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Delmotte V, Foidart P, De VA, Lejeune M, Delwaide J. [Diagnosis of anemia associated with alcoholic cirrhosis]. Rev Med Liege 2019; 74:527-534. [PMID: 31609556] [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] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
We report here the case of a 62-year-old patient with Child-Pugh stage C ethylic cirrhosis associated with severe macrocytic anaemia, refractory to iterative transfusions and withdrawal. After a haemorrhagic, deficiency-related, or sideroblastic etiology was ruled out, haemolytic anaemia was suspected. A blood smear allowed diagnosis of haemolytic anaemia with acanthocytes. This offers the opportunity to discuss anaemia in patients with alcoholic cirrhosis, a frequent complication spanning a broad severity range and having the potential to be life-threatening. Its origin can be multifactorial : acute haemorrhage, dilution, haemolysis (here due to acanthocytosis), marrow insufficiency caused by direct alcohol toxicity, malnutrition, iron deficiency, vitamin B9 or B12 deficiency, chronic inflammation, splenic sequestration induced by portal hypertension...
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Affiliation(s)
- V Delmotte
- Service de Médecine Interne, CHU Liège, Belgique
| | - P Foidart
- Service d'Oncologie clinique, CHU Liège, Belgique
| | - Voeght A De
- Service d'Hématologie clinique, CHU Liège, Belgique
| | - M Lejeune
- Service d'Hématologie clinique, CHU Liège, Belgique
| | - J Delwaide
- Service de Gastro-Entérologie et Hépatologie, CHU Liège, Belgique
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2
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Ping M, Li L, Deng X, Cong Y. [Clinical significance of new urine red blood cell parameter in different kinds of glomerulonephritis]. Zhonghua Yi Xue Za Zhi 2015; 95:2976-2979. [PMID: 26814078] [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: 06/05/2023]
Abstract
OBJECTIVE To investigate the clinical value of new kinds of urinary erythrocyte morphology parameter in discriminating different pathology types of glomerulonephritis. METHODS All of the 52 urine samples were from glomerulonephritis patients who had been diagnosed by renal biopsy results. The change of the percentage of acanthocytes, the size of RBC, the shape of RBC between the primary glomerulonephritis (39 cases) and secondary glomerulonephritis (13 cases) urine were detected by AVE-764 fully automatic urine cell analyzer. RESULTS Acanthocytes could be found in both primary glomerulonephritis and secondary glomerulonephritis. Of the patients whose acanthocytes percentages above 10%, 94.1% had primary glomerulonephritis and 5.9% had secondary glomerulonephritis. The picture of size-shape phase were classified as strip-type, inverted triangle-type and hanging tail-type. 95.2% Strip-type cases were from primary glomerulonephritis patients. Triangle-typenormally cases were all from primary glomerulonephritis patients. Hanging tail-type cases were all from secondary glomerulonephritis. CONCLUSION High acanthocytes percentage is most common in primary glomerulonephritis, going with the size and shape of RBC can be useful in the differential diagnosis of different pathology types of glomerulonephritis.
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Affiliation(s)
- Muye Ping
- Department of Clinical Laboratory in South Building, Chinese PLA General Hospital, Beijing 100853, China
| | - Li Li
- Department of Clinical Laboratory in South Building, Chinese PLA General Hospital, Beijing 100853, China
| | - Xinli Deng
- Department of Clinical Laboratory in South Building, Chinese PLA General Hospital, Beijing 100853, China
| | - Yulong Cong
- Department of Clinical Laboratory in South Building, Chinese PLA General Hospital, Beijing 100853, China;
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Alkhouri N, Alamiry MR, Hupertz V, Eghtesad B, Fung J, Zein NN, Radhakrishnan K. Spur cell anemia as a cause of unconjugated hyperbilirubinemia after liver transplantation and its resolution after retransplantation. Liver Transpl 2011; 17:349-50. [PMID: 21384520 DOI: 10.1002/lt.22242] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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4
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Filippini A, Villa G, Corrocher R, De Franceschi L. Acute Hemolytic Anemia With Acanthocytosis Associated With High-Dose Misoprostol for Medical Abortion. Ann Emerg Med 2007; 50:289-91. [PMID: 17084939 DOI: 10.1016/j.annemergmed.2006.09.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2006] [Revised: 08/04/2006] [Accepted: 09/05/2006] [Indexed: 10/23/2022]
Abstract
We report a case of acute hemolytic anemia in a 21-year-old Nigerian woman after high-dose misoprostol (4 mg), used for medical abortion. The major causes of inherited or immune hemolytic anemia were excluded. The patient's peripheral blood smear showed acanthocytes and anisopoikilocytosis, which progressively disappeared in the days postingestion. We evaluated RBC features, and we observed reduced RBC Na+ and K+ content and abnormalities in membrane cation transport pathways and in Ca2+ activated K+ channel (Gardos channel), suggesting possible direct effects of misoprostol on RBCs. Although further studies need to be carried out, the present case suggests that high-dose misoprostol, a prostaglandin E1 analogue, severely affects RBC features and causes an acquired acute hemolytic anemia, which is self-limited when misoprostol is withdrawn.
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Affiliation(s)
- Alida Filippini
- Department of Clinical and Experimental Medicine, Section of Internal Medicine, University of Verona, Verona, Italy
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5
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Abstract
The term "neuroacanthocytosis" is normally used to refer to autosomal recessive chorea-acanthocytosis and X-linked McLeod syndrome, but there are other movement disorders in which erythrocyte acanthocytosis may also be seen, such as Huntington disease-like 2 and pantothenate kinase-associated neurodegeneration. Disorders of serum lipoproteins such as Bassen-Kornzweig disease form a distinct group of neuroacanthocytosis syndromes in which ataxia is observed, but movement disorders are not seen. Genetic testing has enabled us to distinguish between these disorders, even when there are considerable similarities between phenotypes. Improved detection is important for accurate genetic counseling, for monitoring for complications, and, it is hoped, for implementing causal treatments, once these become available. As in other neurodegenerative conditions, animal models are a promising strategy for the development of such therapies.
