title: Niemann-Pick Disease Type C Presenting as a Developmental Coordination Disorder with Bullying by Peers in a School-Age Child.
abstract: Niemann-Pick disease type C (NPC) is a rare progressive neurodegenerative disorder, often with onset after normal early childhood development. Juvenile onset NPC patients slowly develop cerebellar symptoms and cognitive impairment and often experience difficulties at school. However, these problems may be overlooked due to the unpublicized nature of NPC, given that it is a rare metabolic disorder. In this report, we present an 11-year-old male NPC patient, who suffered from clumsiness and difficulties in attention and academic and social skills. His symptoms were initially considered to be due to developmental coordination disorder (DCD) coexisting with bullying by peers. DCD is a type of neurodevelopmental disorder defined according to DSM-IV and is characterized by clumsiness that interferes with academic achievement and social integration not due to other general medical conditions. However, a detailed investigation of the patient suggested that the problems could be attributed to the onset of NPC. Clinicians should keep neurodegenerative disorders as differential diagnosis of children with multiple school problems.
authors.affiliation: Department of Pediatrics, Nagaoka Chuo General Hospital, 2041 Kawasaki-cho, Nagaoka, Niigata 940-8653, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Suzuki
authors.affiliation: Department of Pediatrics, Nagaoka Chuo General Hospital, 2041 Kawasaki-cho, Nagaoka, Niigata 940-8653, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Tanaka
authors.affiliation: Department of Pediatrics, Nagaoka Chuo General Hospital, 2041 Kawasaki-cho, Nagaoka, Niigata 940-8653, Japan.
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Matsui
authors.affiliation: Department of Pediatrics, Nagaoka Chuo General Hospital, 2041 Kawasaki-cho, Nagaoka, Niigata 940-8653, Japan.
authors.forename: Tetsuki
authors.initials: T
authors.lastname: Gunji
authors.affiliation: Department of Child Neurology, Nishi-Niigata Chuo National Hospital, 1-14-1 Masago, Nishi-ku, Niigata, Niigata 950-2085, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Tohyama
authors.forename: Aya
authors.lastname: Narita
authors.affiliation: Division of Child Neurology, Institute of Neurological Sciences, Faculty of Medicine, Tottori University, 36-1 Nishimachi, Yonago, Tottori 683-8504, Japan.
authors.forename: Aya
authors.initials: A
authors.lastname: Nairita
authors.affiliation: Division of Functional Genomics, Research Center for Bioscience and Technology, Tottori University, 86 Nishimachi, Yonago, Tottori 683-8503, Japan.
authors.forename: Eiji
authors.initials: E
authors.lastname: Nanba
authors.affiliation: Sanin Rosai Hospital, 1-8-1 Kaike Shinden, Yonago, Tottori 683-8605, Japan.
authors.forename: Kousaku
authors.initials: K
authors.lastname: Ohno