Krabbé Disease
Etiology & Pathogenesis [1]
One of a group of genetic disorders called the leukodystrophies that affect the growth of the myelin sheath, the fatty covering on nerve fibers in the brain that acts as an insulator. All patients are deficient in the lysosomal enzyme galactocerebrosidase and show evidence of storage in the central nervous system. Key Symptom Images
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| Hypertonia/Ataxia |
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Hypertonia/Ataxia |
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Hypertonia/Ataxia |
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Clinical Description and Progression/Prognosis [1,2]
A rare degenerative disorder of the central and peripheral nervous systems. Symptoms vary in prevalence and severity, ranging from infantile onset to late-onset forms. The majority of cases are the infantile form and generally present with developmental delay, extreme irritability, and neurologic manifestations by 6 months of age. In late-onset patients, which can present between 6 months and 50 years of age, weakness, vision loss, and mental regression may occur.[3] Inheritance pattern: autosomal recessive Incidence: 1 in 141,000 live births [4] Diagnosis: enzyme assay [3] Conditions with similar presentations: metachromatic leukodystrophy, GM1 and GM2 gangliosidoses, X-linked adrenoleukodystrophy, Canavan disease, Pelizaeus-Merzbacher disease, Alexander disease [3] Management:[2,5] bone marrow transplantation has been shown to have benefit for mild cases early in the course of the disease Other medical care:[1,5] symptom management; physical therapy may help maintain or increase muscle tone and circulation
 Myoclonic seizures  Hypertonia  Irritability  Developmental delays  Loss of previously attained developmental skills  Hypersensitivity  Temperature spikes  Tremor  Decerebration  Ataxia  Spasticity
 Vision loss leading to blindness
Gastrointestinal  Episodes of severe vomiting
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1. Clarke LA. Clinical diagnosis of lysosomal storage diseases. In: Applegarth DA, Dimmick JE, JG Hall. Organelle Diseases: Clinical Features, Diagnosis, Pathogenesis and Management. London: Chapman and Hall 1997; 37-71.
2. National Institute of Neurological Disorders and Stroke. www.ninds.nih.gov/health_and_medical/disorders/krabbe_doc.htm Accessed July 2004.
3. Kleta, Robert, MD, PhD; Gahl, William A, MD, PhD. “Krabbe Disease.” www.genetests.org. Updated 6 June 2003. Accessed July 2004.
4. Meikle PJ, Hopwood JJ, Clague AE, Carey WF. Prevalence of Lysosomal Storage Disorders. JAMA. 1999; 281: 249-254.
5. DL, Hauser SL, Longo DL, eds. Harrison’s Principles of Internal Medicine. 14th ed. New York: McGraw-Hill; 1998; p. 2170. |
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