1
|
Boruah R, Monavari AA, Conlon T, Murphy N, Stroiescu A, Ryan S, Hughes J, Knerr I, McDonnell C, Crushell E. Secondary Hyperparathyroidism in Children with Mucolipidosis Type II (I-Cell Disease): Irish Experience. J Clin Med 2022; 11:jcm11051366. [PMID: 35268460 PMCID: PMC8911139 DOI: 10.3390/jcm11051366] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 02/21/2022] [Accepted: 02/25/2022] [Indexed: 02/06/2023] Open
Abstract
Mucolipidosis type II (ML II) is an autosomal recessive lysosomal targeting disorder that may present with features of hyperparathyroidism. The aim of this study was to describe in detail the clinical cases of ML II presenting to a tertiary referral centre with biochemical and/or radiological features of hyperparathyroidism. There were twenty-three children diagnosed with ML II in the Republic of Ireland from July 1998 to July 2021 inclusive (a 23-year period). The approximate incidence of ML II in the Republic of Ireland is, therefore, 1 per 64,000 live births. Medical records were available and were reviewed for 21 of the 23 children. Five of these had been identified as having biochemical and/or radiological features of hyperparathyroidism. Of these five, three children were born to Irish Traveller parents and two to non-Traveller Irish parents. All five children had radiological features of hyperparathyroidism (on skeletal survey), with evidence of antenatal fractures in three cases and an acute fracture in one. Four children had biochemical features of secondary hyperparathyroidism. Three children received treatment with high dose Vitamin D supplements and two who had antenatal/acute fractures were managed with minimal handling. We observed resolution of secondary hyperparathyroidism in all cases irrespective of treatment. Four of five children with ML II and hyperparathyroidism died as a result of cardiorespiratory failure at ages ranging from 10 months to 7 years. Biochemical and/or radiological evidence of hyperparathyroidism is commonly identified at presentation of ML II. Further studies are needed to establish the pathophysiology and optimal management of hyperparathyroidism in this cohort. Recognition of this association may improve diagnostic accuracy and management, facilitate family counseling and is also important for natural history data.
Collapse
Affiliation(s)
- Ritma Boruah
- National Centre for Inherited Metabolic Diseases (NCIMD), Children’s Health Ireland at Temple Street, D01 XD99 Dublin, Ireland; (A.A.M.); (J.H.); (I.K.); (E.C.)
- Correspondence:
| | - Ahmad Ardeshir Monavari
- National Centre for Inherited Metabolic Diseases (NCIMD), Children’s Health Ireland at Temple Street, D01 XD99 Dublin, Ireland; (A.A.M.); (J.H.); (I.K.); (E.C.)
- School of Medicine, University College Dublin, D04 V1W8 Dublin, Ireland; (T.C.); (N.M.)
| | - Tracey Conlon
- School of Medicine, University College Dublin, D04 V1W8 Dublin, Ireland; (T.C.); (N.M.)
- Department of Endocrinology, Children’s Health Ireland at Temple Street, D01 XD99 Dublin, Ireland;
| | - Nuala Murphy
- School of Medicine, University College Dublin, D04 V1W8 Dublin, Ireland; (T.C.); (N.M.)
- Department of Endocrinology, Children’s Health Ireland at Temple Street, D01 XD99 Dublin, Ireland;
| | - Andreea Stroiescu
- Department of Radiology, Children’s Health Ireland at Temple Street, D01 XD99 Dublin, Ireland; (A.S.); (S.R.)
| | - Stephanie Ryan
- Department of Radiology, Children’s Health Ireland at Temple Street, D01 XD99 Dublin, Ireland; (A.S.); (S.R.)
| | - Joanne Hughes
- National Centre for Inherited Metabolic Diseases (NCIMD), Children’s Health Ireland at Temple Street, D01 XD99 Dublin, Ireland; (A.A.M.); (J.H.); (I.K.); (E.C.)
| | - Ina Knerr
- National Centre for Inherited Metabolic Diseases (NCIMD), Children’s Health Ireland at Temple Street, D01 XD99 Dublin, Ireland; (A.A.M.); (J.H.); (I.K.); (E.C.)
- School of Medicine, University College Dublin, D04 V1W8 Dublin, Ireland; (T.C.); (N.M.)
| | - Ciara McDonnell
- Department of Endocrinology, Children’s Health Ireland at Temple Street, D01 XD99 Dublin, Ireland;
| | - Ellen Crushell
- National Centre for Inherited Metabolic Diseases (NCIMD), Children’s Health Ireland at Temple Street, D01 XD99 Dublin, Ireland; (A.A.M.); (J.H.); (I.K.); (E.C.)
