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Ufuk F. Pulmonary Involvement of Niemann-Pick Disease. Radiology 2024; 310:e232633. [PMID: 38349239 DOI: 10.1148/radiol.232633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Affiliation(s)
- Furkan Ufuk
- From the Department of Radiology, Pamukkale University, Kinikli, 20070 Pamukkale, Denizli, Turkey
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Mendelson DS, Wasserstein MP, Desnick RJ, Glass R, Simpson W, Skloot G, Vanier M, Bembi B, Giugliani R, Mengel E, Cox GF, McGovern MM. Type B Niemann-Pick Disease: Findings at Chest Radiography, Thin-Section CT, and Pulmonary Function Testing. Radiology 2006; 238:339-45. [PMID: 16304086 DOI: 10.1148/radiol.2381041696] [Citation(s) in RCA: 89] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To evaluate findings at radiography, computed tomography (CT), and pulmonary function testing in patients with type B Niemann-Pick disease. MATERIALS AND METHODS The study was approved by the institutional review board or ethics committee at each study site and was compliant with HIPAA at the U.S. site. Written informed consent was obtained from each patient or guardian and minor assent was obtained from all children before any study-related procedures. Pulmonary involvement in 53 patients (27 male and 26 female patients; age range, 7-65 years; mean age, 23.3 years) with type B Niemann-Pick disease was evaluated with imaging and pulmonary function tests. All patients underwent chest radiography and thin-section CT, and images were independently interpreted by one of two radiologists. Spirometry (forced vital capacity [FVC] and forced expiratory volume in 1 second [FEV1]) was performed and diffusing capacity of lung for carbon monoxide (Dlco) was evaluated in all patients who could comply. A score for the degree of interstitial lung disease was derived at both radiography and CT, and the CT scores were then compared with results of pulmonary function testing and patient age by means of linear regression. CT scores were compared between the upper and lower lung zones by using the Wilcoxon signed rank test. RESULTS Chest radiography and CT, respectively, revealed interstitial lung disease in 47 (90%) and 51 (98%) of the 52 patients who completed both imaging examinations. There was a basilar predominance of interstitial lung disease at CT. Six patients had pulmonary nodules, one of which was calcified at chest radiography. There were no statistically significant correlations between interstitial lung disease score at CT and age or percentage predicted FVC, FEV1, or Dlco values. CONCLUSION Although pulmonary function test indexes may be abnormal, imaging findings do not necessarily correlate with pulmonary function in patients with type B Niemann-Pick disease.
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Affiliation(s)
- David S Mendelson
- Dept of Radiology, Mount Sinai School of Medicine, One Gustave L. Levy Place, New York, NY 10029, USA.
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Falco F, Bembi B, Cavazza A, Pittis MG, Zucchi L. Pulmonary involvement in an adult female affected by type B Niemann Pick disease. Sarcoidosis Vasc Diffuse Lung Dis 2005; 22:229-33. [PMID: 16315787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
We describe the case of a 33-year-old woman who presented with a pattern of diffuse micronodular opacities with centrolobular distribution at high resolution chest tomography (HRCT) performed after exposure to the smoke of a home fire. An abdominal CT scan showed the presence of 3 rounded hypodense lesions in the spleen parenchyma. A bronchoalveolar lavage (BAL) was performed, showing the presence of lipid laden cells in the aspirated fluid. A video-assisted thoracoscopic biopsy confirmed the presence of the foamy cells filling the alveolar spaces and showed a preserved background pulmonary architecture; the bronchiolar epithelium presented a cytoplasm with a particularly clear colour. Foam cells were present in the bone marrow aspirate too, that contained also sea-blue histiocytes. These data induced us to consider the diagnosis of a metabolic storage disorder, in the first instance Niemann-Pick type B, that was confirmed by low acid lysosomal sphingomyelinase activity on cultured fibroblasts: 5.22 nmol/mg prot/h (n.v. 92 +/- 18.2). Lung involvement is an important complication of Niemann-Pick disease, presenting with the clinical and radiological features of a diffuse lung disease.
