In:
Journal of Inherited Metabolic Disease, Wiley, Vol. 34, No. 3 ( 2011-06), p. 763-780
Kurzfassung:
Hunter disease is a rare X‐linked mucopolysaccharidosis. Despite frequent neurological involvement, characterizing the severe phenotype, neuroimaging studies are scarce. Objectives To determine frequency and severity of neuroradiological mucopolysaccharidosis‐related features; to correlate them with clinical phenotype; to evaluate their natural evolution and the impact of intravenous enzymatic replacement therapy (ERT). Methods Sixty nine brain MRI examinations of 36 Italian patients (mean‐age 10.4 years; age‐range 2.2‐30.8; severe phenotype in 22 patients) were evaluated. Twenty patients had multiple MRIs (median follow‐up 3.1 years, range 1–16.9): among them 15 had MRIs before and after ERT, six had repeated MRIs without being on ERT and five while on ERT. Perivascular, subarachnoid and ventricle space enlargement, white matter abnormality (WMA) burden, pituitary sella/skull/posterior fossa abnormalities, periodontoid thickening, spinal stenosis, dens hypoplasia, myelopathy, vertebral and intervertebral disc abnormalities were graded by means of dedicated scales. Results Perivascular spaces enlargement (89%), WMAs (97%), subarachnoid space enlargement (83%), IIIrd‐ventricle dilatation (100%), pituitary sella abnormalities (80%), cranial hyperostosis (19%), craniosynostosis (19%), enlarged cisterna magna (39%), dens hypoplasia (66%), periodontoid thickening (94%), spinal stenosis (46%), platyspondylia (84%) and disc abnormalities (79%) were frequently detected. WMAs, IIIrd‐ventricle dilatation and hyperostosis correlated with the severe phenotype (p 〈 0.05). Subarachnoid spaces and ventricle enlargement, WMAs and spinal stenosis progressed despite ERT, while other MR features showed minimal or no changes. Conclusions The spectrum of brain and spine MRI abnormalities in Hunter disease is extremely wide and requires a thorough evaluation. WMAs, atrophy/communicating hydrocephalus and spinal stenosis progress over time and might represent possible disease severity markers for new treatment efficacy assessment.
Materialart:
Online-Ressource
ISSN:
0141-8955
,
1573-2665
DOI:
10.1007/s10545-011-9317-5
Sprache:
Englisch
Verlag:
Wiley
Publikationsdatum:
2011
ZDB Id:
2006875-X
