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Peripheral and autonomic nervous system involvement in chronic GM2-gangliosidosis

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Journal of Inherited Metabolic Disease

Abstract

GM2-gangliosidosis (McKusick 268800 and 272800) is a rare hereditary, progressive disorder of ganglioside metabolism caused by deficiency of lysosomal β-hexosaminidase (EC 3.2.1.52) activity. It is characterized by severe central nervous system involvement. Involvement of the peripheral and autonomic nervous system has been suspected but rarely documented in published case reports in the chronic form of the disease. Four patients, aged 24–29 years, with chronic GM2-gangliosidosis were examined prospectively for evidence of peripheral and autonomic nervous system dysfunction. All had nerve conduction studies, sympathetic skin responses and cardiac monitoring during the head tilt-table test. Three patients had objective evidence of autonomic dysfunction with abnormal sympathetic nervous skin responses and axonal sensorimotor polyneuropathy. None of the patients had evidence of significant cardiovascular autonomic dysfunction on the head tilt-table test. The peripheral and autonomic nervous system may be involved in patients with chronic GM2-gangliosidosis. In some cases, this may be clinically significant. On the other hand, cardiovascular autonomic instability is apparently not a significant problem in young adult patients with the disease.

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REFERENCES

  • Bannister R, Mathias C (992) Autonomic FailureöA Textbook of Diseases of the Autonomic Nervous System, 3rd edn. Oxford: Oxford University Press.

  • Barron HV,Lesh MD (1996) Autonomic nervous system and cardiac death. JAmColl Cardiol 27: 1053–1060.

    Google Scholar 

  • Cashman NR,Antel JP,Hancock LW,Dawson G (1986) N-Acetyl-b-hexosaminidase b locus defect and juvenile motor neuron disease: a case study. Ann Neurol 19: 568–572.

    Google Scholar 

  • Federico A,Ciacci G,D'Amore I,Pallini R et al (1986) GM2 gangliosidosis with hexosaminidase A and B defect: report of a family with motor neurone-like phenotype. J Inherit Metab Dis 9(supplement 2): 307–310.

    Google Scholar 

  • Federico A,Palmeri S,Malandrini A, et al (1991) The clinical aspects of adult hexosaminidase de¢ciencies. Dev Neurosci 13: 280–287.

    Google Scholar 

  • Galvis DA,Nakazato Y,Wells TR,Landing BH (1987) Demonstration of myenteric plexus abnormalities in genetic diseases by a microdissection technique: preliminary studies. Am J Med Genet Suppl. 3: 329–342.

    Google Scholar 

  • Gravel RA,Clarke JTR et al (1995) The GM2 gangliosidoses. In: Scriver CR,Beaudet AL,Sly WS,Valle D, eds. TheMetabolic and Molecular Bases of Inherited Disease, 7th edn, vol. II New York: McGraw-Hill, 2839–2879.

    Google Scholar 

  • Hilz MJ,Kolodny EH,Neuner I,Stemper B,Axelrod FB (1998) Highly abnormal thermotests in familial dysautonomia suggest increased cardiac autonomic risk. J Neurol Neurosurg Psychiatry 65: 338–343.

    Google Scholar 

  • Modigliani R,Lemann M,Melancon SB et al (1994) Diarrhea and autonomic dysfunction in a patient with hexosaminidase B de¢ciency (Sandho¡ disease). Gastroenterology 106 (3): 775–781.

    Google Scholar 

  • Mondelli M,Rossi A,Palmeri S,Rizzuto N,Federico A (1989) Neurophysiological study in chronic GM2 gangliosidosis (hexosaminidase A and B de¢ciency), with motor neuron dis-ease phenotype. Ital J Neurol Sci 10: 433–439.

    Google Scholar 

  • Nakano R,Wakamatsu N,Tsuji S,Matsumura G,Miyatake T (1989) Juvenile Sandho¡ dis-ease with local pan-atrophy, a case report. Rinsho ShinkeigakuöClin Neurol 29: 1032–1038 (Abstract).

    Google Scholar 

  • Ravits JM (1997) Autonomic nervous system testing. Muscle Nerve 20: 919–937.

    Google Scholar 

  • Schnorf H,Gitzelman R,Bosshard NU,Spycher M,Waespe W (1995) Early and serve sensory loss in three adult siblings with hexosaminidase A and B de¢ciency (Sandho¡ disease). J Neurol Neurosurg Psychiatry 59: 520–532.

    Google Scholar 

  • Willner JP,Grabowski GA,Gordan RE,Bender AN,Desnick RJ (1981) Chronic GM2 gangliosidosis masquerading as atypical Friedreich ataxia: clinical, morphologic, and bio-chemical studies of nine cases. Neurology 31: 787–798.

    Google Scholar 

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Salman, M.S., Clarke, J.T.R., Midroni, G. et al. Peripheral and autonomic nervous system involvement in chronic GM2-gangliosidosis. J Inherit Metab Dis 24, 65–71 (2001). https://doi.org/10.1023/A:1005662906859

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