title: Cerebrotendinous xanthomatosis.
abstract: Cerebrotendinous xanthomatosis (CTX) is a familial sterol storage disease based on an inborn error of metabolism involving bile acid synthesis. Predominant clinical features are a chronic progressive neurological syndrome, mental deterioration, bilateral cataract and xanthomas. The presence of xanthomas usually leads to the diagnosis, and the reverse is probably also true: without xanthomas the diagnosis will often not be made. CTX may therefore be less rare than commonly thought, and the incidence of xanthomas in CTX may be overestimated. Four cases without xanthomas among the presenting symptoms are described, and the relevance of xanthomas in CTX is discussed.
authors.affiliation: Department of Neurology and Clinical Neurophysiology, University Hospital, Leiden, The Netherlands.
authors.forename: J L
authors.initials: JL
authors.lastname: van Hellenberg Hubar
authors.forename: E M
authors.initials: EM
authors.lastname: Joosten
authors.forename: R A
authors.initials: RA
authors.lastname: Wevers
mesh_terms: D000125:Achilles Tendon / Q000473:pathology; D000328:Adult; D001928:Brain Diseases, Metabolic / Q000175:diagnosis / Q000235:genetics*; D002869:Chromosome Aberrations / Q000235:genetics; D025063:Chromosome Disorders; D003937:Diagnosis, Differential; D005260:Female; D005808:Genes, Recessive / Q000235:genetics; D006801:Humans; D008297:Male; D008875:Middle Aged; D019965:Neurocognitive Disorders / Q000175:diagnosis / Q000235:genetics; D009460:Neurologic Examination; D012026:Reflex, Stretch / Q000235:genetics; D014972:Xanthogranuloma, Juvenile / Q000175:diagnosis / Q000235:genetics*