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Affiliation(s)
- R H Walker
- Department of Neurology, James J. Peters Veterans Affairs Medical Center, Bronx, NY 10468, USA.
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Peng J, Redman C, Wu X, Song X, Walker RH, Westhoff CM, Lee S. Insights into extensive deletions around the XK locus associated with McLeod phenotype and characterization of two novel cases. Gene 2007; 392:142-50. [PMID: 17300882 PMCID: PMC1931494 DOI: 10.1016/j.gene.2006.11.023] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2006] [Revised: 11/21/2006] [Accepted: 11/27/2006] [Indexed: 11/26/2022]
Abstract
The McLeod phenotype is derived from various forms of XK gene defects that result in the absence of XK protein, and is defined hematologically by the absence of Kx antigen, weakening of Kell system antigens, and red cell acanthocytosis. Individuals with the McLeod phenotype usually develop late-onset neuromuscular abnormalities known as the McLeod syndrome (MLS). MLS is an X-linked multi-system disorder caused by absence of XK alone, or when the disorder is caused by large deletions, it may be accompanied with Duchenne muscular dystrophy (DMD), chronic granulomatous disease (CYBB), retinitis pigmentosa (RPGR), and ornithine transcarbamylase deficiency (OTC). XK defects derived from a large deletion at the XK locus (Xp21.1) have not been characterized at the molecular level. In this study, the deletion breakpoints of two novel cases of McLeod phenotype with extensive deletions are reported. Case 1 has greater than 1.12 million base-pairs (mb) deletion around the XK locus with 7 genes affected. Case 2 has greater than 5.65 mb deletion from TCTE1L to DMD encompassing 20 genes. Phylogenetic analyses demonstrated that DMD, XK and CYBB have close paralogs, some of which may partially substitute for the functions of their counterparts. The loci around XK are highly conserved from fish to human; however, the disorders are probably specific to mammals, and may coincide with the translocation of the loci to the X chromosome after the speciation in birds. The non-synonymous to synonymous nucleotide substitution rate ratio (omega=dN/dS) in these genes was examined. CYBB and RPGR show evidence of positive selection, whereas DMD, XK and OTC are subject to selective constraint.
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Affiliation(s)
| | | | - Xu Wu
- New York Blood Center, New York, NY 10021, USA
| | | | | | | | - Soohee Lee
- New York Blood Center, New York, NY 10021, USA
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7
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Walker RH, Liu Q, Ichiba M, Muroya S, Nakamura M, Sano A, Kennedy CA, Sclar G. Self-mutilation in chorea–acanthocytosis: Manifestation of movement disorder or psychopathology? Mov Disord 2006; 21:2268-9. [PMID: 17044067 DOI: 10.1002/mds.21156] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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8
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Stein G, Fünfstück R, Schiel R. [Erythrocyturia and proteinuria. When should a nephrologist be consulted?]. ACTA ACUST UNITED AC 2005; 100:663-9; quiz 670-1. [PMID: 16220255 DOI: 10.1007/s00063-005-1095-0] [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: 10/25/2022]
Affiliation(s)
- Günter Stein
- Klinikum der Friedrich-Schiller-Universität, Jena.
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Affiliation(s)
- F Demircioğlu
- Department of Pediatrics, Dokuz Eylül University Faculty of Medicine, Izmir, Turkey
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Fischereder M. [Hematuria and nephritic sediment]. MMW Fortschr Med 2004; 146:35-6, 38. [PMID: 15559517] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
Vigorous physical exercise is just as likely to be the cause of hematuria as are diseases of the efferent urinary tract, inflammatory renal disease or tumors. The microscopic search for dysmorphic erythrocytes (acanthocytes), casts or leukocytes in the sediment is a helpful technique for deciding the how to proceed with further diagnostic measures. Morphological changes in more than 17% of the erythrocytes are highly suggestive of a glomerular cause, Also, the presence of various casts points to kidney disease. The typical microscopic picture of interstitial nephritis is sterile leukocytosis. This may be of atheroembolic origin, medication-induced, or viral. In any case, the nephritic sediment should be clinically evaluated only in the context of further information such as the patient's age, comorbidities, or medication.
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Affiliation(s)
- M Fischereder
- Nephrologisches Zentrum, Medizinische Poliklinik Klinikum der Universität München, Innenstadt.
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Affiliation(s)
- Marta Martín
- Liver Unit, Institut de Malalties Digestives, Hospital Clínic, Villarroel 170, 08036 Barcelona, Spain
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Ranawaka UK, Chang AA, Wijesekera JC. Young patients with movement disorders. Ceylon Med J 2004; 48:142-3. [PMID: 15125408 DOI: 10.4038/cmj.v48i4.3334] [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: 11/18/2022]
Affiliation(s)
- U K Ranawaka
- Institute of Neurology, National Hospital of Sri Lanka, Colombo.
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13
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Girndt M, Köhler H. [Differential diagnosis of urinary findings]. MMW Fortschr Med 2004; 146:29-30, 32-3. [PMID: 15222497] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
Classical urinalysis is extremely useful in the differential diagnosis of diseases of the kidneys and lower urinary tract. Although dipsticks are suitable for orientational purposes, when pathology is indicated, and when renal disease presents, they must be supplemented by urine microscopy or quantitative and qualitative protein electrophoresis to establish the diagnosis. Phase-contrast microscopy can distinguish glomerular from nonglomerular hematuria and thus guide the further diagnosis, and the detection of leukocytes and bacteria confirms the diagnosis of urinary tract infection. In asymptomatic patients microhematuria or proteinuria is detected more frequently with increasing age. A differentiated diagnostic strategy must be adapted to the individual risk of the patient, and must avoid overdiagnosis while not missing potentially serious pathology.
