Globular glial tauopathy caused by MAPT P301T mutation: clinical and neuropathological findings.

OBJECTIVE: To describe the clinical, biochemical, and neuropathological findings of an autosomal dominant globular glial tauopathy caused by the P301T mutation at the MAPT gene. METHODS: Five patients from two unrelated pedigrees underwent clinical evaluation. Genetic analysis, brain pathological examination, and biochemical analysis of tau were performed. RESULTS: The patients studied were 3 men and 2 women with a mean age at onset of 52.2 years and mean disease duration of 5.2 years. Three patients presented a corticobasal syndrome, one patient an asymmetric pyramidal syndrome compatible with primary lateral sclerosis, and one patient a frontotemporal dementia. In both pedigrees (4 patients) Sanger sequencing showed the p.P301T mutation in exon 10 of the MAPT gene. Neuropathological findings consisted of atrophy of frontal and temporal lobes with marked spongiosis and astrogliosis, and abundant phosphorylated tau protein deposits in the frontal and temporal cortex, limbic area, basal ganglia, and brain stem. The most striking finding was the presence of oligodendroglial 4R phospho-tau globular positive inclusions in the white matter and cortex. Globose-type neurofibrillary neuronal tangles, and in particular astrocytic globular inclusions and coarse tufts, were present in the grey matter. Biochemical analysis of sarkosyl-insoluble fractions revealed two tau bands of 64 and 68 kDa and case-dependent bands of lower molecular weight. CONCLUSION: This is the first pathological and biochemical study of the MAPT p.P301T mutation showing variable clinical manifestation and neuropathological phenotype of globular glial tauopathy not only among different families but also within families.

[Primary eosinophilic colitis in a celiac patient]. / Colitis eosinofílica primaria en paciente con enfermedad celíaca.

Primary eosinophilic gastrointestinal disorders include a spectrum of inflammatory chronic diseases in which eosinophils infiltrate the gut in the absence of known causes of such tissue eosinophilia. They may affect any area of the gastrointestinal tract although exclusive colonic disease is exceptional. Due to their low prevalence these disorders are not usually taken into account when making a differential diagnosis in a patient with chronic diarrhea, which is the reason why in many cases the diagnosis can take many years. We describe the case of a patient with well-controlled celiac disease and chronic diarrhea of indeterminate origin. The final diagnosis was eosinophilic colitis. A complete response was obtained when she was treated with oral budesonide. Nowadays she remains asymptomatic.