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[桑德霍夫病的神经放射学演变改变]

[Evolutive neuroradiological alterations in Sandhoff's disease].

作者信息

Gutiérrez-Solana L G, Ruiz-Falcó M L, García-Peñas J J, Chabás A, Manzano-Blanco S, Gómez-Mardones G, López-Terradas J M

机构信息

Sección de Neuropediatria, Instituto de Bioquímica Clínica, Barcelonia, España.

出版信息

Rev Neurol. 1996 Oct;24(134):1263-6.

PMID:8983726
Abstract

Sandhoff's disease is a severe form of gangliosidosis GM2 which presents in the first year of life, basically as progressive psychomotor retardation and/or a macular red cherry spot. Our patient presented the clinical picture characteristic of the disease. Diagnosis was confirmed by determining the activity of hexosaminidases A and B in serum and of beta-N-acetil hexosaminases in fibroblast culture. In view of the fatal prognosis of the disease, in 1991 a transplant of alogenic bone marrow (TMO) was carried out to try to replace the enzymes. This required exhaustive radiological follow-up to determine the possible neuro-radiological changes seen in this storage disease. Although treatment was not successful, the neuro-radiological findings may be of interest as perhaps being characteristic of the GM2 gangliosidosis: 1. Bilateral thalamic hyperecogenity in the cerebral ecography. 2. Differences between the thalamo-putamen densities due to bilateral homogeneous thalamic hyperdensity on the CT scan. 3. Thalamic hypointensity both on T2 sequences and in proton density on MR with the cerebral white matter being progressively affected. In conclusion, we suggest that bilateral symmetrical thalamic changes are an early finding which is probably specific to the GM2 gangliosidoses and may be useful from the point of view of carrying out more specific investigations in infants suspected of having a degenerative neurological disorder.

摘要

桑德霍夫病是GM2神经节苷脂沉积症的一种严重形式,在出生后第一年发病,主要表现为进行性精神运动发育迟缓及/或黄斑樱桃红斑。我们的患者呈现出该病的典型临床表现。通过测定血清中己糖胺酶A和B以及成纤维细胞培养中的β-N-乙酰己糖胺酶的活性,确诊了该疾病。鉴于该病的预后不良,1991年进行了异体骨髓移植(TMO)以尝试替代酶。这需要进行详尽的放射学随访,以确定在这种贮积病中可能出现的神经放射学变化。尽管治疗未成功,但神经放射学发现可能会引起关注,因为它们可能是GM2神经节苷脂沉积症的特征:1. 脑超声检查显示双侧丘脑回声增强。2. CT扫描显示由于双侧丘脑均匀性高密度,丘脑-壳核密度存在差异。3. 在T2序列和质子密度加权像上,丘脑呈低信号,脑白质逐渐受到影响。总之,我们认为双侧对称性丘脑改变是一个早期发现,可能是GM2神经节苷脂沉积症所特有的,从对疑似患有退行性神经系统疾病的婴儿进行更具体检查的角度来看可能会有所帮助。

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