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Affiliation(s)
- Francesco Falco
- Division of Respiratory Disease, Santa Maria Nuova Hospital, Reggio Emilia, Italy.
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Abstract
Niemann-Pick disease is a rare inherited disorder characterized by deposition of sphingomyelin in various organs. We describe the high-resolution computed tomography findings in 2 adult sisters with Niemann-Pick disease and extensive pulmonary involvement. The main abnormalities consisted of thickening of the interlobular septa and patchy areas of ground-glass attenuation.
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Affiliation(s)
- Rosana Rodrigues
- Hospital Universitario Clementino Fraga Filho, Rio de Janeiro, Brazil
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González-Reimers E, Sánchez-Pérez MJ, Bonilla-Arjona A, Rodríguez-Gaspar M, Carrasco-Juan JL, Alvarez-Argüelles H, Santolaria-Fernández F. Case report. Pulmonary involvement in an adult male affected by type B Niemann-Pick disease. Br J Radiol 2004; 76:838-40. [PMID: 14623788 DOI: 10.1259/bjr/33503694] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
We report the case of a 39-year-old male patient affected by type B Niemann-Pick disease, in whom pulmonary involvement became evident 15 years after the initial diagnosis. Pulmonary involvement was discovered incidentally during the evaluation of a dry cough and exertional dyspnoea which occurred in the context of an acute febrile, self-limiting illness. In this case, the pulmonary involvement is clinically mild, with minimal alteration of the diffusing capacity for carbon monoxide (DL(CO)), despite moderate fibrosis and widespread infiltration of both alveoli and interstitium by sea blue histiocytes.
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Affiliation(s)
- E González-Reimers
- Departments of Internal Medicine, Radiology and Pathology, Hospital Universitario, Tenerife, Canary Islands, Spain
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Abstract
We report the radiological and high resolution CT (HRCT) findings of the pulmonary involvement in a case of subtype B Niemann-Pick disease, diagnosed in an asymptomatic 22-year-old man, which was proved by bone marrow biopsy and sphingomyelinase assessment. In the present case, HRCT showed smooth interlobular septa thickening and a subtle ground-glass pattern.
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Affiliation(s)
- F Duchateau
- Department of Medical Imaging, Université Catholique de Louvain, Cliniques Universitaires Saint Luc, B-1200 Brussels, Belgium
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Abstract
Niemann-Pick disease (NPD) is a rare, inherited, autosomal recessive, lipid storage disease. The pathognomonic intracellular accumulation of sphingomyelin results in the production and accumulation of 'foam cells'. Interstitial lung disease is a rare manifestation of NPD. We present the case of a 48-year-old white female with NPD involving the lungs, liver and spleen. The chest radiograph showed bilateral, predominantly basal reticulonodular infiltrates and serial pulmonary function tests over a period of years showed preserved expiratory airflow and a severely decreased diffusion capacity for carbon monoxide (DLCO). In view of her visceral involvement, lack of neurological symptoms and survival into adulthood, we believe our patient represents a case of type B NPD. In this type of NPD, aside from prominent hepatosplenomegaly and sexual immaturity, significant pulmonary infiltration with 'Pick cells' has been reported. To date, no therapeutic modality has been shown to alter the natural history of this disease, which results in progressive debilitation and death. This case is unique in that it provides the longest physiological follow-up in the literature, and provides data on the natural history of pulmonary involvement in NPD.