- School of Medicine, University College Dublin, D04 V1W8 Dublin, Ireland; (T.C.); (N.M.)
| |
Collapse
|
2
|
Saraff V, Nadar R, Shaw N. Neonatal Bone Disorders. Front Pediatr 2021; 9:602552. [PMID: 33889553 PMCID: PMC8057522 DOI: 10.3389/fped.2021.602552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 03/08/2021] [Indexed: 11/30/2022] Open
Abstract
Neonatologists care for newborns with either an antenatal suspicion or postnatal diagnosis of bone disease. With improved ultrasound imaging techniques, more cases of neonatal bone disorders are identified antenatally and this requires further diagnostic/molecular testing either antenatally or soon after birth for confirmation of the diagnosis and facilitating subsequent management. Prompt diagnosis is vital in certain conditions where initiation of treatment is time critical and life saving. We outline an approach to diagnosis, investigation, and management of a neonate with a suspected bone disorder.
Collapse
Affiliation(s)
- Vrinda Saraff
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom.,Department of Endocrinology & Diabetes, Birmingham Women's and Children's National Health Service (NHS) Foundation Trust, Birmingham, United Kingdom
| | - Ruchi Nadar
- Department of Endocrinology & Diabetes, Birmingham Women's and Children's National Health Service (NHS) Foundation Trust, Birmingham, United Kingdom
| | - Nick Shaw
- Department of Endocrinology & Diabetes, Birmingham Women's and Children's National Health Service (NHS) Foundation Trust, Birmingham, United Kingdom.,Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, United Kingdom
| |
Collapse
|
3
|
Capobres T, Sabharwal G, Griffith B. A case of I-cell disease (mucolipidosis II) presenting with short femurs on prenatal ultrasound and profound diaphyseal cloaking. BJR Case Rep 2016; 2:20150420. [PMID: 30459979 PMCID: PMC6243348 DOI: 10.1259/bjrcr.20150420] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Revised: 02/06/2016] [Accepted: 02/15/2016] [Indexed: 11/05/2022] Open
Abstract
A 28-year-old G3 P1 SAB1 female with no prior health concerns was found to have a foetus with short femurs on prenatal ultrasound following an abnormal maternal serum screen result. Fluid obtained by amniocentesis revealed an elevated α-fetoprotein level with absence of an acetylcholinesterase band and normal male karyotype (46,XY). Follow-up ultrasound 3 weeks later again demonstrated short femur lengths, but no other abnormalities. At birth, the child was noted to have multiple dysmorphic features, including short humeri and femurs, coarse facial features, retrognathia and yellowish hypertrophic gums in addition to hyperbilirubinaemia and thrombocytopenia. Radiological studies demonstrated bony demineralization with profound diaphyseal cloaking in the long bones. Genetic testing diagnosed I-cell disease.
Collapse
Affiliation(s)
- Thomas Capobres
- Department of Radiology, Henry Ford Health System, Detroit, MI, USA
| | | | - Brent Griffith
- Department of Radiology, Henry Ford Health System, Detroit, MI, USA
| |
Collapse
|
4
|
David-Vizcarra G, Briody J, Ault J, Fietz M, Fletcher J, Savarirayan R, Wilson M, McGill J, Edwards M, Munns C, Alcausin M, Cathey S, Sillence D. The natural history and osteodystrophy of mucolipidosis types II and III. J Paediatr Child Health 2010; 46:316-22. [PMID: 20367762 PMCID: PMC4188554 DOI: 10.1111/j.1440-1754.2010.01715.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM To assess the natural history and impact of the secondary bone disease observed in patients with mucolipidosis (ML) II and III. METHODS Affected children and adults were ascertained from clinical genetics units around Australia and New Zealand. Diagnoses were confirmed by the National Referral Laboratory in Adelaide. The study encompassed all patients ascertained between 1975 and 2005. Data focussing on biochemical parameters at diagnosis, and longitudinal radiographic findings were sought for each patient. Where feasible, patients underwent clinical review and examination. Examinations included skeletal survey, bone densitometry, and measurement of serum and urine markers of bone metabolism. In a subset of patients, functional assessment using the Pediatric Evaluation and Disability Inventory (PEDI) and molecular analysis of GNPTAB were performed. RESULTS Twenty-five patients with mucolipidosis were ascertained over a 30-year period. Morbidity and functional outcomes on living patients were described. Serum calcium and phosphate were normal. All, but one patient, had normal alkaline phosphatase. Serum osteocalcin and urine deoxypyridinoline/creatinine were elevated. Two radiological patterns were observed (i) transient neonatal hyperparathyroidism in infants with ML II and (ii) progressive osteodystrophy in patients with ML intermediate and ML III. Molecular analyses of GNPTAB in nine subjects are reported. CONCLUSION ML is characterised by a progressive bone and mineral disorder which we describe as the 'osteodystrophy of mucolipidosis'. The clinical and radiographic features of this osteodystrophy are consistent with a syndrome of 'pseudohyperparathyroidism'. Much of the progressive skeletal and joint pathology is attributable to this bone disorder.
