Polyarticular Arthritis and Spinal Muscular Atrophy in Acid Ceramidase Deficiency.

Abstract:

:Survival of motor neuron 1-------negative spinal muscular atrophy (SMA) is heterogeneous and remains a diagnostic challenge. The clinical spectrum continues to expand and ∼33 genes have been identified to date. The present report describes a 9-year-old girl with novel clinical phenotype of a patient with polyarticular arthritis followed by symptoms of SMA due to acid ceramidase deficiency. Whole exome sequencing identified compound heterozygous pathogenic mutation in the N-acylsphingosine amidohydrolase 1 gene. Functional assay with leukocyte acid ceramidase activity showed a decreased level in the proband confirming pathogenicity of the mutations. Mutations of N-acylsphingosine amidohydrolase 1 are known to separately cause Farber disease (arthritis, subcutaneous nodules, and dysphonia) or SMA with progressive myoclonic epilepsy. The present combined phenotype is novel, bringing together SMA with progressive myoclonic epilepsy and Farber disease and establishing a phenotypic spectrum. Acid ceramidase deficiency is an important consideration in patients presenting with polyarticular arthritis and motor neuron disease.

journal_name

Pediatrics

journal_title

Pediatrics

authors

Teoh HL,Solyom A,Schuchman EH,Mowat D,Roscioli T,Farrar M,Sampaio H

doi

10.1542/peds.2016-1068

subject

Has Abstract

pub_date

2016-10-01 00:00:00

issue

4

eissn

0031-4005

issn

1098-4275

pii

peds.2016-1068

journal_volume

138

pub_type

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