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Affiliation(s)
- M Girndt
- Medizinische Klinik IV, Universitätskliniken des Saarlandes, Homburg/Saar.
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Zukowska-Szczechowska E, Tomaszewski M. Renal affection in patients with diabetes mellitus is not always caused by diabetic nephropathy. Rocz Akad Med Bialymst 2004; 49:185-9. [PMID: 15631340] [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: 05/01/2023]
Abstract
Accumulated clinical data suggest that non-diabetic nephropathy complicating type 1 diabetes mellitus is rare, accounting for 2-3% of unselected diabetic patients with proteinuria. In contrast, non-diabetic kidney disease is a common finding in patients with type 2 diabetes mellitus. Joint analysis of available data on prevalence of non-diabetic kidney disease among type 2 diabetic patients revealed that non-diabetic nephropathy was evident on kidney biopsy approximately in 22% of European and 26.7% of Asian patients with type 2 diabetes mellitus. Therefore, kidney biopsy may become a useful diagnostic option among proteinuric patients with type 2 diabetes mellitus. However, it is generally agreed that renal biopsy cannot be used as a routine diagnostic test in all type 2 diabetic patients with proteinuria. Diabetic subjects that may benefit form kidney biopsy should be rather identified on a case-by-case basis. Absence of diabetic retinopathy, particularly used in combination with acanthocyturia, may come useful in decisions about kidney biopsy in type 2 diabetic patients.
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Affiliation(s)
- E Zukowska-Szczechowska
- Department of Internal Medicine, Diabetology and Nephrology, Medical University of Silesia, Zabrze, Poland.
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Abstract
Mild myopathy is a common manifestation of the X-linked McLeod neuroacanthocytosis syndrome. We present a patient with McLeod syndrome and a primarily subclinical myopathy, who developed severe rhabdomyolysis with renal insufficiency after a prolonged period of excessive motor restlessness due to an agitated psychotic state and a single dose of clozapine. Other possible causes for rhabdomyolysis such as prolonged immobility, trauma, hyperthermia, generalized seizures, toxin exposure, or metabolic changes were excluded. Clinical course was favorable, with persistent slight elevation of serum creatine kinase levels caused by the underlying myopathy. Our findings suggest that McLeod myopathy is a predisposing factor for severe rhabdomyolysis. This possibly life-threatening condition should be added to the clinical spectrum of McLeod syndrome, and serum creatine kinase levels should be carefully monitored in patients with this syndrome, particularly if a hyperkinetic movement disorder is present or neuroleptic medication is used.
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Affiliation(s)
- Hans H Jung
- Department of Neurology, University Hospital, Zürich 8091, Switzerland.
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17
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Bassères DS, Tavares AC, Costa FF, Saad STO. beta-Spectrin São PauloII, a novel frameshift mutation of the beta-spectrin gene associated with hereditary spherocytosis and instability of the mutant mRNA. Braz J Med Biol Res 2002; 35:921-5. [PMID: 12185384 DOI: 10.1590/s0100-879x2002000800009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [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: 11/21/2022] Open
Abstract
Hereditary spherocytosis (HS) is a common inherited anemia characterized by the presence of spherocytic red cells. Defects in several membrane protein genes have been involved in the pathogenesis of HS. beta-Spectrin-related HS seems to be common. We report here a new mutation in the beta-spectrin gene coding region in a patient with hereditary spherocytosis. The patient presented acanthocytosis and spectrin deficiency and, at the DNA level, a novel frameshift mutation leading to HS, i.e., a C deletion at codon 1392 (beta-spectrin São PauloII), exon 20. The mRNA encoding beta-spectrin São PauloII was very unstable and the mutant protein was not detected in the membrane or in other cellular compartments. It is interesting to note that frameshift mutations of the beta-spectrin gene at the 3' end allow the insertion of the mutant protein in the red cell membrane, leading to a defect in the auto-association of the spectrin dimers and consequent elliptocytosis. On the other hand, beta-spectrin São PauloII protein was absent in the red cell membrane, leading to spectrin deficiency, HS and the presence of acanthocytes.
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Affiliation(s)
- D S Bassères
- Hemocentro, Universidade Estadual de Campinas, Campinas, SP, Brasil
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18
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Catalá López JL, Fábregas Brouard M. [Acanthocyturia is more efficient in to differentiate glomerular from non-glomerular hematuria then dysmorphic erythrocytes]. ARCH ESP UROL 2002; 55:164-6. [PMID: 12014048] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
OBJECTIVE Our purpose was to determine which was the most reliable method for differentiating glomerular from non-glomerular (lower urinary tract) hematuria by microscopic examination of urinary red blood cells: dysmorphic red cell count or acanthocyte count. The latter is a special type of dysmorphic red cell specific to glomerular hematuria. METHODS Urine samples of 170 patients with hematuria [73 had renal and 97 non-renal (urological) pathology] were analyzed. Urinary sediment phase-contrast microscopy was performed to determine the percentage of dysmorphic red cells and acanthocytes in each patient. Data were correlated with the diagnosis. RESULTS Glomerular hematuria defined as dysmorphic red cell count > 35% showed a sensitivity and specificity of 69% and 100%, respectively. Glomerular hematuria defined as acanthocytes > 5% showed a sensitivity and specificity of 88% and 100%, respectively. CONCLUSIONS Phase-contrast microscopy urinary sediment acanthocyte count is more effective than dysmorphic red cell count in the diagnosis of glomerular hematuria.
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Affiliation(s)
- José Luis Catalá López
- Servicio de Bioquímica Clínica, Hospital Insular de Gran Canaria, Las Palmas de Gran Canaria, España.
