title: First report of co-morbidity of pantothenate kinase-associated neurodegeneration and three types of chronic hemolytic anemias.
abstract: BACKGROUND
  Pantothenate kinase-associated neurodegeneration (PKAN), sickle cell anemia, and thalassemia are autosomal recessive disorders that can cause iron deposition in tissues during childhood. PKAN is characterized by accumulation of iron in the basal ganglia causing progressive extrapyramidal manifestations. Thalassemia and sickle cell disease can cause iron overload and deposition in tissues, including central nervous system.
  
  
  METHODS
  we herein report the first report of comorbidity of PKAN, β-thalassemia-major, sickle cell and glucose-6-phosphate dehydrogenase deficiency (G6PD) anemias in a 9 years old Saudi female patient who presented with gait disturbance, speech difficulty, and progressive movement disorders of the neck, upper and lower limbs.
  
  
  CONCLUSIONS
  Although extremely rare, β-thalassemia-major, sickle cell and G6PD anemias can be associated with PKAN. It is unknown whether this association is random or due to an unknown factor that may have caused several mutations.
authors.affiliation: Faculty of Medicine, Ain Shams University, Egypt; Prince Mansour Hospital, Taif, Saudi Arabia.
authors.forename: Iman M
authors.initials: IM
authors.lastname: Talaat
authors.affiliation: Faculty of Medicine, Cairo University, Egypt; Alhada Armed Forces, Taif, Saudi Arabia.
authors.forename: Naglaa M
authors.initials: NM
authors.lastname: Kamal
authors.affiliation: Saad Specialist Hospital, Saudi Arabia.
authors.forename: Ebtessam H K
authors.initials: EH
authors.lastname: El Melegy
authors.affiliation: Director of Alhada Armed Forces Hospital, Taif, Saudi Arabia.
authors.forename: Hamed A
authors.initials: HA
authors.lastname: Alghamdi
authors.affiliation: Alhada Armed Forces, Taif, Saudi Arabia.
authors.forename: Mohammed F
authors.initials: MF
authors.lastname: Aljabri
authors.affiliation: Faculty of Medicine, Cairo University, Egypt.
authors.forename: Enas A A
authors.initials: EA
authors.lastname: Abdallah
authors.affiliation: Saad Specialist Hospital, Saudi Arabia.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Sarar
authors.affiliation: Prince Mansour Hospital, Taif, Saudi Arabia.
authors.forename: Mohamed A
authors.initials: MA
authors.lastname: Alshahrani
keywords: Eye of the tiger sign; Hemosiderosis; Pantothenate kinase-associated neurodegeneration; Sickle cell disease; β-Thalaasemia