The main forms of leukodystrophies. Lecture and clinical cases
https://doi.org/10.17650/2073-8803-2023-18-2-3-45-51
Abstract
Leukodystrophies are genetically determined diseases characterised by primary damage to the white matter of the central nervous system, irrespective of the genetic defect and structural component involved. This paper classification is presented based on the identification of typical patterns characteristic of certain forms of leukodystrophy. Clinical examples are given for each of the identified patterns. The parieto-occipital pattern is considered in a clinical case of a 9-year-old boy with X-linked adrenoleukodystrophy. Frontal pattern there is an example of a genetically verified juvenile form of Alexander’s disease in a 16-year-old female patient. The periventricular pattern reflects leukoencephalopathy with brain stem and spinal cord involvement and increased lactate in a 9-year-old female patient. A subcortical pattern is considered within L-2-hydroxyglutoric aciduria in a 29-year-old patient. As examples of brainstem and cerebellar involvement patterns, autosomal dominant leukodystrophy with adult onset due to tandem duplication of the lamin B gene, identified in a 40-year-old patient, is considered. In conclusion, we present additional diagnostic methods for the differential diagnosis of brain white matter diseases and a brief overview of treatment.
About the Authors
A. A. ErshovaRussian Federation
61/2 Shchepkina St., Moscow 129110
A. S. Kotov
Russian Federation
Aleksey Sergeevich Kotov
61/2 Shchepkina St., Moscow 129110
References
1. Dong B., Lv W., Xu L. et al. Identification of two novel mutations of ABCD1 gene in pedigrees with x-linked adrenoleukodystrophy and review of the literature. Int J Endocrinol 2022;2022:5479781. DOI: 10.1155/2022/5479781
2. Engelen M., Schackmann M.J., Ofman R. et al. Bezafibrate lowers very long-chain fatty acids in X-linked adrenoleukodystrophy fibroblasts by inhibiting fatty acid elongation. J Inher Metabol Dis 2012a;35:1137–45. DOI: 10.1007/s10545-012-9471-4
3. Finnsson J., Sundblom J., Dahl N. et al. LMNB1-related autosomal- dominant leukodystrophy: clinical and radiological course. Ann Neurol 2015;78:412–25.
4. Gaillard F., Sharma R. Alexander disease. Reference article, Radiopaedia. org. DOI: 10.53347/rID-5267
5. Huffnagel I.C., Laheji F.K., Aziz-Bose R. et al. The natural history of adrenal insufficiency in X-linked adrenoleukodystrophy: An international collaboration. J Clin Endocrinol Metab 2019b;104:118–26. DOI: 10.1210/jc.2018-01307
6. Kwong Y., Smith H. L-2-hydroxyglutaric aciduria. Reference article, Radiopaedia.org. DOI: 10.53347/rID-20917
7. Lin T.K., Chang Y.Y., Lin H.Y. et al. Mitochondrial dysfunctions in leukoencephalopathy with brainstem and spinal cord involvement and lactate elevation (LBSL). PLoS One 2019;14(10):e0224173. DOI: 10.1371/journal.pone.0224173
8. Lynch D.S., Wade C., Paiva A.R.B. et al. Practical approach to the diagnosis of adult-onset leukodystrophies: an updated guide in the genomic era. J Neurol Neurosurg Psychiatry 2019;90(5):543–54. DOI: 10.1136/jnnp-2018-319481
9. Mezaki N., Miura T., Ogaki K. et al. Duplication and deletion upstream of LMNB1 in autosomal dominant adult-onset leukodystrophy. Neurol Genet 2018;4(6):e292. DOI: 10.1212/NXG.0000000000000292
10. Resende L.L., de Paiva A.R.B., Kok F. et al. Adult leukodystrophies: a step-by-step diagnostic approach. Radiographics 2019;39(1):153–68.
11. Sharma R., Baba Y. Leukoencephalopathy with brainstem and spinal cord involvement and lactate elevation. Reference article, Radiopaedia. org. DOI: 10.53347/rID-57997
12. Van Geel B.M., Bezman L., Loes D.J. et al. Evolution of phenotypes in adult male patients with X-linked adrenoleukodystrophy. Ann Neurol 2001;49:186–94. DOI: 10.1002/1531-8249(20010201)49:2<186:AID-ANA38>3.0.CO;2-R
13. Weerakkody Y., Lall N. X-linked adrenoleukodystrophy. Reference article, Radiopaedia.org. DOI: 10.53347/rID-10259
14. Yasuda R., Nakano M., Yoshida T. et al. Towards genomic database of Alexander disease to identify variations modifying disease phenotype. Sci Rep 2019;9(1):14763. DOI: 10.1038/s41598-019-51390-8
Review
For citations:
Ershova A.A., Kotov A.S. The main forms of leukodystrophies. Lecture and clinical cases. Russian Journal of Child Neurology. 2023;18(2-3):45-51. (In Russ.) https://doi.org/10.17650/2073-8803-2023-18-2-3-45-51