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19
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Abstract
BACKGROUND The McLeod phenotype is defined by absence of Kx, weakening of Kell system antigens, and acanthocytosis. Individuals with the McLeod phenotype usually develop late-onset neuromuscular abnormalities. Gene deletions, insertions, and point mutations that affect RNA splicing or that lead to premature stop codons have been reported to cause the McLeod phenotype. The McLeod phenotype may also be caused by mutations at a different splice site and by a novel mutation encoding an amino acid substitution that prevents transport to the cell surface. STUDY DESIGN AND METHODS The coding and flanking intron regions of XK from four male, unrelated individuals with the McLeod phenotype and non-chronic granulomatous disease were sequenced and compared with the wild type sequence. Genomic DNA was amplified by PCR, and the products were sequenced. In one case, the mutant cDNA was expressed in a heterologous cell, and cell surface expression was determined. RESULTS Three individuals with the McLeod phenotype had mutations that disrupted conserved GT sequences present at RNA splice sites. Two of them had G>C mutations at the 5' splice site of intron 1, and one had a G>A mutation at the 5' splice site of intron 2. One person with the McLeod phenotype had a 746C>G mutation in exon 3 encoding an R222G substitution. In a transfected cell, the expressed protein from the latter mutant did not travel to the cell surface. CONCLUSION The McLeod phenotype may be caused by several different mutations.
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Affiliation(s)
- David C W Russo
- Lindsley F. Kimball Research Institute, The New York Blood Center, New York, New York 10021, USA.
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Abstract
Neuroacanthocytosis is a progressive multisystem disease with a wide range of symptoms. The involuntary movements mainly include chorea and orofaciolingual dyskinesias. The descriptive name of the disease refers to the presence of abnormal erythrocytes in peripheral blood. Two siblings are presented. One young female had dystonia, self-mutilating behaviour, lip biting and eating difficulties. Her brother had repeated generalized epileptic seizures several years before developing choreatic movements and neuropsychiatric symptoms. Both had clinical signs of sensorimotor axonal polyneuropathy. Fresh blood smears in each patient contained between 15 and 20% acanthocytes compared to less than 2% in normal controls. Neuroacanthocytosis must be kept in mind in young adult patients without heredity for Huntington's disease and the diagnosis is easily confirmed when making a fresh blood smear.
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Affiliation(s)
- J Aasly
- Department of Neurology, University Hospital, Trondheim, Norway
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Abstract
Neuroacanthocytosis (NA) is a rare, degenerative, presumably autosomal-recessive disorder of the nervous system presenting in adulthood and is associated with acanthocytosis of the peripheral blood. The clinical spectrum of NA shares similarities with Huntington's disease (HD), including dyskinetic choreiform movements and degeneration of the caudate nucleus. A woman presented with choreiform movements and was given a presumed diagnosis of HD. Neuroimaging studies were consistent with HD. She lacked the genetic marker for HD, and further evaluation revealed acanthocytosis of the peripheral blood. The case illustrates the similarities and differences in the clinical presentations and neuroimaging studies of these two disease entities, emphasizing the need for a careful clinical evaluation.
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Affiliation(s)
- J S Kutcher
- Department of Psychiatry, Tulane University School of Medicine, New Orleans, LA 70112, USA
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Rubio JP, Levy ER, Dobson-Stone C, Monaco AP. Genomic organization of the human galpha14 and Galphaq genes and mutation analysis in chorea-acanthocytosis (CHAC). Genomics 1999; 57:84-93. [PMID: 10191087 DOI: 10.1006/geno.1999.5758] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [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: 11/22/2022]
Abstract
Chorea-acanthocytosis (CHAC) (OMIM 200150) is a rare neurological syndrome characterized by neurodegeneration in combination with morphologically abnormal red cells (acanthocytosis). A partial yeast artificial chromosome contig of the CHAC critical region on chromosome 9q21 has been constructed, and 21 expressed sequence tags have been mapped. We have subsequently cloned Galpha14, a member of the G-protein alpha-subunit multigene family, and have identified Galphaq in the contig. The genomic structure of both genes has been established after construction of a bacterial artificial chromosome contig that showed Galphaq and Galpha14 to be in a head-to-tail arrangement (Cen-Galphaq-Galpha14-qter). Northern analysis found Galphaq to be ubiquitously expressed and Galpha14 to display a more restricted pattern of expression. Mutation analysis of the coding regions and splice sites for Galphaq and Galpha14 in 10 affected individuals from different families identified no changes likely to cause disease; however, two distinct single nucleotide polymorphisms in the coding region of Galpha14 have been identified. This study has excluded two plausible candidate genes from involvement in CHAC and has provided a solid platform for a positional cloning initiative.
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Affiliation(s)
- J P Rubio
- The Wellcome Trust Centre for Human Genetics, Windmill Road, Headington, OX3 7BN, England
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Tanaka M, Hirai S, Kondo S, Sun X, Nakagawa T, Tanaka S, Hayashi K, Okamoto K. Cerebral hypoperfusion and hypometabolism with altered striatal signal intensity in chorea-acanthocytosis: a combined PET and MRI study. Mov Disord 1998; 13:100-7. [PMID: 9452334 DOI: 10.1002/mds.870130121] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.2] [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: 02/06/2023] Open
Abstract
We studied cerebral perfusion and oxygen metabolism in three patients with chorea-acanthocytosis using positron-emission tomography and oxygen-15 labeled O2 and CO2. High-field magnetic resonance imaging also was performed. Regional cerebral blood flow (rCBF) and oxygen metabolism (rCMRO2) were significantly reduced in the caudate and putamen when compared with seven control subjects. Mild but significant reductions of rCBF (lower than the normal control values -2 SD) were found in the bilateral frontal, left temporal and parietal, and bilateral thalamic areas; rCMRO2 was reduced in the bilateral frontal and left temporal areas. Magnetic resonance imaging showed increased signal intensity accompanied by scattered bright spots in the caudate head and putamen on T2-weighted images; decreased signal intensity was shown at these sites on T1-weighted images. These findings were not observed in 10 neurologically normal volunteers and are rare in the common hyperkinetic form of Huntington's disease. Reduced cerebral perfusion and oxygen metabolism seem to be related to the intellectual and personality changes that occur in chorea-acanthocytosis. Combined positron-emission tomography and magnetic resonance imaging studies may improve diagnostic accuracy in patients with chorea-acanthocytosis and related disorders.