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Affiliation(s)
- O A Minai
- Department of Pulmonary and Critical Care Medicine, The Cleveland Clinic Foundation, Ohio 44195, USA
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Imhof A, Graf C, Streuli RA. [A female patient with splenomegaly, interstitial pneumopathy and giant foam cells in bone marrow]. Schweiz Med Wochenschr 1999; 129:1328-31. [PMID: 10515006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
We describe a case of Niemann-Pick disease type B. A 13-year-old female adolescent of Turkish origin suffered from abdominal pain for several months, finally leading to hospitalisation. The investigations revealed splenomegaly and interstitial pneumopathy. The bone marrow contained giant foam cells typical of Niemann-Pick disease. Enzymatic analysis of a fibroblast culture confirmed the diagnosis of Niemann-Pick disease type B, with reduced activity of acid sphingomyelinase. Niemann-Pick disease is an inherited autosomal recessive lysosomal storage disorder of sphingolipids, resulting in an accumulation of sphingomyelin in the cells of the reticulo-histiocytic system due to an enzymatic defect. In Niemann-Pick disease type B the spleen and lung are the main organs affected. At present no treatment exists for this disorder.
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Affiliation(s)
- A Imhof
- Medizinische Klinik, Regionalspital Langenthal
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Schofer O, Mischo B, Püschel W, Harzer K, Vanier MT. Early-lethal pulmonary form of Niemann-Pick type C disease belonging to a second, rare genetic complementation group. Eur J Pediatr 1998; 157:45-9. [PMID: 9461362 DOI: 10.1007/s004310050764] [Citation(s) in RCA: 49] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
UNLABELLED An infant with an unusual clinical presentation and course of Niemann-Pick disease type C (NPC) is described. The baby presented with severe pulmonary involvement and hepatosplenomegaly at the age of 3 months and died of respiratory failure at the age of 7 months. Cell hybridization studies revealed that the infant belonged to the rare genetic complementation group 2. To our knowledge, this is the third reported case with early-lethal pulmonary involvement in NPC. All three reported patients belong to the minor complementation group 2. An elder brother of the present case had also died at 6 weeks of age from NPC with severe pulmonary involvement. The two complementation groups cannot be distinguished from each other by clinical, cellular and biochemical criteria except for severe pulmonary involvement which may be characteristic of the second group. CONCLUSION NPC may present in early infancy with severe pulmonary involvement mimicking interstitial pneumonia. Such manifestation may be characteristic of the rare genetic complementation group 2.
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Affiliation(s)
- O Schofer
- Kinderklinik Kohlhof, Neunkirchen, Germany
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Crespo Valadés E, Cordero Montero P, Cabanillas Núñez Y, Aguilera Musso D, Checa Pinilla JM. [Empyema and hepatosplenomegaly]. Rev Clin Esp 1997; 197:587-8. [PMID: 9312799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- E Crespo Valadés
- Sección de Neumología, Hospital Regional Universitario Infanta Cristina, Badajoz
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Abstract
We report two cases of a mild form of type-B Niemann-Pick disease manifesting as an adult-onset chronic non-neuropathic clinical picture. Femoral T1- and T2-weighted low-intensity non-enhancing coarse bone marrow pattern was evident on femoral MR associated with splenic hypodense nodule(s) on abdominal CT. The role of imaging is discussed in relation to current techniques of confirmation of this entity based on demonstration of lipid-laden cells within marrow aspirates (which are often sea-blue histiocytes) and sphingomyelinase assay of cultured skin fibroblasts.
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Affiliation(s)
- L Muntaner
- Department of Radiology, Son Dureta University Hospital, Palma de Mallorca, Spain
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Abstract
We present a case of Niemann-Pick disease subtype B in which the excessive storage of sphingomyelin within lung interstitium and alveoli produced an infiltrative lung disease demonstrated on high-resolution CT (HRCT). HRCT findings were correlated to pathological features.
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Affiliation(s)
- G R Ferretti
- Department of Radiology, Hôpital Michallon, CHU Grenoble, France
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Abstract
Niemann-Pick disease (NPD) is a metabolic disease in which cirrhosis is relatively common; however, there is no known association of NPD with hepatocellular carcinoma. We present a case of metastatic, multifocal hepatocellular carcinoma in a 4-year-old boy with NPD and onset of cirrhosis in infancy.
