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Sialidosis - Type II (Neonatal / Infantile / Juvenile Onset)

Metabolic defect: alpha-N-acetylneuraminidase deficiency
Other glycan degradation diseases: aspartylglucosaminuria | fucosidosis: type I, type II | mannosidosis | sialidosis: type I

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Sialidosis - type II

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Etiology and Pathogenesis

One of five conditions that account for the majority of cases of progressive myoclonus epilepsies. Enzyme deficiency results in accumulation of sialyloligosaccharides and sialylglycopeptides, affecting lymphocytes, fibroblasts, bone marrow cells, Kupffer cells (liver), and Schwann cells.

Key Symptom Images
Hepatosplenomegaly Corneal opacity Macular cherry-red spots
Image Credits: Cherry-red macular spots courtesy of Jay M. Haynie, OD.

Clinical Description and Progression/Prognosis

Neurodegenerative disorder characterized by myoclonic seizures, tonic-clonic seizures, progressive neurologic dysfunction (ataxia), and cherry-red macular spots. Distinguished from Type 1 by early onset of progressive visceral, skeletal, neurological involvement. Type II has three variants:

Congenital onset - Stillborn, or death at an early age. If born live, presents with hydrops fetalis and other complications.
Infantile onset - Presents at birth to 12 months, ranging from normal-to-minimal abnormalities to neonates with ascites and hydrops fetalis.
Juvenile onset - Onset at end of 1st decade of life, progressive disorder with mucopolysaccharidosis-like phenotypes. Death occurs in the 2nd decade of life.

Inheritance pattern: autosomal recessive
Incidence: 1 in 4,222,000 live births (for types I and II together)[1]
Diagnosis: Enzyme assay
Conditions with similar presentations: Mucopolysaccharidoses
Management: no disease-specific treatment available
Other medical care: symptom management

Signs and Symptoms

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Gastrointestinal

Ocular

 

Musculoskeletal

Neurologic

 

Cardiovascular

Dermatologic

 

Gastrointestinal
Congenital onset:
Ascites
Organomegaly
Hepatomegaly, with or without splenomegaly
Inguinal hernia
Infantile onset:
Visceromegaly
Renal involvement
Musculoskeletal
Congenital onset:
Facial edema
Juvenile onset:
Dysostosis multiplex
Cardiovascular
Congenital onset:
Pericardial effusion

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Ocular
Congenital onset:
Corneal opacifications
Cherry-red macular spots
Juvenile onset:
Cherry-red macular spots
Decreased visual activity
Neurologic
Mental retardation (all variants)
Juvenile onset:
Myoclonus
Dermatologic
Angiokeratomas (juvenile variant)

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Other Resources

www.emedicine.com/ped/topic2093.htm



References


1. Meikle PJ, Hopwood JJ, Clague AE, Carey WF. Prevalence of Lysosomal Storage Disorders. JAMA. 1999; 281: 249-254.

2. Thomas, George. “Disorders of Glycoprotein Degradation: -Mannosidosis, -Mannosidosis, Fucosidosis, and Sialidosis.” The Metabolic and Molecular Bases of Inherited Disease, 8th Edition Online. McGraw-Hill. http://genetics.accessmedicine.com/server-java/Arknoid/amed/mmbid/co_chapters/ch140/ch140_p01.html Accessed September 2004.