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Affiliation(s)
- M Tanaka
- Department of Neurology, Gumma University, Faculty of Medicine, Maebashi, Japan
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Affiliation(s)
- C H Tsai
- Department of Neurology, Chang Chang Memorial Hospital, Taipei, Taiwan
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Affiliation(s)
- K Okamoto
- Department of Radiology, School of Medicine, Niigata University, Japan
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Bruce LJ, Tanner MJ. Structure-function relationships of band 3 variants. Cell Mol Biol (Noisy-le-grand) 1996; 42:953-73. [PMID: 8960773] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
This review describes many of the naturally occurring band 3 variants that have been reported in the literature to date; from the common band 3 Memphis, to the rare band 3 HT. Both the molecular basis of these variants, and their effect on the structure and/or function of band 3, are described. The blood group antigens that have recently been assigned to band 3, such as Diego, Wright, Waldner, Redelberger and Warrior, are mentioned. Band 3 variants that affect the morphology of the red cell (e.g. acanthocytosis in band 3 HT and stomatocytic ovalocytosis in band 3 SAO) are described, as are many of the band 3 mutations that cause instability, either at the mRNA or protein level, and hence hereditary spherocytosis (HS). Band 3 variants that affect the binding pocket of the anion transport inhibitor, 4,4'-diisothiocyanato-2,2'-dihydrostilbene disulphonic acid (H2DIDS), (e.g. Diego and band 3 HT) and band 3 variants that affect the rate of anion transport (e.g. band 3 HT and band 3 in red cells that lack glycophorin A (GPA)) are reviewed in greater detail. The association between band 3 and GPA is discussed; both with respect to the Wright antigens and with regards the structure/function of band 3 in the absence of GPA.
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Affiliation(s)
- L J Bruce
- Department of Biochemistry, University of Bristol, U.K
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Malandrini A, Cesaretti S, Mulinari M, Palmeri S, Fabrizi GM, Villanova M, Parrotta E, Montagnani A, Montagnani M, Anichini M, Guazzi GC. Acanthocytosis, retinitis pigmentosa, pallidal degeneration. Report of two cases without serum lipid abnormalities. J Neurol Sci 1996; 140:129-31. [PMID: 8866438 DOI: 10.1016/0022-510x(96)00155-4] [Citation(s) in RCA: 18] [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: 02/02/2023]
Abstract
We describe two unrelated patients with Hallervorden-Spatz, disease characterized by prominent facio-bucco-lingual dyskinesia. Acanthocytosis and retinitis pigmentosa were additional findings. Brain MRI showed the typical 'tiger's eye' image of the globus pallidus. This phenotype closely resembled the so-called HARP syndrome (hypoprebetalipoproteinemia, acanthocytosis, retinitis pigmentosa and pallidal degeneration), but extensive serum lipid study failed to demonstrate any lipoprotein abnormality. Our results raise the question whether HARP syndrome is an autonomous entity or a particular phenotype of Hallervorden-Spatz disease.
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Affiliation(s)
- A Malandrini
- Institute of Neurological Sciences, University of Siena, Italy
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30
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Hiersemenzel LP, Johannes S, Themann P, Hofferberth B. [Choreoacanthocytosis. A neurologic-hematologic syndrome]. Nervenarzt 1996; 67:490-5. [PMID: 8767204] [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: 02/02/2023]
Abstract
A 43 year old male patient is reported who presented at the age of 33 years with a hyperkinetic movement disorder. At the time of presentation orofacial dyskinesias, tic-like hyperkinesias with vocalisation and behavioural disturbance dominated the clinical picture. In the course of his illness he developed a marked truncal choreoathetosis and a symmetrical, distal, predominantly motor polyneuropathy with wasting of lower leg muscles. Serum creatinine kinase levels were markedly elevated. Serum lipids and lipoproteins were within normal limits. These clinical features in combination with an increased number of acanthocytes, clearly visible after dilution of whole blood with normal saline (1:1), led to the diagnosis of choreoacanthocytosis (CA). Both parents were neurologically and behaviourally normal, but were found to have acanthocytes in saline diluted whole blood. The literature concerning CA is reviewed.
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Affiliation(s)
- L P Hiersemenzel
- Abteilung Neurologie und Klinische Neurophysiologie, Klinikum der Albert-Ludwigs-Universität, Freiburg
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31
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Allendorff J, Stelzer K, Köhler H. [Hematuria--diagnostic procedure and therapeutic approaches]. Z Arztl Fortbild (Jena) 1996; 90:187-90. [PMID: 8779230] [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: 02/02/2023]
Abstract
Hematuria is a common clinical problem. It may arise from benign diseases posing minimal risk to the patient to potentially life-threatening conditions. Due to its many causes, the evaluation of hematuria often requires various different diagnostic procedures. To prevent unnecessary diagnostic tests, the workup should begin with noninvasive techniques such as history, urinalysis, laboratory data and ultrasonography. This proceeding allows a simple and rapid differentiation in renal and non-renal causes of hematuria in most cases.
