Niemann-Pick disease type C: diagnosis and outcome in children, with particular reference to liver disease
Child; Female; Humans; Male; Prognosis; Age Factors; Biopsy; Preschool; infant; Q3 Literature Search; retrospective studies; Splenomegaly/etiology; Liver/pathology; Liver Function Tests; Developmental Disabilities/etiology; Kupffer Cells/pathology; Liver Diseases/diagnosis/etiology/mortality; Niemann-Pick Diseases/complications/diagnosis/mortality
The records of 52 children with Niemann-Pick disease type C were reviewed to establish whether the disease process and outcome varied with the initial clinical pattern; 34 children (65%) had cholestatic liver disease and hepatosplenomegaly in infancy; 18 were seen at a mean age of 4 years with splenomegaly or neurologic disease or both. Of the 34 children with early cholestatic liver disease, three died in the neonatal period; cholestasis and hepatomegaly subsided in the remaining 31 children, although splenomegaly persisted. Of these 31 children, 15 had persistent liver disease with elevated aminotransferase values. Serial liver biopsy specimens showed that 3 of the 15 children had normal architecture and 12 had hepatic fibrosis, with progression to cirrhosis in 5. No other significant morbidity or additional deaths were associated with the liver disease. The clinical importance of persistent liver disease was overshadowed by the subsequent development of severe neurologic disease. There was no difference in the age at onset of the disease (mean, 4.5 years) or in the pattern of neurologic disease, including supranuclear ophthalmoplegia, whether or not the child had early liver disease. Overt neurologic disease has not yet developed in seven surviving children with liver disease at onset. Sixty-seven percent of children died during the study; the main cause of death was bronchopneumonia. We conclude that the diagnosis of Niemann-Pick disease type C should be considered in patients with unexplained neonatal hepatitis, especially if splenomegaly is a persistent feature. Because liver biopsy specimens may not demonstrate storage cells, bone marrow aspiration to detect the characteristic storage cells is recommended in such patients.
1993
Kelly DA; Portmann B; Mowat AP; Sherlock S; Lake BD
The Journal Of Pediatrics
1993
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1016/s0022-3476(05)81695-6" target="_blank" rel="noreferrer">10.1016/s0022-3476(05)81695-6</a>
Infantile systemic hyalinosis: newly recognized disorder of collagen?
Female; Humans; infant; Prognosis; Movement; Pain/etiology; Newborn; Hyalin/metabolism; Collagen Diseases/metabolism/pathology/physiopathology; Gingiva/pathology; Hypertrophy; Jejunum/pathology; Joints/physiopathology; Skin/pathology/ultrastructure
Four infants with stiff skin and painful joint contractures in the first few months of life are described. Other features included small papules, particularly on the face and trunk, perianal nodules, hyperpigmentation over the metacarpophalangeal joints and over the malleoli, gingival hyperplasia, persistent diarrhea, and failure to thrive. Two of these infants died before the age of 18 months. In each case hyaline material was found in the papillary dermis. Ultrastructurally, there was a distinctive fibrillogranular appearance in which a banding pattern could be observed. This material was also found within membrane-bound vacuoles in macrophages and fibroblasts. It had an appearance and localization identical with that of collagen type VI. These features are similar to those reported in juvenile hyaline fibromatosis. It is believed that these infants have a closely related, but nonetheless distinctive, inherited disorder of collagen.
1991
Glover MT; Lake BD; Atherton DJ
Pediatrics
1991
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1111/j.1365-2133.1990.tb04440.x" target="_blank" rel="noreferrer">10.1111/j.1365-2133.1990.tb04440.x</a>
Gastric antral dysrhythmias in children with chronic idiopathic intestinal pseudoobstruction
Child; Preschool; Non-U.S. Gov't; infant; Human; Support; Adolescence; Manometry; Gastrointestinal Motility/ph [Physiology]; Intestinal Pseudo-Obstruction/pp [Physiopathology]; Pyloric Antrum/pp [Physiopathology]; Electrophysiology; Ileum/pa [Pathology]; Intestinal Pseudo-Obstruction/di [Diagnosis]; Intestinal Pseudo-Obstruction/pa [Pathology]; Intestine; Large/pa [Pathology]
Chronic idiopathic intestinal pseudoobstruction is a serious disorder of intestinal neuromuscular function resulting in recurrent episodes of intestinal obstruction, and is caused by primary disease of the enteric nerves or enteric smooth muscle. Gastric electrical control activity detected by the non-invasive technique of surface electrogastrography was investigated in 11 children (0.1-16 years) with proven chronic idiopathic intestinal pseudoobstruction (four with known disease of the enteric nerves, three with disease of smooth muscle cells, and four without defined pathology), to determine whether abnormalities were present and whether these were useful in detecting the underlying pathology. Abnormalities were present in eight of 11 patients. Persistent tachygastria (electrical control activity frequency > 5 cycles/minute) was found in three patients, all with a proven neuropathy. A continuously irregular frequency was found in five patients, three with a proven myopathy and two with undefined pathology. A normal electrical control activity frequency was present in three patients, one with a proven neuropathy and two with undefined pathology. It is suggested that this non-invasive technique may provide a useful screening test of the pathophysiological basis of the functional obstruction in children with chronic idiopathic intestinal pseudoobstruction.
1992
Devane SP; Ravelli AM; Bisset WM; Smith VV; Lake BD; Milla PJ
Gut
1992
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1136/gut.33.11.1477" target="_blank" rel="noreferrer">10.1136/gut.33.11.1477</a>