The natural history of type B Niemann-Pick disease: Results from a 10-year longitudinal study.

Title

The natural history of type B Niemann-Pick disease: Results from a 10-year longitudinal study.

Creator

Wasserstein MP; Desnick RJ; Schuchman EH; Hossain S; Wallenstein S; Lamm C; McGovern MM

Publisher

Pediatrics

Date

2004

Subject

Child; Female; Humans; Male; Adult; Middle Aged; Disease Progression; Longitudinal Studies; Phenotype; adolescent; Preschool; Q3 Literature Search; Splenomegaly/etiology; Genotype; Blood Cell Count; Hypersplenism/etiology; Leukopenia/etiology; Lipids/blood; Liver/physiopathology; Niemann-Pick Diseases/blood/complications/genetics/physiopathology; Respiratory Physiology; Thrombocytopenia/etiology

Description

OBJECTIVES: Type B Niemann-Pick disease (NPD-B) caused by acid sphingomyelinase deficiency is a rare, autosomal recessive, lysosomal storage disorder with a broad range of disease severity. The objectives of this study were to document the natural history of the disease in a large, clinically heterogeneous patient population that was followed for a period of 10 years and to determine how genotype influences phenotype. METHODS: Twenty-nine patients with NPD-B had serial evaluations at least 9 months apart. Organ volumes, hematologic indices, lipid concentrations, pulmonary function, and hepatic activity were studied, and individual phenotypic severity was compared with genotype. RESULTS: All patients with intact spleens had splenomegaly (mean value: 12.7 multiples of normal [MN]; range: 4.5-27.3 MN), and all but 1 had hepatomegaly (mean volume: 1.91 MN; range: 0.93-3.21 MN). At initial visit, 39% had thrombocytopenia and 3% had leukopenia. At final visit, the percentages increased to 54% and 34%, respectively. Mean annual decreases in platelet count and leukocyte count were 7 x 10(3) and 0.2 x 10(3) per mm3, respectively. The typical atherogenic lipid profile was worse in older patients. A total of 69% of patients had low diffusion capacity for carbon monoxide, and more than one third had low forced expiratory volume in 1 second, forced vital capacity, and forced expiratory volume in 1 second/forced vital capacity at initial visit. All measurements of pulmonary function showed a gradual deterioration over time. Liver dysfunction was characterized by stable elevation of hepatic transaminases and bilirubin. Homozygotes for DeltaR608, P323A, and P330R had milder disease than patients with all other genotypes. CONCLUSIONS: The natural history of NPD-B is characterized by hepatosplenomegaly with progressive hypersplenism, worsening atherogenic lipid profile, gradual deterioration in pulmonary function, and stable liver dysfunction.
2004

Rights

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).

Type

Journal Article

Citation List Month

Backlog

Pages

e672-7

Issue

6

Volume

114

Citation

Wasserstein MP; Desnick RJ; Schuchman EH; Hossain S; Wallenstein S; Lamm C; McGovern MM, “The natural history of type B Niemann-Pick disease: Results from a 10-year longitudinal study.,” Pediatric Palliative Care Library, accessed December 3, 2021, https://pedpalascnetlibrary.omeka.net/items/show/12638.

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