Collapse
Affiliation(s)
| | - Julie Briody
- Bone Densitometry, Department of Nuclear Medicine, The Children’s Hospital at estmead, NSW
| | - Jenny Ault
- Department of Rehabilitation, The Children’s Hospital at Westmead, NSW
| | - Michael Fietz
- Division of Genetic Medicine, Women’s and Children’s Hospital, North Adelaide, SA
| | - Janice Fletcher
- Division of Genetic Medicine, Women’s and Children’s Hospital, North Adelaide, SA
| | - Ravi Savarirayan
- Genetic Health Victoria, Royal Children’s Hospital, Parkville, Victoria
| | - Meredith Wilson
- Department of Clinical Genetics, The Children’s Hospital at Westmead, NSW
| | - Jim McGill
- Department of Metabolism, Royal Children’s Hospital, Brisbane, Qld
| | | | - Craig Munns
- Department of Endocrinology, The Children’s Hospital at Westmead, NSW
| | - Melanie Alcausin
- Department of Clinical Genetics, The Children’s Hospital at Westmead, NSW
| | | | - David Sillence
- Department of Clinical Genetics, The Children’s Hospital at Westmead, NSW,Discipline of Genetic Medicine, University of Sydney, Camperdown, NSW
| |
Collapse
|
5
|
Flanagan-Steet H, Sias C, Steet R. Altered chondrocyte differentiation and extracellular matrix homeostasis in a zebrafish model for mucolipidosis II. THE AMERICAN JOURNAL OF PATHOLOGY 2009; 175:2063-75. [PMID: 19834066 DOI: 10.2353/ajpath.2009.090210] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Mucolipidosis II (ML-II) is a pediatric disorder caused by defects in the biosynthesis of mannose 6-phosphate, the carbohydrate recognition signal responsible for targeting certain acid hydrolases to lysosomes. The mechanisms underlying the developmental defects of ML-II are largely unknown due in part to the lack of suitable animal models. To overcome these limitations, we developed a model for ML-II in zebrafish by inhibiting the expression of N-acetylglucosamine-1-phosphotransferase, the enzyme that initiates mannose 6-phosphate biosynthesis. Morphant embryos manifest craniofacial defects, impaired motility, and abnormal otolith and pectoral fin development. Decreased mannose phosphorylation of several lysosomal glycosidases was observed in morphant lysates, consistent with the reduction in phosphotransferase activity. Investigation of the craniofacial defects in the morphants uncovered striking changes in the timing and localization of both type II collagen and Sox9 expression, suggestive of an accelerated chondrocyte differentiation program. Accumulation of type II collagen was also noted within misshapen cartilage elements at later stages of development. Furthermore, we observed abnormal matrix formation and calcium deposition in morphant otoliths. Collectively, these data provide new insight into the developmental pathology of ML-II and suggest that altered production and/or homeostasis of extracellular matrix proteins are integral to the disease process. These findings highlight the potential of the zebrafish system in studying lysosomal disease pathogenesis.
Collapse
|
6
|
Staretz-Chacham O, Lang TC, LaMarca ME, Krasnewich D, Sidransky E. Lysosomal storage disorders in the newborn. Pediatrics 2009; 123:1191-207. [PMID: 19336380 PMCID: PMC2768319 DOI: 10.1542/peds.2008-0635] [Citation(s) in RCA: 144] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Lysosomal storage disorders are rare inborn errors of metabolism, with a combined incidence of 1 in 1500 to 7000 live births. These relatively rare disorders are seldom considered when evaluating a sick newborn. A significant number of the >50 different lysosomal storage disorders, however, do manifest in the neonatal period and should be part of the differential diagnosis of several perinatal phenotypes. We review the earliest clinical features, diagnostic tests, and treatment options for lysosomal storage disorders that can present in the newborn. Although many of the lysosomal storage disorders are characterized by a range in phenotypes, the focus of this review is on the specific symptoms and clinical findings that present in the perinatal period, including neurologic, respiratory, endocrine, and cardiovascular manifestations, dysmorphic features, hepatosplenomegaly, skin or ocular involvement, and hydrops fetalis/congenital ascites. A greater awareness of these features may help to reduce misdiagnosis and promote the early detection of lysosomal storage disorders. Implementing therapy at the earliest stage possible is crucial for several of the lysosomal storage disorders; hence, an early appreciation of these disorders by physicians who treat newborns is essential.
