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Lobbes H, Reynaud Q, Mainbourg S, Lega JC, Durieu I, Durupt S. [Aceruloplasminemia, a rare condition not to be overlooked]. Rev Med Interne 2020; 41:769-775. [PMID: 32682623 DOI: 10.1016/j.revmed.2020.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 04/24/2020] [Revised: 05/26/2020] [Accepted: 06/01/2020] [Indexed: 01/01/2023]
Abstract
Aceruloplasminemia is a rare iron-overload disease that should be better known by physicians. It is an autosomal recessive disorder due to mutations in ceruloplasmin gene causing systemic iron overload, including cerebral and liver parenchyma. The impairment of ferroxidase ceruloplasmin activity leads to intracellular iron retention leading aceruloplasminemia symptoms. Neurologic manifestations include cognitive impairment, ataxia, extrapyramidal syndrome, abnormal movements, and psychiatric-like syndromes. Physicians should search for aceruloplasminemia in several situations with high ferritin levels: microcytic anaemia, diabetes mellitus, neurological and psychiatric disorders. Diagnosis approach is based on the study of transferrin saturation and hepatic iron content evaluated by magnetic resonance imaging of the liver. Ceruloplasmin dosage is required in case of low transferrin saturation and high hepatic iron content and genetic testing is mandatory in case of serum ceruloplasmin defect. Neurological manifestations occur in the sixties decade and leads to disability. Iron chelators are widely used. Despite their efficacy on systemic and cerebral iron overload, iron chelators tolerance is poor. Early initiation of iron chelation therapy might prevent or slowdown neurodegeneration, highlighting the need for an early diagnosis but their clinical efficacy remains uncertain.
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Affiliation(s)
- H Lobbes
- Service de médecine interne, hôpital Estaing, CHU de Clermont-Ferrand, 1, place Lucie-et-Raymond-Aubrac, 63000 Clermont-Ferrand, France.; Service de médecine interne et vasculaire, Centre de compétence des surcharges en fer rares d'origine génétique, hôpital Lyon Sud, Hospices civils de Lyon, 165, chemin du Grand-Revoyet, 69310 Pierre-Bénite, France..
| | - Q Reynaud
- Service de médecine interne et vasculaire, Centre de compétence des surcharges en fer rares d'origine génétique, hôpital Lyon Sud, Hospices civils de Lyon, 165, chemin du Grand-Revoyet, 69310 Pierre-Bénite, France
| | - S Mainbourg
- Service de médecine interne et vasculaire, Centre de compétence des surcharges en fer rares d'origine génétique, hôpital Lyon Sud, Hospices civils de Lyon, 165, chemin du Grand-Revoyet, 69310 Pierre-Bénite, France
| | - J-C Lega
- Service de médecine interne et vasculaire, Centre de compétence des surcharges en fer rares d'origine génétique, hôpital Lyon Sud, Hospices civils de Lyon, 165, chemin du Grand-Revoyet, 69310 Pierre-Bénite, France
| | - I Durieu
- Service de médecine interne et vasculaire, Centre de compétence des surcharges en fer rares d'origine génétique, hôpital Lyon Sud, Hospices civils de Lyon, 165, chemin du Grand-Revoyet, 69310 Pierre-Bénite, France
| | - S Durupt
- Service de médecine interne et vasculaire, Centre de compétence des surcharges en fer rares d'origine génétique, hôpital Lyon Sud, Hospices civils de Lyon, 165, chemin du Grand-Revoyet, 69310 Pierre-Bénite, France
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Abstract
A cognitive and psychological approach is essential to take into account all the phenomena which can be observed in the everyday life of patients with Parkinson's disease. In order to provide patients and their carer(s) with clear and specific answers to help them gain a better insight into their future everyday life, the non-motor symptoms associated with the disease must be identified: cognitive, psychological and behavioural disorders.
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Affiliation(s)
- Michèle Chazot-Balcon
- Services de neurologie et neurochirurgie, centre hospitalier universitaire, avenue Martin-Luther-King, 87042 Limoges cedex, France
| | - Jean-Pierre Bouchard
- Institut psycho-judiciaire et de psychopathologie, Institute of forensic psychology and psychopathology, unité pour malades difficiles, centre hospitalier, 10, avenue Joseph-Caussil, 33410 Cadillac, France.
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Abstract
PARKINSON'S DISEASE NEUROPSYCHOPATHOLOGY (1/2).: A progressive, neurodegenerative disease of unknown aetiology, Parkinson's disease is characterised mainly by motor disorders. As the disease progresses, other disorders appear: speech, swallowing, perspiration, genitourinary, etc., as well as cognitive and psychological conditions. The consequences are significant, both on a social level and in terms of autonomy. The treatment is specialised and multi-professional.
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Affiliation(s)
- Michèle Chazot-Balcon
- Services de neurologie et neurochirurgie, CHU de Limoges, 2, avenue Martin-Luther-King, 87042 Limoges cedex, France
| | - Jean-Pierre Bouchard
- Institut psycho-judiciaire et de psychopathologie (IPJP), Institute of forensic psychology and psychopathology, Unité pour malades difficiles (UMD), centre hospitalier de Cadillac 10, avenue Joseph-Caussil 33410 Cadillac, France.
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