening spot in a 16 month old boy.
Subject(s)
Humans , Infant , Male , Blepharitis , Conjunctivitis , Ectropion , Ichthyosis , Intellectual Disability , Keratitis , Muscle Spasticity , Sjogren-Larsson SyndromeABSTRACT
Sjogren-Larsson Syndrome is a rare disorder chracterized by congenital icthyosis, spastic diplegia or tetraplegia and mental retardation. The inheritance is autosomal recessive, due to deficiency of alcohol dehydrogenase activity of fatty acid matabolism. We have experienced a case of Sjogren-Larsson Syndrome in a 16 month-old male children who have dried thick skin, developmental delay, and spastic diplegia. He also has glistening spot on macula area with irregular high voltage slow wave (2-3Hz) on electroencephalography. From Biopsy finding, Lamella ictyosis with acanthosis and hyperkeratosis in epithelium is shown. He was much improved clinically for skin lesion and developmental status with etretinate supplement. We report the case with brief review of related literatures.