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Affiliation(s)
- D J Pennington
- Department of Diagnostic Imaging, and Radiology, Children's National Medical Center, 111 Michigan Ave. N. W., Washington, DC 20010, USA
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Pastor Santoveña S, Fernandez-Ramos J, Gonzalez-Reimers CE, Rodriguez LE, Diaz-Ruidavets MC, Comas V. Ultrasonographic features of type B Niemann-Pick disease. Eur J Radiol 1993; 16:215-6. [PMID: 8508839 DOI: 10.1016/0720-048x(93)90076-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- S Pastor Santoveña
- Department of Radiology, Hospital Universitario de Canarias, Canary Islands, Spain
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Coussement A, Aiem A, Forderer A, Albertini M. [The pure visceral form of Niemann-Pick disease in children. Review of the literature apropos of a case]. J Radiol 1988; 69:783-5. [PMID: 3073222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The fortuitous discovery of a pulmonary miliary pattern in a asymptomatic child led the authors to the diagnosis of Niemann-Pick disease.
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Affiliation(s)
- A Coussement
- Service de Radiologie et de Pédiatrie, Hôpital de Cimiez, Nice
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Xu YS. [The roentgenologic manifestations of Niemann-Pick disease]. Zhonghua Fang She Xue Za Zhi 1987; 21:219-21. [PMID: 2961540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Pais MJ. Disease states affecting both liver and bone. Radiol Clin North Am 1980; 18:253-67. [PMID: 6782618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The skeletal system may be profoundly affected by chronic liver disease, resulting in a variety of conditions that may include osteomalacia, osteoporosis, hypertrophic osteoarthropathy, and osteonecrosis. Additionally, many diseases, including glycogen storage disease, Gaucher's disease, and hypervitaminosis A, cause concomitant changes in both liver and bone.
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Abstract
Three unrelated female patients with adult Niemann-Pick disease are described. All the patients had reduced coagulation factors and involvement of the marrow, liver, spleen and lungs. Two patients were shown to have abnormal platelet function; two patients also had pingueculas and a late onset of a menarche. Foam cells and sea-blue histiocytes were seen in the marrow and livers in all three patients, in the spleen in two patients in the lymph nodes in one patient. The clinical presentation, the histologic appearance, the histochemical staining reactions, the lipid analysis and the ultrastructure were all consistent with a diagnosis of adult Niemann-Pick disease. On the basis of these observations, it is clear that adult Niemann-Pick disease is a cause of the syndrome of the sea-blue histiocyte. The existence of the syndrome of the sea-blue histiocyte as a separate entity is also questioned.
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Abstract
The röntgenographic changes are described in two patients with the acute neuronopathic form of Niemann-Pick disease. These consist of metaphyseal splaying, osteoporosis and the quadrate appearance of the lumbar vertebrae with relatively long pedicles. The parenchymatous involvement is manifested by interstitial lung changes, enlargement of liver, spleen and kidney and distended intestinal loops with an abnormal mucosal pattern associated with prolonged transit time of the contrast material. The differential diagnosis of the above changes is discussed.
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Kirkpatrick JA, Capitanio MA. Pulmonary manifestations of systemic diseases in infants. Semin Roentgenol 1972; 7:149-72. [PMID: 5056484 DOI: 10.1016/0037-198x(72)90023-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Gerbeaux J, Grunberg J, Baculard A, Tournier G, Boccon-Gibod L, Cohen-Solal D. [Prolonged form of Niemann-Pick disease with only respiratory manifestation]. Ann Pediatr (Paris) 1971; 18:366-71. [PMID: 5580644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Kaczyńska W, Sroczyńska M. [Bone change in Niemann-Pick disease]. Pediatr Pol 1968; 43:887-890. [PMID: 5670938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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