Guevara Carlos, Barrientos Nelson, Flores Alex, Idiáquez Juan
Servicio de Neurología, Hospital Naval de Valparaíso.
Rev Med Chil. 2003 Oct;131(10):1179-82.
Familial amyloidotic polyneuropathy type I is an autosomal dominant inherited disorder characterized by progressive peripheral and autonomic neuropathy, associated with neural and systemic amyloid deposits. The abnormality usually lies in the transthyretin (TTR) gene. We report a 25 years old man with 18 months history of dysesthesias and pain in the toes, abnormal micturition and sexual dysfunction. Neurophysiologically studies disclosed a sensory-motor axonal polyneuropathy. Autonomic tests showed sympathetic and parasympathetic involvement. An electron micrograph of sural nerve revealed amyloid fibrils in the endoneurium. His mother died after a clinical history suggestive, in retrospect, of familial amyloidotic polyneuropathy type I. The clinical and genetic analysis of this cause of polyneuropathy are discussed.
I型家族性淀粉样多神经病是一种常染色体显性遗传性疾病,其特征为进行性外周和自主神经病变,并伴有神经和全身淀粉样沉积。异常通常存在于转甲状腺素蛋白(TTR)基因中。我们报告一名25岁男性,有18个月的脚趾感觉异常和疼痛、排尿异常及性功能障碍病史。神经生理学研究显示为感觉运动性轴索性多神经病。自主神经测试表明交感神经和副交感神经均受累。腓肠神经的电子显微镜照片显示神经内膜中有淀粉样原纤维。他的母亲在回顾性诊断为疑似I型家族性淀粉样多神经病的临床病史后去世。本文讨论了这种多神经病病因的临床和基因分析。