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Phenotypic Variability of Krabbe Disease Across the Lifespan

Published online by Cambridge University Press:  23 September 2014

Pamela Liao
Affiliation:
Department of Obstetrics & Gynaecology, University of Toronto, Toronto, Ontario
Jennifer Gelinas
Affiliation:
Division of Pediatric Neurology, Faculty of Medicine, University of British Columbia, Vancouver, British
Sandra Sirrs
Affiliation:
Adult Metabolic Diseases, University of British Columbia, Vancouver, British Columbia, Canada
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Abstract

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Krabbe disease (galactocerebrosidase deficiency) is an inherited leukodystrophy that results in severe neurological defects due to altered myelination. Classically, disease onset is within the first year of life. Juvenile and adult-onset cases may have less classic presentations, making diagnosis difficult and often delayed. Here, we review the literature to demonstrate the hetereogeneity of presenting symptoms across all age groups. We also discuss diagnostic approach, emphasizing variation in biochemical, functional, and genetic results among Krabbe phenotypes. Better understanding of the various Krabbe disease phenotypes is critical to facilitate timely diagnosis and appropriate treatment of this clinically heterogeneous disorder.

Résumé

RÉSUMÉ

Variabilité phénotypique dans la maladie de Krabbe au cours de la vie du patient. La maladie de Krabbe (déficit en galactocérébrosidase) est une leukodystrophie héréditaire qui donne lieu à des déficits neurologiques sévères dus à un trouble de la myélinisation. Chez les cas dont la présentation est classique, la maladie débute au cours de la première année de vie. Si la maladie commence chez un adolescent ou un adulte, le mode de présentation peut-être moins classique, ce qui rend le diagnostic difficile et souvent tardif. Nous analysons les articles traitant du sujet pour démontrer l’hétérogénéité des symptômes au moment de la première consultation et ceci dans tous les groupes d’âge. Nous discutons également de l’approche diagnostique en mettant l’emphase sur la variation des résultats biochimiques, fonctionnels et génétiques des différents phénotypes dans la maladie de Krabbe. Une meilleure compréhension des différents phénotypes est cruciale pour faciliter un diagnostic précoce et un traitement approprié de cette maladie dont le mode de présentation clinique est hétérogène.

Type
Review Article
Copyright
Copyright © The Canadian Journal of Neurological 2014

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