title: [Two siblings of Leber's congenital amaurosis with an increase in very long chain fatty acid in blood: relationship between peroxisomal disorders and Leber's congenital amaurosis].
abstract: We reported two siblings of Leber's congenital amaurosis associated with increased level of very long chain fatty acid (VLCFA) in blood. Case 1, a 3 1/2-year-old boy had congenital blindness, severe psychomotor retardation, hepatomegaly, profound hypotonia, loss of deep tendon reflexes, muscular atrophy and weakness, and non-convulsive status epilepticus characterized by a sudden respiratory failure, and also showed a flat electroretinogram, non-pigmentary retinal degeneration, severe atrophy of the brain stem and cerebellum, hepatic fibrosis, decreased motor and sensory conduction velocities and atlanto-axial instability. Sural nerve biopsy revealed severely decreased number of total myelinated fibers without remarkable demyelination or remyelination. Case 2, an elder sister of case 1, with pigmentary retinal degeneration, hepatomegaly and pericarditis had died at 3 months. Autopsy revealed hypomyelination and heterotopy of the cerebral white matter, hepatic fibrosis, renal microcysts and normal adrenal cytoarchitecture. In case 1, the level of VLCFA was increased twofold and sevenfold of controls in serum and in red cell membrane, respectively. Phytanic or trihydroxycholestanoic acid was not detected in the serum and bile. Normal shaped peroxisomes were definitely recognized in biopsied liver by means of electronmicroscopic histochemistry. From the above findings, these patients was thought to be a new variant of peroxisomal disorders relating to degradation of VLCFA, other than Zellweger syndrome, infantile Refsum disease and infantile adrenoleukodystrophy. It was concluded that peroxisomal functions should be studied in cases of Leber's congenital amaurosis.
authors: K
authors: K
authors: Haginoya
authors: J
authors: J
authors: Aikawa
authors: T
authors: T
authors: Noro
authors: M
authors: M
authors: Watanabe
authors: K
authors: K
authors: Iinuma
authors: K
authors: K
authors: Narisawa
authors: K
authors: K
authors: Tada
mesh_terms: D015094:3-Hydroxyacyl CoA Dehydrogenases / Q000172:deficiency*; D002675:Child, Preschool; D004746:Enoyl-CoA Hydratase / Q000172:deficiency*; D005227:Fatty Acids / Q000097:blood*; D005260:Female; D015417:Hereditary Sensory and Motor Neuropathy / Q000378:metabolism*; D006801:Humans; D006836:Hydro-Lyases; D007535:Isomerases; D008099:Liver / Q000166:cytology; D008297:Male; D008830:Microbodies / Q000648:ultrastructure; D008854:Microscopy, Electron; D009097:Multienzyme Complexes; D015418:Optic Atrophies, Hereditary / Q000378:metabolism* / Q000473:pathology; D063994:Peroxisomal Bifunctional Enzyme
chemical_list: D005227:Fatty Acids; D009097:Multienzyme Complexes; D015094:3-Hydroxyacyl CoA Dehydrogenases; D006836:Hydro-Lyases; C576253:EHHADH protein, human; D004746:Enoyl-CoA Hydratase; D063994:Peroxisomal Bifunctional Enzyme; D007535:Isomerases