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Affiliation(s)
- J Allendorff
- Innere Medizin IV der Universitätskliniken des Saarlandes, Homburg/Saar
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32
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Cavalli G, de Gregorio C, Nicosia S, Melluso C, Serra S. [Cardiac involvement in familial amytrophic chorea with acantocytosis: description of two new clinical cases]. Ann Ital Med Int 1995; 10:249-252. [PMID: 8718661] [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: 05/22/2023]
Abstract
Familial amyotrophic chorea and acanthocytosis, also known as the Levine-Critchley syndrome, is a rare inherited disease characterized primarily by central nervous system involvement with progressive demyelinization and autosomic or dominant transmission. Clinical symptoms include orofaciolingual dyskinesia and involuntary choreiform movements associated with skeletal muscle atrophy due to axonal demyelinization and erythrocyte acanthocytosis. A few patients have some cardiac abnormality, including an electrocardiographic pattern of left ventricular hypertrophy, left atrial wave abnormalities, non-specific ST-T wave changes, and a pseudonecrosis pattern with abnormal Q waves in the inferior leads. Two-dimensional echocardiography has disclosed concentric ventricular hypertrophy and the typical findings of congestive cardiomyopathy. We report the case of two brothers, 40 and 58 years old, who had asymmetric left ventricular hypertrophy (more marked in the younger brother), left ventricular mass index increase unrelated to a hypertensive state or the percent of circulating acanthocytes. Functional systolic parameters were normal. The younger brother had dilation of the aortic root and marked enlargement of the non-coronary Valsalva sinus, and both patients manifested mitral leaflet redundancy without evident prolapse. Our observations suggest the hypothesis that connective tissue and/or vessel muscle-elastic fiber pathology is associated with the well-known neurological disorders typical of the Levine-Critchley syndrome. It is thus advisable that these patients undergo thorough cardiovascular evaluation.
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Affiliation(s)
- G Cavalli
- Istituto Pluridisciplinare di Clinica Medica e Terapia Medica Generale e Speciale, Università degli Studi di Messina
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33
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Terao S, Sobue G, Takahashi M, Miura N, Mitsuma T, Takeda A, Sakakibara T. [Disturbance of hypothalamic-pituitary hormone secretion in familial chorea-acanthocytosis]. No To Shinkei 1995; 47:57-61. [PMID: 7669403] [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: 01/26/2023]
Abstract
An endocrinological study was performed dopaminergic regulation of the hypothalamic-pituitary axis of 3 patients with familial chorea-acanthocytosis (females, 38 to 47 years of age). All 3 patients exhibited low basal levels of triiodo-thyronine (T3), and 2 patients had a slightly elevated baseline plasma prolactin (PRL) level. The patients had a delayed plasma thyroid stimulating hormone (TSH) response and plasma PRL excessive response to thyrotropin releasing hormone (TRH), and a low plasma growth hormone releasing hormone (GRF) response to L-dopa. These TSH, PRL and GRF responses represent a secretion pattern due to a hypothalamic disorder, suggesting impaired regulation of hormone secretion by the dopaminergic system, primarily in the hypothalamus. In addition, an increased growth hormone (GH) response secretion following TRH (paradoxical response) was observed in 2 patients, suggesting that the pituitary was also involved. An oral glucose tolerance test (75g-OGTT) revealed a diabetic pattern in all 3 patients, indicating frequent association with impaired glucose tolerance.
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Affiliation(s)
- S Terao
- Fourth Department of Internal Medicine, Aichi Medical University, Japan
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34
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Silvestri R, Raffaele M, De Domenico P, Tisano A, Mento G, Casella C, Tripoli MC, Serra S, Di Perri R. Sleep features in Tourette's syndrome, neuroacanthocytosis and Huntington's chorea. Neurophysiol Clin 1995; 25:66-77. [PMID: 7603414 DOI: 10.1016/0987-7053(96)81034-3] [Citation(s) in RCA: 68] [Impact Index Per Article: 2.3] [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: 01/26/2023] Open
Abstract
Twenty-one patients affected by extrapyramidal disorders were polygraphically recorded during spontaneous nocturnal sleep for two consecutive nights to assess their sleep and movement patterns. The patients (pts) sample included: Gilles de La Tourette syndrome (TS, nine pts), neuroacanthocytosis (NA, six pts) and Hungtington's chorea (HC, six pts). Sleep recording included C3/A2, 01/A2, ROC/LOC, submental EMG, EKG, nasal airflow thoracoabdominal respirogram, bilateral anterior tibialis and other EMGs, in relation to the individual distribution of the abnormal movements. According to our observations, abnormal movements always decreased but never ceased completely during sleep. Sleep efficiency (SE) was nearly always poor with a high percentage of wakefulness after sleep onset (WASO) and increased number of arousals. REM sleep was often reduced and in some cases (3 TS pts) incompletely defined as far as its microstructural aspects. Slow wave sleep (SWS) was reduced in HC, normal in NA, and increased in all TS patients with the exception of the two adult subjects more severely affected, while the percentage of stage 2 was not affected. Spindling was increased in NA, HC and in the two most severely affected adult TS patients.
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Affiliation(s)
- R Silvestri
- Department of Clinical Neurology 1, University of Messina, Italy
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35
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Harding AE. Inherited movement disorders. Baillieres Clin Neurol 1994; 3:259-79. [PMID: 7952847] [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: 01/28/2023]
Abstract
A high proportion of neurological diseases characterized by movement disorders are caused by single genes; in others, such as Parkinson's disease, there appears to be a genetic component. Gene mapping studies have made substantial progress in unravelling the aetiology of dystonias and Huntington's disease, and are underway in other disorders such as essential tremor and Gilles de la Tourette syndrome. These advances are already applicable to clinical practice, particularly in Huntington's disease where identification of the disease mutation has led to the possibility of improved diagnosis and more widespread availability of predictive testing for asymptomatic family members.
