Familial centronuclear myopathy

A girl with typical clinical and histologic features of centronuclear myopathy (CNM) is described. The electromyogram was clearly of myopathic type; the motor conduction velocity was reduced. The analysis of the pedigree, in which three other members were similarly affected, suggests autosomal dominant inheritance with low penetrance.

Accidental glibenclamide ingestion in an infant: clinical and electroencephalographic aspects

The clinical and EEG features of an infant during and after a severe episode of glibenclamide-induced hypoglycaemia are reported, with a 12-month follow-up. The very few cases reported in the literature, together with the present report, suggest that the neurological sequelae of severe hypoglycaemia resulting from ingestion of this drug are due to more patchy involvement of the central nervous system than would be expected from experimental work on hypoglycaemia.

Autosomal recessive generalized myotonia

Four cases of autosomal recessive generalized myotonia are reported. Attention is drawn to the fact that this condition represents a disease entity distinct from the myotonia congenita of Thomsen, which is transmitted as an autosomal dominant trait. The clinical features of the two conditions are similar, apart from minor quantitative differences. The family history is the major tool for the differential diagnosis. The possibility of the detection of heterozygotes by electromyography is discussed.

[Neurological and muscular manifestations of thalassemia major (author's transl)]

Five out of 89 sicilian children with homozygous thalassemia major had central nervous system signs but they were probably not due to the disease. Much more commonly peripheral nerve or muscle involvement was detected. Among 51 patients who had detailed clinical and electrophysiological studies (EMG and nerve conduction studies) 20 (39.2%) had clinical signs of neuro-muscular disease and five others had electrophysiological abnormalities only. Serum CPK was normal in all cases. The results suggest that muscle disease in thalassemia major is mostly of neurogenic origin.

Congenital obstruction of the lacrimal passages in five consecutive generations

Congenital epiphora due to absence or imperfection of lacrimal puncta and/or canaliculi was present in 21 members from five consecutive generations of a Sicilian family. The anomaly was transmitted as an autosomal-dominant characteristic with apparently complete penetrance and highly variable expressivity.

Krabbe's disease with unusual clinical and morphological features

A progressive encephalopathy appeared in two sibs aged 7 and 5 months. The children died at 23 respectively 29 months of age. Autopsy of the second child disclosed a severe demyelination involving the whole brain. Only few globoid cells were identified. Ultrastructural and biochemical investigations confirmed the diagnosis of Krabbe's disease.

Immuno-deficiency in Schwartz-Jampel syndrome

Two sisters born in a consanguineous marriage and affected by Schwartz-Jampel syndrome had a complex immunodeficiency, involving not only the humoral but also the cellular immune response.

Schwartz-Jampel syndrome in two daughters of first cousins

The clinical and pathological features of two sisters born from consanguineous parents and affected by the rare Schwartz-Jampel syndrome are reported. The parental consanguinity of these two patients and the findings of electromyographic changes in the mother strongly support an autosomal recessive pattern of inheritance. No response of growth hormone secretion to arginine and insulin stimulation tests was found.

Trisomy 22 mosaicism

A child with many symptoms of trisomy 22 syndrome is described. The child showed a 46,XY/47,XY,+22 chromosome constitution. This is the first reported case of a trisome 22 phenotype with such a mosaic karyotype.

Haematological studies in a case of oculocerebrorenal syndrome

A four-year-old boy affected by oculocerebrorenal syndrome had moderate anaemia. The haematological study indicated hyperhaemolysis probably due to an extra-erythrocytic factor. It is suggested that this factor might be related to the metabolic disturbance of the disease, particularly the hyperchloraemic acidosis.

Hyperprolinaemia: a disease which does not need treatment?

The authors observed two cases of hyperprolinaemia (one of type I and the other of type II) which were asymptomatic. The anomalies described up to the present time in association with hyperprolinaemia are inconstant, nonspecific, and extremely heterogeneous. This suggests that the relationship between hyperprolinaemia and other anomalies is purely coincidental, and that a therapeutic approach by diet is unjustified.

Asymptomatic type II hyperprolinaemia associated with hyperglycinaemia in three sibs

Three clinically normal sibs were discovered to have type II hyperprolinaemia in a routine serum amino acid screening programme in Sicily. In addition to the basic biochemical features of type II hyperprolinaemia, all 3 children had marked hyperglycinaemia, whereas their parents had both normal blood proline and glycine concentrations. Clinical normality in individuals with hyperprolinaemia may suggest that these two metabolic disorders (types I and II) are benign entities. Furthermore, the absence of clinical abnormality in these sibs, despite the presence of marked hyperprolinaemia and hyperglycinaemia, may suggest that neither of these findings alone causes brain damage. The hyperglycinaemia in these sibs is unexplained and is an unusual if not unique finding in association with hyperprolinaemia.

[Congenital hereditary corneal dystrophy associated with various extraoculary anomalies]

Two subjects (brother and sister), children of consanguineous parents, showed a typical congenital corneal dystrophy associated with mental retardation and a bilateral malformation of the little finger. One of them, a boy of 10, was fat and showed a hearing loss for high tones. His corneal opacity diminished during 7 years observation. Seeing that the affected tissues were of mesenchymal origin, the authors conclude that the syndrome was mesodermal.

Robins's syndrome in three children of consanguineous parents. A pedigree suggesting autosomal recessive inheritance

A family is described in which three siblings were affected by Robin's syndrome (micrognathia and glossoptosis with cleft palate) in its severe form. Two children died very early in life, the third is surviving after surgical management and appropriate nursing care. The children were born from a consanguineous marriage (their parents were first cousins). This pedigree is highly suggestive of an autosomal recessive kind of inheritance. Malformations of the extremities (hands and/or feet) were present in the probands as well as in two relatives of the paternal line.