Göpel W, Tuschy U, Gerlach K D
Neurologischen Klinik Bezirksnervenklinik Hildburghausen.
Z Gesamte Inn Med. 1990 Nov 15;45(22):689-91.
In a 32-year-old patient on account of an insufficiency of the adrenal cortex as well as of a leg-related tetraspasticity with a simultaneous subclinical peripheral neuropathy after exclusion of other endocrine and neurological diseases which are to be regarded differential-diagnostically the diagnosis of a myeloneuropathic adult variant of the adrenoleukodystrophy, the adrenomyeloneuropathy, was made. The disease in question is an x-chromosomally inherited disease, the basis of which is a metabolic disease in the destruction of long-chained fatty acids as basal disturbance. The cerebral radiologic exclusion diagnostics was made with CCT and MRT. On the basis of the literature the differential-diagnostic problems of this rare subspecies of the adrenoleukodystrophy which is at present causally not to be treated are discussed and it is referred to the clinical conclusions concerning a timely hormonal substitution therapy and genetic consultation.
一名32岁患者,因肾上腺皮质功能不全以及腿部相关的四肢痉挛,同时排除其他需进行鉴别诊断的内分泌和神经系统疾病后存在亚临床周围神经病变,被诊断为肾上腺脑白质营养不良的脊髓神经病性成人型,即肾上腺脊髓神经病。所讨论的疾病是一种X染色体隐性遗传病,其基础是一种代谢性疾病,即长链脂肪酸破坏作为基本紊乱。通过计算机断层扫描(CCT)和磁共振成像(MRT)进行脑部放射学排除诊断。基于文献,讨论了目前无法进行病因治疗的这种罕见的肾上腺脑白质营养不良亚型的鉴别诊断问题,并提及了关于及时进行激素替代治疗和遗传咨询的临床结论。