title: Niemann-Pick disease type C in adults.
abstract: Although it is often perceived as a paediatric disorder, significant numbers of patients with Niemann-Pick disease type C present for the first time in adult life or survive into adult life. The presentation in these patients differs from that seen in the classical juvenile form of the disease. Adult patients are often referred to clinicians with psychosis or other major psychiatric problems. The dystonia with preserved intellectual functioning can be mistaken for other basal ganglia disorders such as Wilson disease. The presence of vertical gaze palsy is an important clinical clue and, in the presence of a modest increase in plasma chitotriosidase activity, can be very helpful in the differential diagnosis. The diagnosis should be confirmed in suspected cases by filipin staining of cultured fibroblasts, as well as cholesterol esterification studies and DNA mutation analysis.
authors.affiliation: Willink Biochemical Genetics Unit, Royal Manchester Children's Hospital, Manchester M27 4HA, UK.
authors.forename: J
authors.initials: J
authors.lastname: Imrie
authors.forename: S
authors.initials: S
authors.lastname: Vijayaraghaven
authors.forename: C
authors.initials: C
authors.lastname: Whitehouse
authors.forename: S
authors.initials: S
authors.lastname: Harris
authors.forename: L
authors.initials: L
authors.lastname: Heptinstall
authors.forename: H
authors.initials: H
authors.lastname: Church
authors.forename: A
authors.initials: A
authors.lastname: Cooper
authors.forename: G T N
authors.initials: GT
authors.lastname: Besley
authors.forename: J E
authors.initials: JE
authors.lastname: Wraith
mesh_terms: D000293:Adolescent; D000328:Adult; D001259:Ataxia / Q000209:etiology; D002648:Child; D004247:DNA / Q000235:genetics; D018450:Disease Progression; D017809:Fatal Outcome; D005260:Female; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000503:physiopathology; D006505:Hepatitis / Q000473:pathology; D006801:Humans; D007231:Infant, Newborn; D007361:Intelligence Tests; D008297:Male; D009542:Niemann-Pick Diseases / Q000235:genetics / Q000503:physiopathology* / Q000523:psychology; D011247:Pregnancy; D011618:Psychotic Disorders / Q000209:etiology; D012640:Seizures; D013163:Splenomegaly / Q000209:etiology; D014202:Tremor / Q000503:physiopathology
chemical_list: D004247:DNA