Department of Pediatrics, Saqr Hospital, Ras Al-Khaimah P.O. Box 5450, United Arab Emirates.
Department of Pediatrics, RAK College of Medical Sciences, RAKMHSU, Ras Al-Khaimah P.O. Box 11172, United Arab Emirates.
Medicina (Kaunas). 2024 Aug 15;60(8):1322. doi: 10.3390/medicina60081322.
Infantile neuroaxonal dystrophy (INAD) is a rare neurodegenerative disorder affecting 1:1,000,000 children. It results from pathogenic variants in the PLA2G6 gene located on chromosome 22q13.1. The onset of symptoms usually occurs between 6 and 18 months, causing developmental regression leading to debilitating symptoms such as muscle weakness, dementia, and loss of basic skills. Eventually, it progresses to life-threatening symptoms, including breathing difficulties, which limit the life expectancy to 5-10 years. While potential genetic therapies for treatment are being developed, they are yet to be approved for use, and management remains essentially supportive. This case report is about a nine-year-old Pakistani girl with INAD. She presented with recurrent chest infections, developmental regression, loss of speech, paralysis, hypertension, and eventually breathing difficulties. Brain magnetic resonance imaging and genetic testing confirmed the diagnosis. This case posed diagnostic challenges in view of its overlapping clinical presentation. Through this report, we aim to raise awareness about this condition among practitioners, outline the importance of genetic counseling in susceptible couples, and suggest potential areas of further research.
婴儿神经轴索性营养不良(INAD)是一种罕见的神经退行性疾病,影响 1/100 万儿童。它是由位于 22q13.1 染色体上的 PLA2G6 基因突变引起的。症状通常在 6 至 18 个月之间开始出现,导致发育倒退,出现肌肉无力、痴呆和丧失基本技能等衰弱症状。最终,它会发展为危及生命的症状,包括呼吸困难,这将预期寿命限制在 5-10 年。虽然正在开发用于治疗的潜在基因疗法,但它们尚未获得批准使用,管理仍然主要是支持性的。本病例报告是关于一名患有 INAD 的 9 岁巴基斯坦女孩。她反复出现胸部感染、发育倒退、丧失语言能力、瘫痪、高血压,最终出现呼吸困难。脑部磁共振成像和基因检测证实了诊断。鉴于其重叠的临床表现,该病例提出了诊断挑战。通过本报告,我们旨在提高临床医生对此病症的认识,强调在易感夫妇中进行遗传咨询的重要性,并提出进一步研究的潜在领域。