Charcot-Marie-Tooth disease type 1A: clinicopathological correlations in 24 patients.
We examined nerve biopsies from 24 patients with Charcot-Marie-Tooth disease type 1A (CMT1A) and proven 17p11.2-12 duplication. There were seven males and 17 females with a mean age of 27.85 +/- 18.95 years at the time of nerve biopsy. A family history consistent with dominant inheritance was present in 17 patients. Clinical features were classical in 16 patients and were atypical in the other eight: one had calf hypertrophy; two had Roussy-Levy syndrome; one had had a subacute inflammatory demyelinating polyneuropathy 11 years earlier and presented a relapse on the form of a chronic inflammatory demyelinating polyneuropathy; one had carpal tunnel syndrome; one had a recent painful neuropathy in both legs; and two had chronic inflammatory demyelinating polyneuropathy. Onion bulb formations (OMFs) were present in every case and most of them were characteristic, whereas burnt-out or cluster-associated OMFs were less common. Depletion of myelinated fibers was severe in 20 cases (169-2927/mm2) and varied from 5187 to 3725/mm2 in three children (4-9 years old). In addition, features of macrophage-associated demyelination were observed in the last four atypical cases. Known for more than 20 years, inflammatory demyelination superimposed in the course of CMT1A has been reported in a few cases in the past few years, mainly concerning asymptomatic or atypical patients. Such an association deserves to be better known because corticotherapy improves weakness in most of these patients.
Carvalho
Alzira A S
AA
Neuropathology Department, Victor Segalen University, Pessac, Bordeaux, France.
Vital
Anne
A
Ferrer
Xavier
X
Latour
Philippe
P
Lagueny
Alain
A
Brechenmacher
Christiane
C
Vital
Claude
C
D000293:Adolescent; D000328:Adult; D001706:Biopsy; D002607:Charcot-Marie-Tooth Disease / Q000235:genetics / Q000473:pathology* / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D003711:Demyelinating Diseases / Q000235:genetics / Q000473:pathology / Q000503:physiopathology; D004594:Electrophysiology; D005260:Female; D006801:Humans; D008297:Male; D046529:Microscopy, Electron, Transmission; D008875:Middle Aged; D009474:Neurons / Q000473:pathology* / Q000648:ultrastructure; D012583:Schwann Cells / Q000473:pathology / Q000648:ultrastructure