Collapse
Affiliation(s)
- Orna Staretz-Chacham
- Office of the Clinical Director, Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland
| | - Tess C. Lang
- Section on Molecular Neurogenetics, Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland
| | - Mary E. LaMarca
- Section on Molecular Neurogenetics, Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland
| | - Donna Krasnewich
- Office of the Clinical Director, Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland
| | - Ellen Sidransky
- Section on Molecular Neurogenetics, Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland
| |
Collapse
|
7
|
Chitayat D, Keating S, Zand DJ, Costa T, Zackai EH, Silverman E, Tiller G, Unger S, Miller S, Kingdom J, Toi A, Curry CJ. Chondrodysplasia punctata associated with maternal autoimmune diseases: Expanding the spectrum from systemic lupus erythematosus (SLE) to mixed connective tissue disease (MCTD) and scleroderma report of eight cases. Am J Med Genet A 2008; 146A:3038-53. [DOI: 10.1002/ajmg.a.32554] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
8
|
Unger S, Paul DA, Nino MC, McKay CP, Miller S, Sochett E, Braverman N, Clarke JTR, Cole DEC, Superti-Furga A. Mucolipidosis II presenting as severe neonatal hyperparathyroidism. Eur J Pediatr 2005; 164:236-43. [PMID: 15580357 DOI: 10.1007/s00431-004-1591-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2004] [Revised: 10/19/2004] [Accepted: 10/21/2004] [Indexed: 10/26/2022]
Abstract
UNLABELLED Mucolipidosis II (ML II or I-cell disease ) (OMIM 252500) is an autosomal recessive lysosomal enzyme targeting disorder that usually presents between 6 and 12 months of age with a clinical phenotype resembling Hurler syndrome and a radiological picture of dysostosis multiplex. When ML II is severe enough to be detected in the newborn period, the radiological changes have been described as similar to hyperparathyroidism or rickets. The biological basis of these findings has not been explored and few biochemical measurements have been recorded. We describe three unrelated infants with ML II who had radiological features of intrauterine hyperparathyroidism and biochemical findings consistent with severe secondary neonatal hyperparathyroidism (marked elevation of serum parathyroid hormone and alkaline phosphatase levels). The vitamin D metabolites were not substantially different from normal and repeatedly normal calcium concentrations excluded vitamin D deficiency rickets and neonatal severe hyperparathyroidism secondary to calcium-sensing receptor gene mutations (OMIM 239200). The pathogenesis of severe hyperparathyroidism in the fetus and newborn with ML II is unexplained. We hypothesize that the enzyme targeting defect of ML II interferes with transplacental calcium transport leading to a calcium starved fetus and activation of the parathyroid response to maintain extracellular calcium concentrations within the normal range. CONCLUSION Newborns with mucolipidosis II can present with radiological and biochemical signs of hyperparathyroidism. Awareness of this phenomenon may help in avoiding diagnostic pitfalls and establishing a proper diagnosis and therapy.
Collapse
Affiliation(s)
- Sheila Unger
- Division of Clinical and Metabolic Genetics, The Hospital for Sick Children, Toronto, Canada.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
9
|
Kabra M, Gulati S, Kaur M, Sharma J, Singh A, Chopra V, Menon PS, Kalra V. I-cell disease (Mucolipidosis II). Indian J Pediatr 2000; 67:683-7. [PMID: 11028124 DOI: 10.1007/bf02762185] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
I-cell disease (Mucolipidosis II) is one of the lysosomal storage diseases which presents in the neonatal period, and within six months will phenotypically resemble the severe forms of the group of disorders called the "mucopolysaccharidoses" but without mucopolysacchariduria. In Mucolipidosis II, fibrocytes exhibit "abnormal lysosomes". Activities of several lysosomal enzymes are low in fibroblast cultures but high in mucolipidosis II serum. We present a patient with I-cell disease diagnosed on the basis of clinical, radiological and biochemical features. The mother of this child was pregnant and the fetus was also found to be affected.
