Skip to main content
Log in

Generalised nuclear and cytoplasmic inclusion disease: a rare case investigated by microscopy and immunohistochemistry

  • Case Report
  • Published:
Acta Neuropathologica Aims and scope Submit manuscript

Abstract

A Caucasian female who was noted to be mildly microcephalic at birth was diagnosed as having cerebral palsy at the age of 1 year. Her development was delayed and she never walked or talked. She appeared relatively stable neurologically until the age of 17 years when she had an illness with fever thought to be due to a virus. She was noted to deteriorate from this time on until her death at the age of 19 years. Autopsy revealed intranuclear and cytoplasmic inclusions widespread throughout the brain and visceral organs. There was no evidence of inflammation. Immunohistochemistry revealed strong immunoreactivity for tau protein and neurofilament protein. Electron microscopy revealed the inclusions to be composed of homogeneous finely granular material. Scattered with the granular material in the cytoplasmic bodies were crystalline structures with a honeycomb appearance. The possibility of these changes representing an old viral infection or a primary metabolic disorder are discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Bancher C, Lassmann H, Budka H, Grunde-Iqbal K, Iqbal K, Wiche G, Seitelberger F, Wisniewski HM (1987) Neurofibrillary tangles in Alzheimer's disease and progressive supranuclear palsy: antigenic similarities and differences. Acta Neuropathol (Berl) 74: 39–46

    Google Scholar 

  2. Defossez A, Beauvillain JC, Delacourte A, Mazzuca M (1988) Alzheimer's disease: a new evidence for common epitopes between microtubule-associated protein tau and paired helical filaments (PHF). Demonstration at the electron microscope level by a double immunogold labelling. Virchows Arch [A] 413: 141–145

    Google Scholar 

  3. Funata N, Maeda Y, Koike M, Yano Y, Kaseda M, Muro T, Okeda R, Iwata M, Yokoji M (1990) Neuronal intranuclear hyaline inclusion disease: report of a case and review of the literature. Clin Neuropathol 9: 89–96

    Google Scholar 

  4. Gambetti P (1993) Neuronal proteins: basic and applied aspects. Brain Pathol 3: 27–38

    Google Scholar 

  5. Garen PD, Powers JM, Young GF, Lee V (1986) Neuronal intranuclear hyaline inclusion disease in a nine-year old. Acta Neuropathol (Berl) 70: 327–332

    Google Scholar 

  6. Goutieres F, Mikol J, Aicardi J (1990) Neuronal intranuclear inclusion disease in a child: diagnosis by rectal biopsy. Ann Neurol 27: 103–106

    Google Scholar 

  7. Haltia M, Somer H, Palo J, Johnson WG (1949) Neuronal intranuclear inclusion disease in identical twins. Ann Neurol 15: 316–321

    Google Scholar 

  8. Hirano A, Zimmerman HM (1970) Some effects of vinblastine implantation in the cerebral white matter. Lab Invest 23: 358–367

    Google Scholar 

  9. Janota I (1979) Widespread intranuclear neuronal corpuscles (Marinesco bodies) associated with a familial spinal degeneration with cranial and peripheral nerve involvement. Neuropathol Appl Neurobiol 5: 311–317

    Google Scholar 

  10. Katsuragi S, Eto K, Takeya M (1981) One autopsy case presenting a variety of neurological disorders such as oculogyric crises and kinesia paradoxale in conjunction with numerous neuronal intranuclear eosinophilic inclusions (abstract, in Japanese). Neuropathology (Tokyo) 2: 63

    Google Scholar 

  11. Kosik KS (1993) The molecular and cellular biology of tau. Brain Pathol 3: 39–43

    Google Scholar 

  12. Lee G (1990) Tau protein: an update on structure and function. Cell Motil Cytoskeleton 15: 199–203

    Google Scholar 

  13. Lindenberg R, Rubinstein LJ, Herman MM, Hydon GB (1968) A light and electron microscopy study of an unusual widespread nuclear inclusion body disease. Acta Neuropathol (Berl) 10: 54–73

