Szabó Antal, Mechler Ferenc
Debreceni Egyetem, Oryos-és Egészségtudományi Centrum, Neurológiai Klinika, Debrecen.
Ideggyogy Sz. 2002 Sep 20;55(9-10):323-9.
Kennedy syndrome is a late-onset, bulbar-spinal type of muscular atrophy, with X-linked recessive inheritance. The characteristic features of the disease become prominent in the 4-5th decades: proximal muscle wasting and weakness, bulbar signs, fasciculations in skeletal muscles, subtle signs of endocrine dysfunction, such as gynaecomastia or testicular atrophy. The electrophysiological examinations are the keypoint to the diagnosis. Electroneurography shows normal conduction velocity in peripheral nerves, but the sensory nerves usually show axonal degeneration, which causes only very mild or subclinical neurological deficits. Electromyography shows chronic anterior horn cell degeneration in skeletal muscles. Molecular genetic diagnosis was introduced in 1991, when on abnormal expansion of CAG repeat was found in the first exon of the androgen receptor gene on chromosome X with a frequency of 100% in the affected population. Since the progression is very slow and these patients can expect a normal life span, it is essential to distinguish this syndrome from other, often more severe diseases, such as ALS. There is no proven therapy for Kennedy's disease yet. This is the first case of Kennedy's disease published in Hungary.
肯尼迪综合征是一种迟发性、延髓-脊髓型肌肉萎缩症,呈X连锁隐性遗传。该病的特征在40至50岁时变得明显:近端肌肉萎缩和无力、延髓体征、骨骼肌束颤、内分泌功能障碍的细微体征,如男性乳房发育或睾丸萎缩。电生理检查是诊断的关键。神经电图显示周围神经传导速度正常,但感觉神经通常显示轴突变性,仅导致非常轻微或亚临床神经功能缺损。肌电图显示骨骼肌慢性前角细胞变性。分子遗传学诊断于1991年引入,当时在X染色体上雄激素受体基因的第一个外显子中发现CAG重复序列异常扩增,在受影响人群中的频率为100%。由于病情进展非常缓慢,这些患者预期寿命正常,因此必须将该综合征与其他往往更严重的疾病,如肌萎缩侧索硬化症区分开来。目前尚无经证实的肯尼迪病治疗方法。这是匈牙利发表的首例肯尼迪病病例。