UNLABELLED: The clinical spectrum and the effects of treatment over a period of 5 years in five children with cerebrotendinous xanthomatosis (CTX) are described. In all children biochemical, neuroradiological, and neurophysiological studies were done. CTX was diagnosed and effects of therapy were evaluated by determination of the serum cholestanol/cholesterol ratio (CCR) and the urinary excretion of bile alcohols. All children were treated with chenodeoxycholic acid (15 mg/kg/day) in three divided oral doses. Diarrhoea and juvenile cataract were the main clinical features. Psychomotor retardation, pyramidal and cerebellar signs were also found. After starting treatment, biochemical abnormalities normalized and diarrhoea disappeared. After 1 year of therapy there was no further delay in motor development, and in three children the intelligence quotient improved. EEG abnormalities disappeared. After 5 years of therapy the children are in a stable clinical condition. CONCLUSION: The clinical, biochemical and neurophysiological abnormalities in five children with CTX showed a remarkable improvement after starting treatment with chenodeoxycholic acid. The early diagnosis of CTX and the start of treatment with chenodeoxycholic acid has prevented neurological deterioration for a period of 5 years.
UNLABELLED: The clinical spectrum and the effects of treatment over a period of 5 years in five children with cerebrotendinous xanthomatosis (CTX) are described. In all children biochemical, neuroradiological, and neurophysiological studies were done. CTX was diagnosed and effects of therapy were evaluated by determination of the serum cholestanol/cholesterol ratio (CCR) and the urinary excretion of bile alcohols. All children were treated with chenodeoxycholic acid (15 mg/kg/day) in three divided oral doses. Diarrhoea and juvenile cataract were the main clinical features. Psychomotor retardation, pyramidal and cerebellar signs were also found. After starting treatment, biochemical abnormalities normalized and diarrhoea disappeared. After 1 year of therapy there was no further delay in motor development, and in three children the intelligence quotient improved. EEG abnormalities disappeared. After 5 years of therapy the children are in a stable clinical condition. CONCLUSION: The clinical, biochemical and neurophysiological abnormalities in five children with CTX showed a remarkable improvement after starting treatment with chenodeoxycholic acid. The early diagnosis of CTX and the start of treatment with chenodeoxycholic acid has prevented neurological deterioration for a period of 5 years.
Authors: F Ginanneschi; A Mignarri; M Mondelli; G N Gallus; M Del Puppo; S Giorgi; A Federico; A Rossi; M T Dotti Journal: J Neurol Date: 2012-08-10 Impact factor: 4.849
Authors: Frédéric M Vaz; Albert H Bootsma; Willem Kulik; Aad Verrips; Ron A Wevers; Peter C Schielen; Andrea E DeBarber; Hidde H Huidekoper Journal: J Lipid Res Date: 2017-03-17 Impact factor: 5.922
Authors: Andrea E DeBarber; Limor Kalfon; Ayalla Fedida; Vered Fleisher Sheffer; Shani Ben Haroush; Natalia Chasnyk; Efrat Shuster Biton; Hanna Mandel; Krystal Jeffries; Eric S Shinwell; Tzipora C Falik-Zaccai Journal: J Lipid Res Date: 2018-08-22 Impact factor: 5.922