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[诺曼-杰克恩小脑共济失调。7例西班牙患者的病例报告]

[Cerebellar ataxia of Norman-Jaeken. Presentation of seven Spanish patients].

作者信息

Pascual-Castroviejo I, Pascual-Pascual S I, Quijano-Roy S, Gutiérrez-Molina M, Morales M C, Velázquez-Fragua R, Maties M

机构信息

Servicio de Neurología Pediátrica, Hospital Universitario La Paz, 28046 Madrid, España.

出版信息

Rev Neurol. 2006;42(12):723-8.

Abstract

AIM

To show that the cerebellar ataxias described by Norman and by Jaeken (CDG1a) are the same disease.

PATIENTS AND METHODS

Seven patients, five females and two males (there were two siblings pairs), who presented a severe cerebellar disease slowly progressive associated with generalized cerebellar atrophy. The sister of one of the patients of the series had been studied because of psychomotor retardation but she died at two years of age due to respiratory problems. An autopsy was carried out that showed severe cerebellar atrophy, and the histological study revealed loss of granular cells and diverse abnormalities of Purkinje's cells, especially focal swellings of 'asteroid bodies' or 'cactus like' type. This suggested to us that Norman's ataxia and CDG1a could be the same pathological entity.

RESULTS

All seven patients had severe cerebellar hypoplasia-atrophy and a small brainstem. Most patients showed peripheral neuropathy with decreased motor nerve conduction velocity, but very little decreased sensory nerve conduction velocity. All seven patients had highly raised serum concentrations of asialotransferrin, and heterozygous molecular PMM2 deficit (CDG1a). One of these seven cases was the patient whose sister had histological cerebellar changes corresponding to Norman's ataxia.

CONCLUSION

The findings observed in our series suggest that the diseases described by Norman and Jaeken are the same pathological entity and CDG1a can be the biological basis of the histological changes of the cerebellum in Norman's ataxia. We suggest the name of Norman-Jaeken ataxia or disease for this entity.

摘要

目的

证明诺曼(Norman)所描述的小脑性共济失调与杰克恩(Jaeken)所描述的(先天性糖基化障碍1a型,CDG1a)是同一种疾病。

患者与方法

七名患者,五名女性和两名男性(有两对是兄弟姐妹),均患有严重的小脑疾病,呈缓慢进展,并伴有广泛性小脑萎缩。该系列中一名患者的姐姐因精神运动发育迟缓接受过研究,但她在两岁时因呼吸问题死亡。尸检显示严重的小脑萎缩,组织学研究发现颗粒细胞丢失以及浦肯野细胞的多种异常,尤其是“星状体”或“仙人掌样”类型的局灶性肿胀。这使我们认为诺曼型共济失调和CDG1a可能是同一病理实体。

结果

所有七名患者均有严重的小脑发育不全-萎缩以及脑干较小。大多数患者表现为周围神经病变,运动神经传导速度降低,但感觉神经传导速度降低很少。所有七名患者的血清去唾液酸转铁蛋白浓度均显著升高,且存在杂合子分子磷酸甘露糖异构酶2缺陷(CDG1a)。这七例中的一例就是其姐姐小脑组织学改变符合诺曼型共济失调的患者。

结论

我们系列研究中观察到的结果表明,诺曼和杰克恩所描述的疾病是同一病理实体,且CDG1a可能是诺曼型共济失调中小脑组织学改变的生物学基础。我们建议将该实体命名为诺曼-杰克恩共济失调或疾病。

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