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Affiliation(s)
- A E Harding
- University Department of Clinical Neurology, Institute of Neurology, London, UK
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36
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Anand IS, Khwaja GA, Gupta M. Choreoacanthocytosis. J Assoc Physicians India 1994; 42:495-6. [PMID: 7852238] [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] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- I S Anand
- Dept. of Neurology, G.B. Pant Hospital, New Delhi, India
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37
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Gil-Nagel A, Morlán L, Balseiro J, García de Yébenes J, Cabello A, Martínez-Martín P. [Neuro-acanthocytosis with associated myopathy. A case report]. Neurologia 1994; 9:165-8. [PMID: 7517146] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Abnormalities of striated muscle histology in patients with neuroacanthocytosis have been previously attributed to chronic denervation. This hypothesis is based in the presence of axonal peripheral neuropathy. In this 37-year-old patient clinical, biochemical and histologic data revealed a non specific primary myopathy. Other important findings were decreased levels of 5-hydroxy-indoleacetic acid (5-HILA) and homovanillic acid (HVA) in the CSF, cerebellar and basal ganglia atrophy seen in MRI and infertility of probable gonadal origin.
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Affiliation(s)
- A Gil-Nagel
- Sección de Neurología, Hospital Universitario de Getafe, Madrid
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38
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Ogawa T, Seki H, Okita N, Nomura H, Takase S. [A case of chorea-acanthocytosis associated with low glycohemoglobin A1c]. Rinsho Shinkeigaku 1993; 33:344-6. [PMID: 8334801] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
We reported the first case of chorea-acanthocytosis associated with low glycohemoglobin A1c. Fasting blood sugar, daily profile of blood sugar, serum fructosamine and 75 g glucose tolerance test were all within normal limits. While abnormal hemoglobins were not detected, red blood cell half-life was sharply reduced to 13.4 days. These findings suggest that the low glycohemoglobin A1c in this case is highly ascribable to the reduction of red blood cell half-life rather than to continuous hypoglycemia. However, we can not rule out that the abnormalities of red blood cell membrane, suggested factors in this disease, may be related to the low glycohemoglobin A1c value. Further investigations on chorea-acanthocytosis cases with normal red blood cell half-life are necessary in order to elucidate whether an abnormal glycohemoglobin A1c value is a specific indication regarding this disease.
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Affiliation(s)
- T Ogawa
- Department of Neurology, Miyagi National Hospital
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39
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Witt TN, Danek A, Reiter M, Heim MU, Dirschinger J, Olsen EG. McLeod syndrome: a distinct form of neuroacanthocytosis. Report of two cases and literature review with emphasis on neuromuscular manifestations. J Neurol 1992; 239:302-6. [PMID: 1512605 DOI: 10.1007/bf00867584] [Citation(s) in RCA: 54] [Impact Index Per Article: 1.7] [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: 12/27/2022]
Abstract
McLeod syndrome was originally described on the basis of a specific blood group phenotype with weak expression of Kell antigens. This erythrocyte abnormality also causes acanthocytosis. The haematological findings are associated with abnormalities in other organ systems, including neuromuscular manifestations. A 51-year-old patient was followed up for 11 years. He presented with persistent muscle creatine kinase elevation and progressive heart disease and later developed a slowly progressive neuropathy and choreic movements. His younger brother presented with grand mal seizures, involuntary movements and high muscle creatine kinase when aged 43 years. Clinical myopathy was absent in both, yet muscle biopsy showed mild myopathic changes. The presence of a motor axonopathy was supported by electrophysiological findings. One brother also showed sensory axonopathy. The movement disorder suggested accompanying basal ganglia dysfunction. Earlier reports of McLeod syndrome are reviewed with respect to neuromuscular involvement. Absence of the Kx membrane protein seems to be the cause of this multi-system disorder.
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Affiliation(s)
- T N Witt
- Neurologische Klinik, Klinikum Grosshadern, Ludwig-Maximilians-Universität, München, Federal Republic of Germany
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40
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Behari M, Saha P, Prasad K, Ahuja GK. Choreoacanthocytosis with marked dysphagia and laryngeal dystonia. J Assoc Physicians India 1991; 39:967-8. [PMID: 1816230] [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: 12/28/2022]
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41
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Betticher DC, Pugin P. [Hypothyroidism and acanthocytes: diagnostic significance of blood smear]. Schweiz Med Wochenschr 1991; 121:1127-32. [PMID: 1871565] [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: 12/29/2022]
Abstract
We report on 3 cases of hypothyroidism in which the diagnoses were suspected after having observed acanthocytes on the blood film. The diagnostic value of this erythrocyte change has been neglected, although the results of studies have shown a test specificity of 87-99%, other diseases related to acanthocytes being very rare. After an analysis of the studies and case reports dealing with acanthocytes we conclude that hypothyroidism must be excluded in all cases where acanthocytes are observed on the blood film.
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Affiliation(s)
- D C Betticher
- Hôpital cantonal de Fribourg, Clinique médicale, Service d'hématologie
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42
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Brooks DJ, Ibanez V, Playford ED, Sawle GV, Leigh PN, Kocen RS, Harding AE, Marsden CD. Presynaptic and postsynaptic striatal dopaminergic function in neuroacanthocytosis: a positron emission tomographic study. Ann Neurol 1991; 30:166-71. [PMID: 1897909 DOI: 10.1002/ana.410300207] [Citation(s) in RCA: 48] [Impact Index Per Article: 1.5] [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: 12/29/2022]
Abstract
Using [18F]dopa, [11C]raclopride, C15O2, and positron emission tomography, we have assessed striatal dopamine storage capacity, dopamine D2-receptor integrity, and regional cerebral blood flow, respectively, of 6 patients with neuroacanthocytosis. The patients with neurocanthocytosis all had chorea and variable combinations of seizures, dementia, axonal neuropathy, and orolingual self-multiation. [18F]dopa positron emmission tomographic findings were compared with 30 normal controls and 16 patients with sporadic, L-dopa-responsive, Parkinson's disease. Caudate and anterior putamen [18F]dopa uptake were normal in patients with neuroacanthocytosis, but mean posterior putamen [18F]dopa uptake was reduced to 42% of normal, similar to that in patients with Parkinson's disease. In patients with neuroacanthocytosis, mean equilibrium caudate: cerebellum and putamen: cerebellum [11C]raclopride uptake ratios were reduced to 54% and 62% of normal, compatible with a 65% and 53% loss of caudate and putamen D2-receptor-binding sites, respectively. Striatal and frontal blood flow was also depressed. The severe loss of D2-receptor-bearing striatal neuron, with concomitant loss of dopaminergic projections from the nigra to the posterior putamen, is consistent with both chorea and extrapyramidal rigidity being features of patients with neuroacanthocytosis.
