Volume 24, Issue 2 (Iranian South Medical Journal 2021)                   Iran South Med J 2021, 24(2): 126-133 | Back to browse issues page


XML Persian Abstract Print


Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Yazdanparast A, Fathpour G, Jalali P. Niemann Peak Disease Type A in Necropsy of the Liver of a Four-Month-Old Female with Fe-ver and Pancytopenia. Iran South Med J 2021; 24 (2) :126-133
URL: http://ismj.bpums.ac.ir/article-1-1440-en.html
1- Dpartment of Pediatrics, school of Medicine, Bushehr University of Medical Sciences, Bushehr Iran
2- Dpartment of Pediatrics, school of Medicine, Bushehr University of Medical Sciences, Bushehr Iran , dr.reza.fathpour@gmail.com
Abstract:   (2940 Views)
Niemann-pick disease is a severe disorder in sphingolipid metabolism and esterification of cholesterol which results in accumulations of sphingomyelin in different tissues. This disease is characterized with hepatosplenomegaly, fever and foam cell appearance in microscopic examination of bone marrow, liver and spleen. The case presented in this study is a four-month-old female infant with chief complaint of fever, pancytopenia, and severe abdominal distension, and anemia since 10 days before admission to our hospital. The case was the third child of the family born with cesarian section and without any significant health problems before hospitalization. Her siblings had both died in the hospital, but the cause of death is unknown. Significant laboratory findings include WBC=1500 (neutrophil 70%), RBC=2,000,000, Hb=5.5 g/dl, Plt= 30,000, CRP=3+, ESR=45, ALT=300 IU, and AST-150 IU. No other abnormal findings were observed in laboratory report. Thoracoabdominal X-ray revealed significant hepatosplenomegaly. Her parents were cousins. Soon after admission to our hospital, she received a wide spectrum antibiotic, but underwent ventilator due to sepsis. Unfortunately,  our therapeutic management was not successful, and the patient died due to septicemia the next morning. After obtaining written consent of the parents, the patient underwent necropsy, which revealed lipid storage disease, Niemann-pick disease. The purpose of our study was to emphasize the importance of necropsy and follow-up until a definite diagnosis.
Full-Text [PDF 396 kb]   (895 Downloads)    
Type of Study: Case Report | Subject: Pediatrics
Received: 2021/03/31 | Accepted: 2021/05/2 | Published: 2021/05/26

