2006, Number 6
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Cir Cir 2006; 74 (6)
Diagnosis of Krabbe’s leukodystrophy by transmission electron microscopy. Case report
Villegas CH, Hernández PAD, Peralta S, Vázquez EJ, Reyes MB
Language: Spanish
References: 24
Page: 477-481
PDF size: 229.84 Kb.
ABSTRACT
Krabbe’s leukodystrophy is a rare hereditary disease in Mexico. For that reason we report the case of an 11-year-old child. Ultrastructural studies of sural nerve biopsy specimen are described. Myelin sheaths were uniformly thin for the fiber diameters. Cytoplasm of Schwann cells exhibited a moderate dilatation with non-membrane masses with partly curvilinear, needle-shaped structures of variable length. The inclusions often had electron-dense or electron-lucent halos. These inclusions ultrastructurally represented Krabbe’s leukodystrophy, and this method aids in the diagnosis in cases that are not available for genetic studies or special laboratory techniques. In this patient, diagnosis of Krabbe’s disease was delayed and established several years after the initial symptoms. Electron microscopic examination of a sural nerve provided evidence for a diagnosis of Krabbe’s leukodystrophy.
REFERENCES
Seitelberger F. Structural manifestations of leukodystrophies. Neuro-pediatrics 1984;15(Suppl):53-61.
2. Wenger DA. Research update on lisosomal disorders with special emphasis on metachromatic leukodystrophy and Krabbe disease. APMIS 1993;Suppl 40;101:81-87.
3. Korn LI, Dor WT, Soffer D, Raas RA, Hurvits H, Nevo Y. Early peripheral nervous system manifestations of infantile Krabbe disease. Pediatr Neurol 2003;28:115-118.
4. De Gasperi R, Gama Sosa MA, Sartorato E, Battistini S, Raghavan S, Kolodny EH. Molecular basis of late-life globoid cell leukodystrophy. Hum Mutat 1999;14:256-262.
5. Sabatelli M, Quaranta L, Madia F, et al. Peripheral neuropathy with hypomyelinating features in adult-onset Krabbe’s disease. Neuromusc Disord 2002;12:386-391.
6. Matalon R, Matalon KM. Canavan disease: prenatal diagnosis and genetic counseling. Obstet Gynecol Clin North Am 2002;29:297-304.
7. Johnson AB. Alexander disease: a review and the gene. Int J Dev Neurosci 2002;20:391-394.
8. Golomb MR, Walsh LE, Carvalho KS,Christensen CK, DeMyer WE. Clinical findings in Pelizaeus-Merzbacher disease. J Clin Neurol 2004;19:328-331.
9. www.ncbi.nlm.nih.gov/entrez/dispomim.cgi?id=245200; Krabbe disease; MIM#245200.
10. Kwan E, Drace J, Enzmann D. Specific CT findings in Krabbe’s disease. AJNR 1984;5:453-458.
11. Baram TZ, Goldman AM, Percy AK. Krabbe’s disease: specific MRI and CT findings. Neurology 1986;36:111-115.
12. Cavanagh N. High density in CT in infantile Krabbe’s disease: a case report. Dev Med Child Neurol 1986;28:799.
13. Sasaki M, Sakuragawua N, Takashima S, et al. MRI and CT findings in Krabbe disease. Pediatr Neurol 1991;7:283-288.
14. Farley TJ, Ketonene LM, Bodensteiner JB, Wang DD. Serial MRI and CT findings in infantile Krabbe disease. Pediatr Neurol 1992;8: 455-458.
15. Finelli DA, Tarr RW, Sawyer RN, Horwitz SJ. Deceptively normal MR in early infantile Krabbe disease. AJNR 1994;15:167-171.
16. Jones BV, Barron TF, Towfighi J. Optic enlargement in Krabbe’s disease. AJNR 1999;20:1228-1231.
17. Bernal OG, Lenn N. Nerve enhancement in early infantile Krabbe’s disease. Neurology 2000;54(12):2348-2349.
18. Given CA, Santos CC, Durden DD. Intracranial and spinal MRI findings associated with Krabbe’s disease: case report. AJNR 2001;22: 1782-1785.
19. Alexander CG, Petrella JR, Kurtzberg J, Provenzale JM. Evaluation of white matter anisotropy in Krabbe disease with diffusion tensor MRI: initial experience. Radiology 2001;218:809-815.
20. Loes DJ, Peters Ch, Krivit W. Globoid cell leukodystrophy: distinguishing early-onset from late-onset disease using a brain MR imaging scoring method. AJNR 1999;20:316-323.
21. Thomas PK, King RH, Kocen RS, Brett EM. Comparative ultrastructural observations on peripheral nerve abnormalities in the late infantile juvenile and late onset forms of metachromatic leukodystrophy. Acta Neuropathol 1977;39:237-245.
22. Matsumoto R, Oka N, Nagahama Y, Akiguchi I, Kimura J. Peripheral neuropathy in late-onset Krabbe’s disease: histochemical and ultrastructural findings. Acta Neuropathol 1996;92:635-639.
23. Bischoff A, Ulrich J. Peripheral neuropathy in globoid cell leukodystrophy (Krabbe’s disease). Ultrastructural and histochemical findings. Brain 1969;92:861-870.
24. Schochet SS, McCormick WF, Powell GF. Krabbe’s disease. A light and electron microscopic study. Acta Neuropathol 1976;36:153-160.