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Affiliation(s)
- D J Brooks
- MRC Cyclotron Unit, Hammersmith Hospital, London, England
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43
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Abstract
We report three siblings, offspring of normal consanguineous parents, with a progressive neurological illness that began in midlife and was characterized primarily by chorea and leading to death in the fourth decade. The proband had erythrocyte acanthocytosis with normal serum beta-lipoprotein. Biopsy of left gastrocnemius muscle showed neurogenic muscular atrophy. There was a decrease in the numbers of large myelinated axons of the sural nerve. Postmortem examination of two cases showed marked atrophy, neuronal loss and gliosis of the caudate nucleus and putamen. Autosomal recessive inheritance is likely in this family.
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Affiliation(s)
- M E Alonso
- Department of Genetics, National Institute of Neurology and Neurosurgery, Mexico, D.F
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Abstract
Dysplastic hematopoiesis associated with erythrocyte macrocytosis is a morphologic hallmark of myelodysplasia. We report the cases of six patients with myelodysplasia in which acanthocytosis was the predominant red blood cell (RBC) abnormality. In each case acanthocytes represented 5% to 10% of circulating RBC forms and was the primary reason for referral in two cases. None of the patients had comorbid conditions known to be associated with acanthocyte formation. Myelodysplasia should be considered in the differential diagnosis of acanthocytosis, particularly in the anemic, elderly individual. Acanthocytosis may be a harbinger of an unrecognized, hematologic stem-cell disorder.
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Affiliation(s)
- D C Doll
- Department of Medicine, Veterans Administration Hospitals, Columbia, MO 65201
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45
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Ong B, Devathasan G, Chong PN. Choreoacanthocytosis in a Chinese patient--a case report. Singapore Med J 1989; 30:506-8. [PMID: 2617308] [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: 01/01/2023]
Abstract
A 50-year old Chinese woman with the rare neurological disorder of Choreoacanthocytosis is described. Her illness is characterised by seizures, buccolingual dyskinesia, choreiform movements, arreflexia and mild sensorimotor polyneuropathy. Acanthocytes were present in her peripheral blood in large numbers but the serum lipid profile was normal. Her features are consistent with those so far described in Caucasian and Japanese patients. The disease differs from Huntington's chorea in that there are acanthocytes, peripheral neuropathy, and metal function remains relatively intact.
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46
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Abstract
Two brothers with neuroacanthocytosis had [18F]-2-fluoro-2-deoxyglucose PET scans showing marked glucose hypometabolism of the caudate and putamen. MRIs showed no evidence of atrophy or modification of signal intensity in these structures. Decreased glucose utilization of the striatum can underlie hyperkinetic movement disorders of various etiologies.
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Affiliation(s)
- R M Dubinsky
- Human Motor Control Section, National Institute of Neurological Disorders and Stroke, Bethesda, MD 20892
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47
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Senda Y, Koike Y, Sugimura K, Matsuoka Y, Takahashi A. [Chorea-acanthocytosis with catecholamine abnormality and orthostatic hypotension--a case report]. Rinsho Shinkeigaku 1987; 27:898-903. [PMID: 3665281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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48
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Spencer SE, Walker FO, Moore SA. Chorea-amyotrophy with chronic hemolytic anemia: a variant of chorea-amyotrophy with acanthocytosis. Neurology 1987; 37:645-9. [PMID: 3561776 DOI: 10.1212/wnl.37.4.645] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
We studied two siblings with chorea and amyotrophy of adult onset and spherocytic hemolytic anemia. Autopsy revealed an atrophic striatum with iron deposition and spheroid bodies. Degeneration of the substantia nigra and spinal cord anterior horns was seen without iron deposition. The disorder seems to be a variant of the chorea-amyotrophy-acanthocytosis syndrome, and the pathology may account for evidence of parkinsonism and amyotrophy in that syndrome. Acanthocytosis may not be the only hematologic abnormality in this disorder.
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49
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Bramanti P, Ricci RM, Candela L, Serra S, Di Perri R. A polygraphic test for the diagnosis of amyotrophic choreo-acanthocytosis. Acta Neurol (Napoli) 1987; 9:134-8. [PMID: 3508349] [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: 01/06/2023]
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50
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Savage RA, Sipple C. Marrow myxedema. Gelatinous transformation of marrow ground substance in a patient with severe hypothyroidism. Arch Pathol Lab Med 1987; 111:375-7. [PMID: 2950837] [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: 01/03/2023]
Abstract
Replacement of marrow ground substance by hyaluronic acid-rich mucopolysaccharides (gelatinous transformation) has been previously reported to occur in severely malnourished patients. A patient with severe anemia and hypothyroidism without malnutrition was found to have gelatinous transformation of the marrow. This process is similar histologically to dermal myxedema, and the findings in this patient suggest questions for further study involving possible roles for thyroid-stimulating hormone in the development of marrow and visceral myxedema and the alterations in the normal partitioning process between serum and red blood cell low-density lipoproteins that produce acanthocytes in blood smears from patients with hypothyroidism.
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