[Progress in molecular chorea diagnosis. McLeod syndrome and chorea acanthocytosis].
McLeod syndrome and chorea-acanthocytosis are classified with the so-called neuroacanthocytosis group of syndromes. Both lead to progressive basal ganglia degeneration and were not easily distinguished in the past. With the discovery of their molecular bases, mutations of the X-linked gene XK and autosomal recessive mutations of the gene coding for chorein, respectively, the two phenotypes can now be differentiated and extend the diagnostic spectrum in patients presenting with chorea. The present review compares the two conditions and proposes a practical approach to diagnosis and treatment. Better-defined disease concepts should eventually replace the umbrella term of "neuroacanthocytosis." Animal models are needed to understand the underlying mechanisms. A final common pathway is likely for the pathogenesis of these conditions and is most probably shared with Huntington's disease.
Danek
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Neurologische Klinik, Ludwig-Maximilians-Universität, Postfach 701260, 81366 München. danek@nefo.med.uni-muenchen.de
D026921:Amino Acid Transport Systems, Neutral / Q000235:genetics*; D001921:Brain / Q000473:pathology; D002819:Chorea / Q000175:diagnosis / Q000235:genetics*; D002899:Chromosomes, Human, Pair 9; D004252:DNA Mutational Analysis; D003937:Diagnosis, Differential; D006801:Humans; D006816:Huntington Disease / Q000175:diagnosis / Q000235:genetics; D008279:Magnetic Resonance Imaging; D009460:Neurologic Examination; D009483:Neuropsychological Tests; D011506:Proteins / Q000235:genetics*; D012729:Sex Chromosome Aberrations; D013577:Syndrome; D033921:Vesicular Transport Proteins; D014960:X Chromosome
D026921:Amino Acid Transport Systems, Neutral; D011506:Proteins; C429654:VPS13A protein, human; D033921:Vesicular Transport Proteins; C087883:XK protein, human