Summary
The retinal and neurological complications of abetalipoproteinaemia may be preventable by replacing vitamins A and E from an early age, but their role in adult presentations is less clear. Two adult females with abetalipoproteinaemia have received 8 and 10 years respectively of replacement therapy with vitamins A, E and linoleic acid. In Case 1, visual function improved objectively on commencing therapy but has subsequently deteriorated and her neuropathy has slowly progressed. The rate of progression of neurological impairment in Case 2 was slowed but not halted by therapy, and her severe visual disturbance was unaffected. Replacement by fat soluble vitamins has only a limited role in the management of abetalipoproteinaemia once irreversible neurological/retinal damage has occurred.
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Azizi, E., Zaidman, J. L., Eschar, J. and Steinberg, A. Abetalipoproteinemia treated with parenteral and oral vitamins A and E, and with medium chain triglycerides.Acta Paediatr. Scand. 67 (1978) 797–801
Barnard, G., Fosbrooke, A. S. and Lloyd, J. K. Neutral lipids of plasma and adipose tissue in abetalipoproteinemia.Clin. Chim. Acta 28 (1970) 417–422
Bassen, F. A. and Kornzweig, A. L. Malformation of the erythrocytes in a case of atypical retinitis pigmentosa.Blood 5 (1950) 381–387
Bieri, J. G., Hoeg, J. M., Schaeffer, E. J., Zech, L. A. and Brewer, H. B. Vitamin A and vitamin E replacement in abetalipoproteinemia.Ann. Intern. Med. 100 (1984) 238–239
Bishara, S., Merin, S., Cooper, M., Azizi, E., Delpre, G. and Deckelbaum, R. J. Combined vitamin A and E therapy prevents retinal electrophysiological deterioration in abetalipoproteinaemia.Br. J. Ophthalmol. 66 (1982) 767–770
Diplock, A. T. and Lucy, J. A. The biochemical modes of action of vitamin E and selenium: a hypothesis.FEBS Lett. 29 (1973) 205–210
Dworkin, R. H., Bates, D., Millar, J. H. and Paty, D. W. Linoleic acid and multiple sclerosis: a re-analysis of three double-blind trials.Neurology 34 (1984) 1441–1445
Fabianek, J., De Fillipi, J., Rickards, T. and Herp, A. Micro-method for tocopherol determination in blood serum.Clin. Chem. 14 (1968) 456–462
Hegele, R. A. and Angel, A. Arrest of neuropathy and myopathy in abetalipoproteinemia with high dose vitamin E therapy.Can. Assoc. J. 132 (1985) 41–44
Herbert, P. N., Assmann, G. A., Gotto, A. M. and Fredrickson, D. S. Familial lipoprotein deficiency: abetalipoproteinemia and Tangier disease. In: Stanbury, J. B., Wynegaarden, J. B., Frederickson, D. S., Goldstein, J. L. and Brown, M. S. (eds.)Metabolic Basis of Inherited Disease, 5th Edn., McGraw-Hill, New York, 1983, pp. 597–605
Kaser, M. and Stekol, J. A.J. Lab. Clin. Med. 28 (1943) 904
Miller, R. G., Davis, C. J., Illingworth, R. and Bradley, W. The neuropathy of abetalipoproteinemia.Neurology 30 (1980) 1286–1291
Muller, D. P. and Lloyd, J. K. Effect of large doses of vitamin E on the neurological sequelae of patients with abetalipoproteinemia.Ann. N. Y. Acad. Sci. 393 (1983) 133–142
Muller, D. P. R., Lloyd, J. K. and Wolff, O. H. Vitamin E and neurological function.Lancet 1 (1983) 225–228
Robinson, W. G., Kuwabara, T. and Bieri, J. G. Deficiencies of vitamins E and A in the rat: retinal damage and lipofuscin accumulation.Invest. Ophthalmol. Visual Sci. 19 (1980) 1030–1037
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MacGilchrist, A.J., Mills, P.R., Noble, M. et al. Abetalipoproteinaemia in adults: Role of vitamin therapy. J Inherit Metab Dis 11, 184–190 (1988). https://doi.org/10.1007/BF01799870
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DOI: https://doi.org/10.1007/BF01799870