Natural history of Type A Niemann-Pick disease
Possible endpoints for therapeutic trials
Abstract
Objective: To describe the disease course and natural history of Type A Niemann-Pick disease (NPD).
Methods: Ten patients with NPD-A (six male, four female; age range at entry: 3 to 6 months) were serially evaluated including clinical neurologic, ophthalmologic, and physical examinations, and assessment of development. Laboratory analyses, abdominal and brain ultrasounds, and chest radiographs also were obtained and information on intercurrent illnesses and cause of mortality was collected.
Results: All affected infants had a normal neonatal course and early development. The first symptom detected in all patients was hepatosplenomegaly. Developmental age did not progress beyond 10 months for adaptive behavior, 12 months for expressive language, 9 months for gross motor skills, and 10 months for fine motor skills. Non-neurologic symptoms included frequent vomiting, failure to thrive, respiratory infections, irritability, and sleep disturbance. Neurologic examination at the time of presentation was normal in most patients. Later neurologic examinations revealed progressive hypotonia with loss of the deep tendon reflexes. All patients had cherry red spots by 12 months. The median time from diagnosis to death was 21 months. The cause of death was respiratory failure in nine patients and complications from bleeding in the tenth.
Conclusions: The clinical course in Type A Niemann-Pick disease is similar among affected patients and is characterized by a relentless neurodegenerative course that leads to death, usually within 3 years.
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Published online: January 24, 2006
Published in print: January 24, 2006
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- Pathological Functions of Lysosomal Ion Channels in the Central Nervous System, International Journal of Molecular Sciences, 25, 12, (6565), (2024).https://doi.org/10.3390/ijms25126565
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- Acid sphingomyelinase deficiency in France: a retrospective survival study, Orphanet Journal of Rare Diseases, 19, 1, (2024).https://doi.org/10.1186/s13023-024-03234-6
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