Collapse
Affiliation(s)
- M Kabra
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi
| | | | | | | | | | | | | | | |
Collapse
|
10
|
Beck M, Barone R, Hoffmann R, Kratzer W, Rakowsky T, Nigro F, Fiumara A. Inter- and intrafamilial variability in mucolipidosis II (I-cell disease). Clin Genet 1995; 47:191-9. [PMID: 7628121 DOI: 10.1111/j.1399-0004.1995.tb03958.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
In this paper nine patients with mucolipidosis II (I-cell disease) are described. They had clinical features commonly found in mucolipidosis II, including disproportionate dwarfism, coarse facial features and mental retardation. However, there was remarkable variability in age of onset, organ manifestation and radiological findings. Some had unusual clinical symptoms including pericardial effusion and profound brain atrophy. Striking differences in phenotypic expression were also seen in two affected siblings. Clinical heterogeneity is observed not only in mucolipidosis II but also in many other lysosomal storage disorders. The factors that may contribute to this clinical diversity are discussed.
Collapse
Affiliation(s)
- M Beck
- Universitäts-Kinderklinik, Mainz, Germany
| | | | | | | | | | | | | |
Collapse
|
11
|
Roberts DJ, Ampola MG, Lage JM. Diagnosis of unsuspected fetal metabolic storage disease by routine placental examination. PEDIATRIC PATHOLOGY 1991; 11:647-56. [PMID: 1946081 DOI: 10.3109/15513819109064796] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
GM1 gangliosidosis (type 1) is a rare hereditary, autosomal recessive, lysosomal storage disease characterized by a marked deficiency of active acid beta-galactosidase resulting in accumulation of gangliosides and mucopolysaccharides in tissues. Disease status of newborns from affected kindreds may be diagnosed by placental examination. Typical findings include a characteristic vacuolar distension of the cytoplasm of syncytiotrophoblast and stromal Hofbauer cells. We report a case of unsuspected fetal storage disorder initially diagnosed by routine placental examination of a normal-appearing infant born to a previously unaffected family. Progressive, third-trimester oligohydramnios and fetal growth retardation had been documented by ultrasonography. Placental findings included vacuolization of syncytiotrophoblast, intermediate trophoblast, and stromal Hofbauer cells. Subsequent enzyme analysis confirmed the placental findings of storage disorder and diagnosed GM1 gangliosidosis.
Collapse
Affiliation(s)
- D J Roberts
- Departments of Pathology, Women's and Perinatal Division, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115
| | | | | |
Collapse
|
12
|
Pazzaglia UE, Beluffi G, Bianchi E, Castello A, Coci A, Marchi A. Study of the bone pathology in early mucolipidosis II (I-cell disease). Eur J Pediatr 1989; 148:553-7. [PMID: 2744018 DOI: 10.1007/bf00441557] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Histological examination of the bones obtained on autopsy of a 5-month-old child with mucolipidosis II (I-cell disease) revealed inhibition of the growth plate calcification with defective vascular invasion and signs of hyperparathyroidism. These findings are the chondro-osseous basis of the early radiological ricket-like appearance of bones in the neonatal period or soon thereafter. Whether the early skeletal abnormalities of mucolipidosis II result from a primary enzymatic defect of cartilage and bone cells or from factors controlling bone metabolism deserves further study.
Collapse
Affiliation(s)
- U E Pazzaglia
- Clinica Ortopedica e Traumatologica dell'Universitá di Pavia, Italy
| | | | | | | | | | | |
Collapse
|
13
|
Pazzaglia UE, Beluffi G, Campbell JB, Bianchi E, Colavita N, Diard F, Gugliantini P, Hirche U, Kozlowski K, Marchi A. Mucolipidosis II: correlation between radiological features and histopathology of the bones. Pediatr Radiol 1989; 19:406-13. [PMID: 2771479 DOI: 10.1007/bf02387638] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Twelve cases of Mucolipidosis II (I-cell disease) with a wide range of severity of skeletal involvement were studied. Pathological findings in two cases provided helpful information in understanding the radiographic features of dysostosis multiplex. Inhibition of the growth plate cartilage calcification and rickets-like lesions were observed in the metaphyses. Enhanced subperiosteal remodelling and paratrabecular fibrosis were also evident in the diaphyses. High levels of parathormone were found in one case. This finding supports the hypothesis that bone lesions may be secondary, at least in part, to damage in such viscera as the kidney and/or the liver and that they are mediated by vitamin D and parathormone.
Collapse
|