    Google Scholar 

  14. Michaud J, Gilbert JJ (1981) Multiple system atrophy with neuronal intranuclear hyaline inclusions: report of a case with light and electron microscopic studies. Acta Neuropathol (Berl) 54: 113–119

    Google Scholar 

  15. Munoz-Garcia D, Ludwín SK (1986) Adult-onset neuronal intranuclear hyaline inclusion disease. Neurology 36: 785–790

    Google Scholar 

  16. Nixon RA (1993) The regulation of neurofilament protein dynamics by phosphorylation: clues to neurofibrillary pathobiology. Brain Pathol 3: 29–38

    Google Scholar 

  17. Oyer CE, Cortez S, OShea P, Popovic M (1991) Cardiomyopathy and myocyte intranuclear inclusions in neuronal intranuclear inclusion disease: a case report. Hum Pathol 22: 722–724

    Google Scholar 

  18. Palo J, Haltia M, Carpenter S, Karpati G, Mushynski W (1984) Neurofilament subunit-related proteins in neuronal intranuclear inclusions. Ann Neurol 15: 322–328

    Google Scholar 

  19. Parker JC (1983) Sporadic spinocerebellar degeneration associated with intranuclear neuronal inclusions and arteriosclerotic heart disease. J Neuropathol Exp Neurol 42: 352

    Google Scholar 

  20. Parker JC Jr, Dyer ML, Paulsen WA (1987) Neuronal intranuclear hyaline inclusion disease associated with premature coronary artherosclerosis. J Clin Neuroopthalmol 7: 244–249

    Google Scholar 

  21. Patel H, Norman MG, Perry TL, Berry KE (1985) Multiple system atrophy with neuronal intranuclear hyaline inclusions: report of a case and review of the literature. J Neurol Sci 67: 57–65

    Google Scholar 

  22. Schuffler MD, Bird TD, Sumi SM, Cook A (1978) A familial neuronal disease presenting as intestinal pseudo-obstruction. Gastroenterology 75: 889–898

    Google Scholar 

  23. Soffer D (1985) Neuronal intranuclear hyaline inclusion disease presenting as Friedreich's ataxia. Acta Neuropathol (Berl) 65: 322–329

    Google Scholar 

  24. Sung JH (1980) Light, fluorescence and electron microscopic features of neuronal intranuclear hyaline inclusions associated with multisystem atrophy. Acta Neuropathol (Berl) 50: 115–120

    Google Scholar 

  25. Sung JH, Ramirez-Lassepas M, Mastri AR, Larkin SM (1980) An unusual degenerative disorder of neurons associated with a novel intranuclear hyaline inclusion (neuronal intranuclear hyaline inclusion disease). J Neuropathol Exp Neurol 39: 107–130

    Google Scholar 

  26. Tateishi J, Nagara H, Ohta M, Matsumoto T, Fukunaga H, Shida K (1984) Intranuclear inclusions in muscle, nervous tissue, and adrenal gland. Acta Neuropathol (Berl) 63: 24–32

    Google Scholar 

  27. Trojanowski JQ, Schmidt ML, Shin R-W, Bramblett GT, Rao D, Lee VM-Y (1993) Altered Tau and Neurofilament Proteins in Neurodegenerative diseases: Diagnostic Implications for Alzheimer's disease and Lewy Body Dementias. Brain Pathol 3: 45–54

    Google Scholar 

  28. Waggener JD, Beggs J, Sidell AD (1972) Virus-like filaments in juvenile parkinsonism. J Neuropathol Exp Neurol 31: 187

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ruszkiewics, A., Opeskin, K., Anderson, R.M.D. et al. Generalised nuclear and cytoplasmic inclusion disease: a rare case investigated by microscopy and immunohistochemistry. Acta Neuropathol 87, 648–654 (1994). https://doi.org/10.1007/BF00293327

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00293327

Key words

Navigation