Yokoi S, Suzuki K, Amano N, Yagishita S
Department of Psychiatry, Yokohama City University Medical School, Japan.
No To Shinkei. 1988 Feb;40(2):141-7.
Lipid chemical analysis of a case of membranous lipodystrophy (Nasu-Hakola disease) was reported. The case is a 43 yr-old man (at death). Onset of the disease was at his age of 10 when he had complained of leg pain. Since his age of 14, he had bone fractures of the lower extremities many times. At the age of 35, he was admitted to a hospital for the neurological examination. At that time, he showed exaggerated tendon reflexes and intension tremor of the upper extremities. He was euphoric and demented. His IQ was 31. Histological examination of biopsy specimen from the bone marrow revealed the typical membrano-cystic lesion. He had status epilepticus which was followed by comatous state for a week. The disease progressed gradually and he fell into decorticated state. He died at the age of 43. The total clinical course was 33 years. The brain weighed 680 g. Remarkable atrophy was observed in the whole brain. Loss of nerve cells in the upper layers of the cortex was marked. There were loss of myelin sheath and severe gliosis in the white matter. A part of the brain, liver and subcutaneous fat was frozen at the time of autopsy for the chemical examination. Quantitative determination of cholesterol, glycolipid, phospholipid, free fatty acid in the brain and liver, cholesterol, free fatty acid, triglyceride in the subcutaneous fat were carried out. Cholesterol was decreased about 33% in the cortex and 42% in the white matter in comparing with those of controls and the content of cerbroside in the white matter was about 1/3 of that of controls.(ABSTRACT TRUNCATED AT 250 WORDS)
报告了一例膜性脂肪营养不良(纳苏 - 哈科拉病)的脂质化学分析情况。该病例为一名43岁男性(死亡时)。发病年龄为10岁,当时他诉说腿痛。自14岁起,他下肢多次骨折。35岁时,他因神经系统检查入院。当时,他出现腱反射亢进和上肢意向性震颤。他情绪欣快且痴呆。智商为31。骨髓活检标本的组织学检查显示典型的膜性囊肿病变。他发生了癫痫持续状态,随后昏迷一周。病情逐渐进展,他陷入去皮层状态。43岁时死亡。整个临床病程为33年。脑重680克。全脑观察到明显萎缩。皮质上层神经细胞丢失明显。白质中有髓鞘脱失和严重胶质增生。尸检时将部分脑、肝和皮下脂肪冷冻用于化学检查。对脑和肝中的胆固醇、糖脂、磷脂、游离脂肪酸以及皮下脂肪中的胆固醇、游离脂肪酸、甘油三酯进行了定量测定。与对照组相比,皮质中胆固醇降低约33%,白质中降低42%,白质中脑苷脂含量约为对照组的1/3。(摘要截断于250字)