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Larson A, Weisfeld-Adams JD, Benke TA, et al. Cerebrotendinous Xanthomatosis Presenting with Infantile Spasms and Intellectual Disability. JIMD Rep. 2016;35:1-5doi: 10.1007/8904_2016_16.
Larson, A., Weisfeld-Adams, J. D., Benke, T. A., & Bonnen, P. E. (2017). Cerebrotendinous Xanthomatosis Presenting with Infantile Spasms and Intellectual Disability. JIMD reports, 351-5. https://doi.org/10.1007/8904_2016_16
Larson, Austin, et al. "Cerebrotendinous Xanthomatosis Presenting with Infantile Spasms and Intellectual Disability." JIMD reports vol. 35 (2017): 1-5. doi: https://doi.org/10.1007/8904_2016_16
Larson A, Weisfeld-Adams JD, Benke TA, Bonnen PE. Cerebrotendinous Xanthomatosis Presenting with Infantile Spasms and Intellectual Disability. JIMD Rep. 2017;35:1-5. doi: 10.1007/8904_2016_16. Epub 2016 Nov 18. PMID: 27858369; PMCID: PMC5585103.
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JIMD Rep. 2017;35:1-5. doi: 10.1007/8904_2016_16. Epub 2016 Nov 18.

Cerebrotendinous Xanthomatosis Presenting with Infantile Spasms and Intellectual Disability.

JIMD reports

Austin Larson, James D Weisfeld-Adams, Tim A Benke, Penelope E Bonnen

Affiliations

  1. Department of Pediatrics, Section of Genetics, University of Colorado School of Medicine, Aurora, CO, USA. [email protected].
  2. Children's Hospital Colorado, Mail Stop 153, 13123 E 16th Ave, Aurora, CO, 80045, USA. [email protected].
  3. Department of Pediatrics, Section of Genetics, University of Colorado School of Medicine, Aurora, CO, USA.
  4. Departments of Pediatrics, Pharmacology, Neurology and Otolaryngology, University of Colorado School of Medicine, Aurora, CO, USA.
  5. Department of Molecular and Human Genetics, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA. [email protected].

PMID: 27858369 PMCID: PMC5585103 DOI: 10.1007/8904_2016_16

Abstract

Cerebrotendinous xanthomatosis (CTX) is an inborn error of metabolism leading to progressive multisystem disease. Symptoms often begin in the first decade of life with chronic diarrhea, cataracts, developmental delay, intellectual disability, and cerebellar or pyramidal dysfunction. Later manifestations include tendon xanthomas, polyneuropathy, and abnormal neuroimaging. Pathogenic biallelic variants in CYP27A1 leading to compromised function of sterol 27-hydroxylase result in accumulation of detectable toxic intermediates of bile acid synthesis rendering both genetic and biochemical testing effective diagnostic tools. Effective treatment with chenodeoxycholic acid is available, making early diagnosis critical for patient care. Here we report a new patient with CTX and describe the early signs of disease in this patient. Initial symptoms included infantile spasms, which have not previously been reported in CTX. Developmental delay, mild intellectual disability with measured cognitive decline in childhood, was also observed. These clinical signs do not traditionally compel testing for CTX, and we highlight the need to consider this rare but treatable disorder among the differential diagnosis of children with similar clinical presentation. Increased awareness of early signs of CTX is important for improving time to diagnosis for this patient population.

Keywords: Cataracts; Cerebrotendinous xanthomatosis; Developmental delay; Infantile spasms; Intellectual disability

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