Presentation
From late infancy onward, the presentation is dominated by neurologic manifestations. [ncbi.nlm.nih.gov]
NPD-C has a variable age of presentation, ranging for the neonatal period into adulthood. hepatobiliary signs and symptoms 2 neonatal presentation: cholestatic liver failure infancy and childhood presentation: hepatosplenomegaly neurological signs and [radiopaedia.org]
Neonatal and infantile presentations of NPC are most commonly nonspecific and may go unrecognized. [centogene.com]
[…] disease Also disorders with massive cell destruction that overloads body's capacity to digest lipids ( thalassemia, sickle cell anemia, ITP, chronic renal failure ) Type A Definition / general : Acute neuronopathic form Most common type Occurs in infants Presents [pathologyoutlines.com]
Isolated splenomegaly may be the presenting symptom in some adolescents or adults. [rarediseases.org]
Immune System
- Splenomegaly
[…] cells Foam cells Abnormality of the digestive system Dysphagia Hepatomegaly Jaundice Prolonged neonatal jaundice Abnormality of the eye Vertical supranuclear gaze palsy Abnormality of the immune system Bone-marrow foam cells Sea-blue histiocyte syndrome Splenomegaly [ncbi.nlm.nih.gov]
Common symptoms include hepatomegaly, splenomegaly, jaundice and vertical supranuclear gaze palsy (VSGP). 95% of NPC patients will have mutations in the NPC1 gene. [mangen.co.uk]
The same cells involving the alveoli are associated with ground-glass opacities. 2, 13, 15, 24 Hepatosplenomegaly is the most important clinical finding in NPD type B, 11, 25 with splenomegaly being more marked than hepatomegaly. 6, 11 Splenomegaly may [scielo.br]
Isolated splenomegaly may be the presenting symptom in some adolescents or adults. [rarediseases.org]
[…] in newborn 0006579 Psychosis 0000709 Respiratory failure 0002878 Respiratory insufficiency Respiratory impairment 0002093 Sea-blue histiocytosis 0001982 Seizures Seizure 0001250 Spasticity Involuntary muscle stiffness, contraction, or spasm 0001257 Splenomegaly [rarediseases.info.nih.gov]
Neurologic
- Aphasia
Other neurologic symptoms include ataxia, facial dyskinesis, bradykinesia, expressive aphasia, dysarthria and cognitive decline. Visceromegaly seems to be less common than in type C1 ( 257220 ). [disorders.eyes.arizona.edu]
[…] inheritance.At present,there is no universally accepted effective treatment,and clinical interventions consist of mainly symptomatic treatments.The main clinical manifestations of NPD type C are severe infant jaundice,psychomotor retardation,hypotonia,aphasia [chinagp.net]
- Expressive Aphasia
Other neurologic symptoms include ataxia, facial dyskinesis, bradykinesia, expressive aphasia, dysarthria and cognitive decline. Visceromegaly seems to be less common than in type C1 ( 257220 ). [disorders.eyes.arizona.edu]
- Bradykinesia
Other neurologic symptoms include ataxia, facial dyskinesis, bradykinesia, expressive aphasia, dysarthria and cognitive decline. Visceromegaly seems to be less common than in type C1 ( 257220 ). [disorders.eyes.arizona.edu]
Workup
Papandreou A, Gissen P: Diagnostic workup and management of patients with suspected Niemann-Pick type C disease. Therapeutic advances in neurological disorders 2016;9(3):216-229. [rarediseases.org]
Other Pathologies
- Neurofibrillary Tangle
tangles Perseveration Psychotic disorder Seizure Spasticity Abnormality of the respiratory system Neonatal respiratory distress Pulmonary fibrosis Respiratory failure Respiratory insufficiency IMPORTANT NOTE: NIH does not independently verify information [ncbi.nlm.nih.gov]
tangles 0002185 Onset Age symptoms begin 0003674 Perseveration 0030223 Prolonged neonatal jaundice Prolonged yellowing of skin in newborn 0006579 Psychosis 0000709 Respiratory failure 0002878 Respiratory insufficiency Respiratory impairment 0002093 Sea-blue [rarediseases.info.nih.gov]
Treatment
Treatment & Management No specific treatment is known for type A and B, but symptoms are treated. [ordindia.org]
Treatment with anticonvulsants and more recent disease specific treatments as Miglustat or hydroxypropyl-β-cyclodextrin have showed a variable response. [content.iospress.com]
