Die Ahornsirupkrankheit mit famili�rem Befall

Ultrastructural findings in maple syrup urine disease in Poll Hereford calves

Ultrastructural findings in the nervous systems of two Poll Hereford calves affected with maple syrup urine disease or branched chain ketoacid decarboxylase deficiency are described. The calves were affected within 2 days of birth with a severe generalised central nervous system (CNS) disorder characterised by dullness and weakness, progressing to recumbency and opisthotonus. The urine had an odour of burnt sugar. Analysis of plasma and cerebrospinal fluid demonstrated significantly elevated levels of the branched chain amino acids leucine, isoleucine and valine. Status spongiosus affecting mainly the white matter was recorded at microscopic examination of the CNS, with ultrastructural examination confirming the presence of intramyelinic vacuole formation, suggesting myelin oedema.

CT findings in a case of deficiency of 3-hydroxy-3-methylglutaryl-CoA-lyase

Two CT scans have been performed on a child with a biochemically confirmed 3-HMG-CoA-lyase deficiency. Macrocephalus, widespread hypodensity of the white matter with cystic alterations and progressive dilatation of the ventricles were found. The clinical features and CT findings are surprisingly similar to findings in patients with spongy degeneration (Canavan).

A neuropathological investigation of a case of tyrosinosis

An autopsy case of tyrosinosis was reported. The patient was a 5-month-old boy who had jaundice and hepatosplenomegaly since 10 weeks after his birth. Tyrosine blood level was 6.937 mg/dl and the level of p-HPPA oxidase low. Neuropathologically, the cerebral lesions were characterized by a spongy state, vacuoles in neuronal cells and focal deposition of PAS-positive substance in and around the axon. The electron microscopic examination revealed axonal degeneration and unusual deep cortical structure, possibly axons, containing numerous lysosomes, elongated mitochondria and MCB-like bodies in unmyelinated axon. These facts were suggested to represent morphologic evidence of altered cellular metabolism, related to impaired tyrosine degradation.

Cerebral malformation associated with metabolic disorder. A report of 2 cases

A clinical and neuropathological study is presented of two cases each of which showed neuronal heterotopia. Microgyria was also present in one case. One patient was suffering from a degenerative disorder affecting the white matter. The other was a case of Menkes' disease. It is suggested that the antenatal damage may have been caused by an imbalance of the maternal metabolism, the predisposing factor being the mother's carrier state for a metabolic defect. This is the first report of teratogenesis in a case of Menkes' disease. It is also noted that in this case there is interference with the postnatal as well as the antenatal development of the brain.

Spongy degeneration in the white matter of the central nervous system in the newborn: pathological findings in three infants, one with hyperglycinaemia

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