Neurology 2012;79:21–22 Two disease mechanisms operate in Lafora progressive myoclonus epilepsy (Lafora PME) to produce 3 phenotypes (epilepsy, rapid neurologic deterioration, and Lafora polyglucosan inclusion bodies). These 2 disease mechanisms are 1) an error in glycogen metabolism and 2) neurodegeneration. The question is, which comes first and which is primary and more important in disease ...

Wolman disease and cholesteryl ester storage disease (CESD) are caused by a deficiency of lysosomal acid lipase activity, resulting in massive accumulation of cholesteryl ester and triglycerides. Wolman disease occurs in infancy, with hepatosplenomegaly, steatorrhea and adrenal calcification. It is fatal before the age of 1 year. In CESD, hepatomegaly may be the only clinical abnormality, altho...

319 Olfaction in Parkin heterozygotes and compound heterozygotes: The CORE-PD study R.N. Alcalay, A. Siderowf, R. Ottman, E. Caccappolo, H. Mejia-Santana, M.-X. Tang, L. Rosado, E. Louis, D. Ruiz, C. Waters, S. Fahn, L. Cote, S. Frucht, B. Ford, M. Orbe-Reilly, B. Ross, M. Verbitsky, S. Kisselev, C. Comella, A. Colcher, D. Jennings, M. Nance, S. Bressman, W.K. Scott, C. Tanner, S. Mickel, M. Re...

Wilson's disease is one form of cirrhosis affecting young people that is often amenable to treatment. It is therefore important to pick out patients with this condition from the whole group of juvenile cirrhotics. We here report a patient who suffered from a familial cirrhosis. He showed some but not all of the biochemical features of Wilson's disease and had copper deposition in the liver much...

In 1882, Philippe Gaucher described a 32-year-old woman with massive splenomegaly and unusually large cells in the spleen, which he called a "primary epithelioma of the spleen." The systemic nature and inheritance of the disease and its variants involving the viscera and CNS were described over the next century. The delineation of the causal enzymatic defects, genetics, molecular pathology, and...

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ease. The underlying metabo lic defect i s deficiency of lysosomal enzyme cer amidetrihexosidase. The disease has multisystem i nvo lvement. Neur ol og ical man ifestations i ncl ude smal l-fiber po lyneuropathy man ifested as painful distal extr emities and anhidrosis. Fabry’s disease also presents with both s ma ll -v ess el a nd cor ti cal mu l ti pl e cerebral i nfarcts. Enzyme-replacement ...

Cholesteryl ester storage disease (CESD) is an autosomal recessive chronic liver disease caused by lysosomal acid lipase (LAL) deficiency. The gene is located on chromosome 10q23.2-q23.3, and the enzyme is essential for triglycerides and cholesteryl ester hydrolysis in lysosomes. CESD is characterized by hypercholesterolemia, hypertriglyceridemia, HDL deficiency, and abnormal lipid deposition i...

A patient with a lysosomal storage disease, progressive neurologic degeneration, and renal failure was found to have accumulated a low molecular weight nin-hydrin and phenol-HzS04 reactive compound. Amino acid analysis and gas chromatography-mass spectrometry identified a glutamic acid moiety. Direct insertion mass spectrometry proved the carbohydrate portion to be a sugar phosphate. NaB3H4 red...