1
|
Alkhalifa A, Chen S, Hasiloglu ZI, Filosto M, Cali E, Houlden H, Sgobbi de Souza P, Alavi A, Goizet C, Stevanin G, Taithe F, Nicita F, Vasco G, Tozza S, Cocozza S, Carboni N, Figus A, Wu J, Basak AN, Brais B, Rouleau G, La Piana R. White matter abnormalities in 15 subjects with SPG76. J Neurol 2023; 270:5784-5792. [PMID: 37578488 DOI: 10.1007/s00415-023-11918-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 07/27/2023] [Accepted: 07/30/2023] [Indexed: 08/15/2023]
Abstract
BACKGROUND AND OBJECTIVES Hereditary spastic paraplegias (HSPs) are heterogenous genetic disorders characterized by progressive pyramidal tract involvement. SPG76 is a recently identified form of HSP, caused by biallelic calpain-1 (CAPN1) variants. The most frequently described MRI abnormality in SPG76 is mild cerebellar atrophy and non-specific white matter abnormalities were reported in only one case. Following the identification of prominent white matter abnormalities in a subject with CAPN1 variants, which delayed the diagnosis, we aimed to verify the presence of MRI patterns of white matter involvement specific to this HSP. METHODS We performed a retrospective radiological qualitative analysis of 15 subjects with SPG76 (4 previously unreported) initially screened for white matter involvement. Moreover, we performed quantitative analyses in our proband with available longitudinal studies. RESULTS We observed bilateral, periventricular white matter involvement in 12 subjects (80%), associated with multifocal subcortical abnormalities in 5 of them (33.3%). Three subjects (20%) presented only multifocal subcortical involvement. Longitudinal quantitative analyses of our proband revealed increase in multifocal white matter lesion count and increased area of periventricular white matter involvement over time. DISCUSSION SPG76 should be added to the list of HSPs with associated white matter abnormalities. We identified periventricular white matter involvement in subjects with SPG76, variably associated with multifocal subcortical white matter abnormalities. These findings, in the presence of progressive spastic paraparesis, can mislead the diagnostic process towards an acquired white matter disorder.
Collapse
Affiliation(s)
- Abdulrahman Alkhalifa
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, 3801 rue University, Montreal, QC, H3A 2B4, Canada
- Bahrain Defence Force Royal Medical Services, Military Hospital, Riffa, Bahrain
| | - Shihan Chen
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, 3801 rue University, Montreal, QC, H3A 2B4, Canada
| | - Zehra Isik Hasiloglu
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, 3801 rue University, Montreal, QC, H3A 2B4, Canada
| | - Massimiliano Filosto
- Department of Clinical and Experimental Sciences, University of Brescia, NeMO-Brescia Clinical Center for Neuromuscular Diseases, Brescia, Italy
| | - Elisa Cali
- Department of Neuromuscular Disease, University College London; The National Hospital for Neurology and Neurosurgery, London, UK
| | - Henry Houlden
- Department of Neuromuscular Disease, University College London; The National Hospital for Neurology and Neurosurgery, London, UK
| | - Paulo Sgobbi de Souza
- Department of Neurology and Neurosurgery, Division of Neuromuscular Diseases, Universidade Federal de São Paulo, Sao Paulo, Brazil
| | - Afagh Alavi
- University of Social Welfare and Rehabilitation Sciences, Genetics Research Center, Tehran, Iran
| | - Cyril Goizet
- NRGEN Team, Univ. Bordeaux, CNRS, INCIA, UMR 5287, EPHE, 33000, Bordeaux, France
- Centre de Référence Maladies Rares Neurogénétique, Service de Génétique Médicale, Bordeaux University Hospital (CHU Bordeaux), Bordeaux, France
| | - Giovanni Stevanin
- Centre de Référence Maladies Rares Neurogénétique, Service de Génétique Médicale, Bordeaux University Hospital (CHU Bordeaux), Bordeaux, France
| | - Frederic Taithe
- Service de Neurologie, Hôpital Gabriel Montpied, CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | - Francesco Nicita
- Genetics and Rare Diseases Research Division, Unit of Neuromuscular and Neurodegenerative Diseases, Bambino Gesù Hospital, IRCCS, Rome, Italy
| | - Gessica Vasco
- Department of Neurosciences, Unit of Neurorehabilitation, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Stefano Tozza
- Department of Neuroscience and Reproductive and Odontostomatological Sciences, University of Naples Federico II, Naples, Italy
| | - Sirio Cocozza
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Nicola Carboni
- Department of Neurology, San Francesco Hospital, Nuoro, Italy
| | - Andrea Figus
- Department of Radiology, San Francesco Hospital, Nuoro, Italy
| | - Jianjun Wu
- National Center for Neurological Disorders and National Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - A Nazli Basak
- Translational Medicine Research Center-NDAL, School of Medicine, Koc University, Istanbul, Turkey
| | - Bernard Brais
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, 3801 rue University, Montreal, QC, H3A 2B4, Canada
- The Neuro (Montreal Neurological Institute-Hospital), McGill University, Montreal, Canada
| | - Guy Rouleau
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, 3801 rue University, Montreal, QC, H3A 2B4, Canada
- The Neuro (Montreal Neurological Institute-Hospital), McGill University, Montreal, Canada
| | - Roberta La Piana
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, 3801 rue University, Montreal, QC, H3A 2B4, Canada.
