Abstract
A newborn infant with oedema, ascites and hepatosplenomegaly is described. In ascites fluid foamy macrophages were found, in a liver biopsy cytoplasmic inclusions and membrane-bound vacuoles were seen. Furthermore the child excreted excessive amounts of sialic acid-rich oligosaccharides in the urine, and therefore a neurovisceral degenerative disorder was assumed. The diagnosis of sialidosis was confirmed by enzymatic assay in cultured fibroblasts, in which a complete deficiency of the lysosomal enzyme neuraminidase could be demonstrated. After recurrent septicaemias the child became dystrophic and died at the age of 6 months. Our case is compared with sialidoses observed by other authors, the wide phenotypic diversity within this biochemical defect is emphasised. The occurrence of hydrops fetalis in lysosomal storage diseases is discussed.
Similar content being viewed by others
References
Abu-Dalu KI, Tamary H, Livni N, Rivkind AI, Yatziv S (1982) GM1-gangliosidosis presenting as neonatal ascites. J Pediatr 100: 940–943
Aylsworth AS, Thomas GH, Hood JL, Malouf N, Libert J (1980) A severe infantile sialidosis: Clinical biochemical, and microscopic features. J Pediatr 96:662–668
D'Azzo A, Hoogeveen A, Reuser AJJ, Robinson D, Galjaard H (1982) Molecular defect in combined β-galactosidase and neuraminidase deficiency in man. Proc Natl Acad Sci USA 79:4535–4539
Cantz M, Kresse H, Barton RW, Neufeld EF (1972) Corrective factors for inborn errors of mucopolysaccharide metabolism. In: Ginsburg V (ed) Methods in enzymology, vol 28. Academic Press, New York London, pp 884–897
Cantz M, Gehler J, Spranger J (1977) Mucolipidosis I: Increased sialic acid content and deficiency of a α-N-acetylneuraminidase in cultured fibroblasts. Biochem Biophys Res Commun 74:732–738
Daneman A, Stringer D, Reilly BJ (1983) Neonatal ascites due to lysosomal storage disease. Radiology 149:463–467
Freda VJ, Gorman JG, Pollack W (1966) Rh factor: Prevention of immunization and clinical trial on mothers. Science 151:828–830
Gehler J, Cantz M, Tolksdorf M, Spranger J (1974) Mucopolysaccharidosis VII: β-Glucuronidase deficiency. Humangenetik 23: 149–158
Gehler J, Cantz M, Stoeckenius M, Spranger J (1976) Prenatal diagnosis of mucolipidosis II (I-cell disease). Eur J Pediatr 122: 201–206
Ginsburg SJ, Groll M (1973) Hydrops fetalis due to infantile Gaucher's disease. J Pediatr 82:1046–1048
Hancock LW, Thaler MM, Horwitz AL, Dawson G (1982) Generalized N-acetylneuraminic acid storage disease: Quantitation and identification of the monosaccharide accumulating in brain and other tissues. J Neurochem 38:803–809
Irani D, Kim HS, El-Hibri H, Dutton RV, Beaudet A, Armstrong D (1983) Postmortem observations on β-glucuronidase deficiency presenting as hydrops fetalis. Ann Neurol 14:486–490
Johnson WG, Thomas GH, Miranda AF, Driscoll JM, Wigger JN, Yeh MN, Schwartz RC, Cohen CS, Berdon WE, Koenigsberger MR (1980) Congenital sialidosis: Biochemical studies; clinical spectrum in four sibs; two successful prenatal diagnoses. Am J Hum Genet 32:43A
Kleijer WJ, Hoogeveen A, Verheijen FW, Niermeijer MF, Galjaard H, O'Brien JS, Warner TG (1979) Prenatal diagnosis of sialidosis with combined neuraminidase and β-galactosidase deficiency. Clin Genet 16:60–61
Laver J, Fried K, Beer SI, Iancu TC, Heyman E, Bach G, Zeigler M (1983) Infantile lethal neuraminidase deficiency (sialidosis). Clin Genet 23:97–101
Lowden JA, O'Brien JS (1979) Sialidosis: A review of human neuraminidase deficiency. Am J Hum Genet 31:1–18
Machin GA (1981) Differential diagnosis of hydrops fetalis. Am J Med Genet 9:341–350
Maroteaux P, Humbel R, Strecker G, Michalski JC, Mande R (1978) Un nouveau type de sialidose avec atteinte renale: La nephrosialidose. Arch Fr Pediatr 35:819–829
Moerman P, Fryns JP, Goddeeris P, Lauweryns JM (1982) Non-immunologic hydrops fetalis: A study of ten cases. Arch Pathol Lab Med 106:635–640
Nelson A, Peterson LA, Frampton B, Sly WS (1982) Mucopolysaccharidosis VII (β-glucuronidase deficiency) presenting as non-immune hydrops fetalis. J Pediatr 101:574–576
O'Brien JS (1977) Neuraminidase deficiency in the cherry-red spot-myoclonus syndrome. Biochem Biophys Res Commun 79: 1136–1141
Riches WG, Smuckler EA (1983) A severe infantile mucolipidosis. Clinical, biochemical, and pathologic features. Arch Pathol Lab Med 107:147–152
Sewell AC (1981) Simple laboratory determination of excess oligosacchariduria. Clin Chem 27:243–245
Warren L (1959) The thiobarbituric acid assay of sialic acids. J Biol Chem 234:1971–1975
Wenger DA, Tarby TJ, Wharton C (1978) Macular cherry-red spots and myoclonus with dementia: Coexistent neuraminidase and β-galactosidase deficiencies. Biochem Biophys Res Commun 82:589–595
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Beck, M., Bender, S.W., Reiter, HL. et al. Neuraminidase deficiency presenting as non-immune hydrops fetalis. Eur J Pediatr 143, 135–139 (1984). https://doi.org/10.1007/BF00445802
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00445802