You may also want to contact a university or tertiary medical center in your area, because these centers tend to see more complex cases and have the latest technology and treatments. [rarediseases.info.nih.gov]
Prognosis
In 2006, Jiang et al., summarized that decreased serum levels of cholesterol and apoAI may indicate a poor prognosis [ 21 ]. [jcancer.org]
What is the prognosis for an individual with Niemann-Pick Disease Type C2? Niemann-Pick disease type C shows variable disease advancement, with an earlier onset associated with faster disease progression. [myriad.com]
[…] signal, particularly parieto-occipital periventricular regions 3 deep grey matter and hippocampal atrophy (reported in the adult-onset patient) 4 reduced midbrain to pons ratio (not as marked as in progressive supranuclear palsy (PSP)) 5 Treatment and prognosis [radiopaedia.org]
The prognosis for people with Type C Niemann-Pick disease varies, with some who are less severely affected living well into adulthood. [medium.com]
[…] general : Chronic form (visceral form) without nervous system involvement Highest incidence in those of Turkish, Arabic and North African descent Uncommon in Ashkenazi Jews ( Am J Hum Genet 2002;71:1413 ) Onset of hepatosplenomegaly in preteen years Good prognosis [pathologyoutlines.com]
Etiology
Niemann-Pick type C2 disease (NP-C2) is a fatal hereditary disorder of unknown etiology characterized by defective egress of cholesterol from lysosomes [5]. [wikigenes.org]
The association of diffuse pulmonary infiltration and hepatosplenomegaly can be observed in a number of diseases of varying etiologies, such as infectious diseases (tuberculosis, fungal diseases, malaria, and schistosomiasis), neoplastic diseases (lymphoma [scielo.br]
Niemann-Pick disease type C (NP-C) Ataxia Ataxia is a common but nonspecific sign of NP-C. 4, 23, 24 Early-onset ataxia, ataxia in combination with other clinical symptoms 25 (“ataxia plus”; see table 1 ), ataxia without neuropathy, or ataxia of unknown etiology [cp.neurology.org]
Epidemiology
The objectives of the present study were to describe the most common HRCT findings and the major clinical and epidemiological characteristics observed in these patients. [scielo.br]
Pathophysiology
Discussed topics • Introduction • History • Types • Prognosis • Incidence • Causes • Pathophysiology • Mechanism of Cholesterol Trafficking • Signs and Symptoms • Diagnosis • Treatment • Prevention • Research Direction 2 3. [de.slideshare.net]
The pathophysiology and mechanisms of NP-C disease. Biochim Biophys Acta. 2004 Oct 11;1685(1-3):83-7. Review. Vance JE. Lipid imbalance in the neurological disorder, Niemann-Pick C disease. FEBS Lett. 2006 Oct 9;580(23):5518-24. Epub 2006 Jun 15. [ghr.nlm.nih.gov]
The pathophysiology and mechanisms of NP-C disease. Biochim Biophys Acta. 2004 Oct 11;1685(1-3):83-7. Review. Citation on PubMed Vance JE. Lipid imbalance in the neurological disorder, Niemann-Pick C disease. FEBS Lett. 2006 Oct 9;580(23):5518-24. [medlineplus.gov]
Metab. (2005) [Pubmed] The pathophysiology and mechanisms of NP-C disease. Sturley, S.L., Patterson, M.C., Balch, W., Liscum, L. Biochim. Biophys. [wikigenes.org]
Prevention
Good pulmonary hygiene is important and precautions should be taken to prevent aspiration. References References Verot L, Chikh K, Freydi?(r)re E, Honor?(c) R, Vanier MT, Millat G. [disorders.eyes.arizona.edu]
Chest physiotherapy and antibiotics may help to prevent regular lung infections. Individuals with the condition need a gastronomy tube for feeding when they can no longer swallow well enough to avoid choking or malnutrition. [myriad.com]
Miglustat is classified as an enzyme inhibitor, and works by preventing the body from producing fatty substances (in the case of type C, cholesterol) so that less of it will build up in the body. [omicsonline.org]
Mutations in these genes lead to a shortage of functional protein, which prevents movement of cholesterol and other lipids, leading to their accumulation in cells. [medicinenet.com]
Discussed topics • Introduction • History • Types • Prognosis • Incidence • Causes • Pathophysiology • Mechanism of Cholesterol Trafficking • Signs and Symptoms • Diagnosis • Treatment • Prevention • Research Direction 2 3. [de.slideshare.net]