References
1. Vanier MT. Chapter 176 - Niemann-Pick Diseases. Handbook Clin Neurol 2013; 113: 1717-21. [DOI:10.1016/B978-0-444-59565-2.00041-1] [PMID]
2. Schuchman EH, Wasserstein MP. Types A And B Niemann-Pick Disease. Best Pract Res Clin Endocrinol Metab 2015; 29(2): 237-47. [DOI:10.1016/j.beem.2014.10.002] [PMID]
3. Chuang WL, Pacheco J, Cooper S, et al. Lyso-Sphingomyelin Is Elevated In Dried Blood Spots Of Niemann-Pick B Patients. Mol Genet Metab 2014; 111(2): 209-11. [DOI:10.1016/j.ymgme.2013.11.012] [PMID]
4. Fujiwaki T, Tasaka M, Yamaguchi S. Quantitative Evaluation Of Sphingomyelin And Glucosylceramide Using Matrix-Assisted Laser Desorption Ionization Time-Of-Flight Mass Spectrometry With Sphingosylphosphorylcholine As An Internal Standard: Practical Application To Tissues From Patients With Niemann-Pick Disease Types A And C, And Gaucher Disease. J Chromatogr B Analyt Technol Biomed Life Sci 2008; 870(2): 170-6. [DOI:10.1016/j.jchromb.2008.05.013] [PMID]
5. Bounford KMK, Gissen P. Genetic And Laboratory Diagnostic Approach In Niemann Pick Disease Type C. J Neurol 2014; 261(Suppl 2): 569-75. [DOI:10.1007/s00415-014-7386-8] [PMID] [PMCID]
6. Schuchman EH, Desnick RJ. Types A And B Niemann-Pick Disease. Mol Genet Metab 2017; 120(1-2): 27-33. [DOI:10.1016/j.ymgme.2016.12.008] [PMID] [PMCID]
7. Vanier MT. Niemann-Pick Disease Type C. Orphanet J Rare Dis 2010; 5: 16. [DOI:10.1186/1750-1172-5-16] [PMID] [PMCID]
8. Patterson MC, Hendriksz CJ, Walterfang M, et al. Recommendations For The Diagnosis And Management Of Niemann-Pick Disease Type C: An Update. Mol Genet Metab 2012; 106(3): 330-44. [DOI:10.1016/j.ymgme.2012.03.012] [PMID]
9. Dalal SR, Jadhav MV, Deshmukh SD. Autopsy Study Of Pediatric Deaths. The Indian J Pediatr 2002; 69: 23-5. [DOI:10.1007/BF02723770] [PMID]
10. Alsaif M, Dabelah K, Girim H, et al. Congenital Brucellosis: A Systematic Review Of The Literature. Vector Borne Zoonotic Dis 2018; 18(8): 393-403. [DOI:10.1089/vbz.2018.2280] [PMID]
11. Ashley EA, Phyo AP, Woodrow CJ. Malaria. Lancet 2018; 391(10130): 1608-21. [DOI:10.1016/S0140-6736(18)30324-6]
12. Figueiro-Filho EA, Duarte G, El-Beitune P, et al. Visceral Leishmaniasis (Kala-Azar) And Pregnancy. Infect Dis Obstet Gynecol 2004; 12(1): 31-40. [DOI:10.1080/1064744042000210384] [PMID] [PMCID]
13. Solovyeva VV, Shaimardanova AA, Chulpanova DS, et al. New Approaches To Tay-Sachs Disease Therapy. Front Physiol 2018; 9: 1663. [DOI:10.3389/fphys.2018.01663] [PMID] [PMCID]
14. Fabian PS, Amintas S, Levade T, et al. Acid Ceramidase Deficiency: Farber Disease And SMA-PME. Orphanet J Rare Dis 2018; 13(1): 121. [DOI:10.1186/s13023-018-0845-z] [PMID] [PMCID]
15. Gieselmann V, Krägeloh-Mann I. Metachromatic Leukodystrophy-An Update. Neuropediatrics 2010; 41(1): 1-6. [DOI:10.1055/s-0030-1253412] [PMID]
16. Mahmood A, Berry J, Wenger DA, et al. Metachromatic Leukodystrophy: A Case Of Triplets With The Late Infantile Variant And A Systematic Review Of The Literature. J Child Neurol 2010; 25(5): 572-80. [DOI:10.1177/0883073809341669] [PMID] [PMCID]
17. Escolar ML, Aldenhoven M. Leukodystrophies And Lysosomal Storage Disorders. Stem Cell Therapy In Lysosomal Storage Diseases. Springer, 2013, 63-125. [DOI:10.1007/978-1-4614-8357-1_4]
18. Lee JS, Choi JM, Lee M, et al. Diagnostic Challenge For The Rare Lysosomal Storage Disease: Late Infantile GM1 Gangliosidosis. Brain Dev 2018; 40(5): 383-90. [DOI:10.1016/j.braindev.2018.01.009] [PMID]
19. Pastores GM, Hughes DA. Gaucher Disease. Genereviews®[Internet] University Of Washington, Seattle, 2018.
20. Markuszewska-Kuczynska A, Klimkowska M, Regenthal S, et al. Atypical Cytomorphology Of Gaucher Cells Is Frequently Seen In Bone Marrow Smears From Untreated Patients With Gaucher Disease Type 1. Folia Histochem Cytobiol 2015; 53(1): 62-9. [DOI:10.5603/FHC.a2015.0003] [PMID]
21. Saito S, Ohno K, Suzuki T, et al. Structural Bases Of Wolman Disease And Cholesteryl Ester Storage Disease. Mol Genet Metab 2012; 105(2): 244-8. [DOI:10.1016/j.ymgme.2011.11.004] [PMID]

Send email to the article author


Rights and Permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

© 2024 CC BY-NC 4.0 | Iranian South Medical Journal

Designed & Developed by: Yektaweb