Radke Josefine, Stenzel Werner, Goebel Hans Hilmar
Department of Neuropathology, Charité - Universitätsmedizin, Berlin, Germany.
Department of Neuropathology, Charité - Universitätsmedizin, Berlin, Germany.
Handb Clin Neurol. 2017;145:133-146. doi: 10.1016/B978-0-12-802395-2.00009-2.
Neurometabolic and neurodegenerative diseases in children (NDDC) differ from those in adults in that most of the former are autosomal-recessively inherited - few have X-linked inheritance - while the latter are often sporadic or autosomal-dominantly inherited. NDDC may be catabolic and/or anabolic conditions, some of which combine maldevelopmental and degenerative features, for instance, peroxisomal biogenesis disorders or congenital disorders of glycosylation. NDDC are often multiorgan disorders, such as lysosomal, peroxisomal, and polyglucosan disorders. This multiorgan involvement may be marked by extracerebral formation of disease-specific neuropathologic findings, especially in lysosomal diseases allowing diagnostic biopsies in easily accessible tissues, e.g., blood lymphocytes, skin, skeletal muscle, and rectum to be investigated by electron microscopy. NDDC comprise nonvacuolar and vacuolar lysosomal, peroxisomal, polyglucosan, amino and organic acid, white-matter disorders, and congenital disorders of glycosylation.
儿童神经代谢性和神经退行性疾病(NDDC)与成人的此类疾病不同,前者大多为常染色体隐性遗传,少数为X连锁遗传,而后者通常为散发性或常染色体显性遗传。NDDC可能是分解代谢和/或合成代谢状态,其中一些兼具发育异常和退行性特征,例如过氧化物酶体生物发生障碍或先天性糖基化障碍。NDDC往往是多器官疾病,如溶酶体、过氧化物酶体和多聚葡萄糖疾病。这种多器官受累可能表现为在脑外形成疾病特异性神经病理学表现,尤其是在溶酶体疾病中,这使得可以对易于获取的组织(如血淋巴细胞、皮肤、骨骼肌和直肠)进行诊断性活检,通过电子显微镜进行研究。NDDC包括非空泡性和空泡性溶酶体、过氧化物酶体、多聚葡萄糖、氨基酸和有机酸、白质疾病以及先天性糖基化障碍。