Presentation
A male and female with juvenile metachromatic leukodystrophy (MLD) with unusual manifestations are presented, each involving a novel arylsulfatase A gene mutation. [ncbi.nlm.nih.gov]
However, the focus of the book remains clinical, describing symptoms and signs at presentation, how to come to a diagnosis and methods for treatment. As with the previous edition, the book can be used in two main ways. [books.google.de]
The juvenile form, which is less common than the late infantile form, presents with the onset of educational and behavioral difficulties between 4 and 12 years of age. [jamanetwork.com]
Skin
- Photosensitivity
Neurogastrointestinal Encephalomyopathy 221 Leigh Syndrome and Mitochondrial Leukoencephalopathies 224 Pyruvate Carboxylase Deficiency 245 Multiple Carboxylase Deficiency 248 Cerebrotendinous Xanthomatosis 252 Cockayne Syndrome 259 Trichothiodystrophy with Photosensitivity [books.google.de]
Psychiatrical
- Distractibility
He was easily distractible, with disinhibited behavior and poor short-term memory. His language and constructional abilities were unimpaired. [jamanetwork.com]
Urogenital
- Primary Amenorrhea
Late-adverse effects of the conditioning regimen were not detectable except for an early tremor and a primary amenorrhea. Levels of thyroid and growth hormones remained in the appropriate range until present. [nature.com]
Neurologic
- Bradykinesia
At the age of 7 years, the brother presented with deteriorating schoolwork that progressed over the next few years, and then he developed dysarthria, bradykinesia, ataxia, extensor plantar responses, and urinary incontinence. [jamanetwork.com]
Treatment
He is also director of the Human Gene Therapy Applications Laboratory, the Center for the Study and Treatment of Jewish Genetic Diseases, and the Comprehensive Gaucher Disease Treatment Center. [books.google.com]
[…] disorders across the lifespan (pediatric, adult, and geriatric populations) Includes interventions and methods of treatment for the outcomes patients may experience [books.google.de]
Bone marrow transplantation has been advocated as a treatment in an attempt to correct the enzyme deficiency. [ncbi.nlm.nih.gov]
Bone marrow transplantation (BMT) has been the only partially effective treatment reported for MLD. [clinicaltrials.gov]
Prognosis
Support Groups For additional information and resources, see: United Leukodystrophy Association -- www.ulf.org MLD Foundation -- www.mldfoundation.org Outlook (Prognosis) MLD is a severe disease that gets worse over time. [mountsinai.org]
Prognosis is severe, leading to death within a few years [ 3 ]. In the juvenile form, difficulties in school may precede these symptoms [ 2 ]. There is currently no specific treatment for MLD. [ojrd.biomedcentral.com]
Gonorazky H.D....Dowling J.J. 2017 28 Metachromatic Leukodystrophy (MLD): a Pakistani Family with Novel ARSA Gene Mutation. ( 28799099 ) Shahzad M.A....Mahmood S. 2017 29 Quantitative MR spectroscopic imaging in metachromatic leukodystrophy: value for prognosis [malacards.org]
Epidemiology
Based on epidemiological surveys the incidence of MLD per 100 000 live births varied from 0.6 to 2.5. [journals.plos.org]
Epidemiology Frequency United States Incidence is estimated to be 1 case per 40,000 births. Mortality/Morbidity Morbidity and mortality rates vary with each form of the disease. [emedicine.medscape.com]
Epidemiology [ edit ] The incidence of metachromatic leukodystrophy is estimated to occur in 1 in 40,000 to 1 in 160,000 individuals worldwide. [11] There is a much higher incidence in certain genetically isolated populations, such as 1 in 75 in Habbanites [en.wikipedia.org]
Cerebroside-Sulfatase 12 Metachromatic Leukodystrophy, Adult 76 Arylsulfatase a Deficiency Disease 26 Leukodystrophy Metachromatic Adult 56 Scholz Cerebral Sclerosis 12 Sulfatide Lipoidosis 12 Greenfield Disease 26 Arylsulfatase a 13 Characteristics: Orphanet epidemiological [malacards.org]
Pathophysiology
The article provides information about the pathophysiology of metachromatic leukodystrophy, the natural progression of symptoms, and how hematopoietic stem cell transplant may work to halt the progression of juvenile metachromatic leukodystrophy. [ncbi.nlm.nih.gov]
Pathophysiology In patients, the inability to degrade sulfated glycolipids, especially the galactosyl-3-sulfate ceramides, characterizes metachromatic leukodystrophy. [emedicine.medscape.com]
The occurrence of spared myelin may provide important insight into the pathophysiology of MLD. [ajnr.org]
Prevention
HSCT may prevent disease progression, if performed sufficient time before loss of walking, which typically initiates rapid deterioration. [ncbi.nlm.nih.gov]
Though this procedure will not reverse damage already done by the disease, it can stop future damage to the nervous system and prevent mental disability for some people. [healthline.com]
We conclude that bone marrow transplantation may increase brain levels of arylsulfatase A enough to prevent deterioration in patients with juvenile metachromatic leukodystrophy. [jamanetwork.com]
Gene therapy was reported in 2013 to have successfully prevented the manifestation or progression of infantile MLD in a trial of three patients. [britannica.com]
ARSA activity was seen in blood cells and cerebrospinal fluid (CSF) from all patients and disease onset was prevented or disease progression halted in 8 of these children resulting in clinical benefit. [bsgct.org]