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Neurology 1999;52:372
© 1999 American Academy of Neurology
Articles

GM2 gangliosidosis AB variant

Clinical and biochemical studies of a Japanese patient

H. Sakuraba, MD, K. Itoh, PhD, M. Shimmoto, MS, K. Utsumi, MD, R. Kase, PhD, Y. Hashimoto, MD, T. Ozawa, MD, Y. Ohwada, MD, G. Imataka, MD, M. Eguchi, MD, T. Furukawa, MD, U. Schepers, PhD and K. Sandhoff, PhD

From the Departments of Clinical Genetics (Drs. Sakuraba, Itoh, Utsumi, and Kase, and M. Shimmoto) and Membrane Biochemistry (Dr. Hashimoto), The Tokyo Metropolitan Institute of Medical Science, Japan; the Second Department of Pediatrics (Drs. Ozawa, Ohwada, Imataka, Eguchi, and Furukawa), Dokkyo University School of Medicine, Mibu, Japan; the Institut für Organische Chemie und Biochemie der Universität Bonn (Drs. Schepers and Sandhoff), Germany; and the Department of Cell Biology (Dr. Schepers), Harvard Medical School and Center for Blood Research, Boston, MA.

Address correspondence and reprint requests to Dr. Hitoshi Sakuraba, Department of Clinical Genetics, The Tokyo Metropolitan Institute of Medical Science, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo 113-8613, Japan.

OBJECTIVE: To determine the clinical features and biochemical basis of the first Japanese patient with the GM2 gangliosidosis AB variant.

METHODS: The clinical manifestations and laboratory findings in the patient were investigated. Cultured fibroblasts from the patient were analyzed by means of immunofluorescence staining with an anti-GM2 ganglioside monoclonal antibody and thin-layer chromatography and immunostaining. GM1 ganglioside catabolism in cultured cells was analyzed by pulse labeling, and the amount of GM2 activator in cells was determined by Western blot analysis. Gene analysis was performed according to standard protocols.

RESULTS: The patient showed progressive neurologic manifestations of quite early onset. Muscular weakness and hypotonia became evident by 1 month of age, and the patient then developed a startle reaction, severe psychomotor retardation, and myoclonic seizures. Immunocytochemical analysis clearly revealed the accumulation of GM2 ganglioside in cultured fibroblasts from the patient, and thin-layer chromatography confirmed it. Western blot and metabolic studies showed a complete deficiency of GM2 activator. Gene analysis did not reveal any mutations in the protein coding region of the GM2 activator gene.

CONCLUSION: The clinical features and biochemical basis of this Japanese patient with GM2 gangliosidosis AB variant were determined. Immunocytochemical analysis using cultured fibroblasts as samples is available for the diagnosis of this disease.






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