- The Neuro (Montreal Neurological Institute-Hospital), McGill University, Montreal, Canada.
- Department of Diagnostic Radiology, McGill University, Montreal, QC, Canada.
| |
Collapse
|
2
|
Dugourd PM, Dupont A, Hubiche T, Chiaverini C, Alkhalifa A, Roudiere L, Tristan A, Gustave CA, Del Giudice P. [Staphylococcal toxic shock syndrome should be considered in the event of diffuse erythema with fever and shock]. Ann Dermatol Venereol 2019; 146:287-291. [PMID: 30691878 DOI: 10.1016/j.annder.2018.12.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 08/24/2018] [Accepted: 12/03/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND Toxic shock syndrome (TSS) was first described by Todd in 1978. The relevant Lancet publication reported 7 cases of children with fever, exanthema, hypotension and diarrhoea associated with multiple organ failure. An association between TSS and use of hyper-absorbent tampons in menstruating women was discovered in the 1980s. Following the market withdrawal of such tampons, TSS virtually disappeared. Herein we report a new case of TSS in a 15-year-old girl. PATIENTS AND METHODS A 15-year-old patient was admitted to intensive care for severe sepsis and impaired consciousness associated with diffuse abdominal pain. Dermatological examination revealed diffuse macular exanthema. Laboratory tests showed hepatic cytolysis (ASAT 101 U/L, ALAT 167 U/L, total bilirubin 68μmol/L) and an inflammatory syndrome. Lumbar puncture and blood cultures were sterile while thoraco-abdomino-pelvic and brain scans were normal. The patient was menstruating and had been using a tampon over the previous 24hours. Vaginal sampling and tampon culture revealed TSST-1 toxin-producing S. aureus. Management consisted of intensive care measures and treatment with amoxicillin-clavulanic acid and clindamycin for 10 days. CONCLUSION In case of septic shock associated with diffuse macular exanthema a diagnosis of TSS must be envisaged, particularly in menstruating women.
Collapse
Affiliation(s)
- P-M Dugourd
- Service de dermatologie-infectiologie, CHI Fréjus Saint-Raphaël, 240, avenue de Saint-Lambert, 83600 Fréjus, France.
| | - A Dupont
- Service de rénimation-pédiatrique, CHU de Nice Lenval, 06000 Nice, France
| | - T Hubiche
- Service de dermatologie-infectiologie, CHI Fréjus Saint-Raphaël, 240, avenue de Saint-Lambert, 83600 Fréjus, France
| | - C Chiaverini
- Service de dermatologie, CHU d'Archet 2, 06200 Nice, France
| | - A Alkhalifa
- Service de dermatologie, CHU d'Archet 2, 06200 Nice, France
| | - L Roudiere
- Service de biologie médicale, CHI Fréjus Saint-Raphaël, 83600 Fréjus, France
| | - A Tristan
- Centre de biologie et pathologie Nord, Centre national de référence des staphylocoques, institut des agents infectieux, CHU de Lyon, 69317 Lyon, France
| | - C-A Gustave
- Centre de biologie et pathologie Nord, Centre national de référence des staphylocoques, institut des agents infectieux, CHU de Lyon, 69317 Lyon, France
| | - P Del Giudice
- Service de dermatologie-infectiologie, CHI Fréjus Saint-Raphaël, 240, avenue de Saint-Lambert, 83600 Fréjus, France
| |
Collapse
|