Abstract:
OBJECTIVE:To critically re-evaluate cases diagnosed as adult neuronal ceroid lipofuscinosis (ANCL) in order to aid clinicopathologic diagnosis as a route to further gene discovery. METHODS:Through establishment of an international consortium we pooled 47 unsolved cases regarded by referring centers as ANCL. Clinical and neuropathologic experts within the Consortium established diagnostic criteria for ANCL based on the literature to assess each case. A panel of 3 neuropathologists independently reviewed source pathologic data. Cases were given a final clinicopathologic classification of definite ANCL, probable ANCL, possible ANCL, or not ANCL. RESULTS:Of the 47 cases, only 16 fulfilled the Consortium's criteria of ANCL (5 definite, 2 probable, 9 possible). Definitive alternate diagnoses were made in 10, including Huntington disease, early-onset Alzheimer disease, Niemann-Pick disease, neuroserpinopathy, prion disease, and neurodegeneration with brain iron accumulation. Six cases had features suggesting an alternate diagnosis, but no specific condition was identified; in 15, the data were inadequate for classification. Misinterpretation of normal lipofuscin as abnormal storage material was the commonest cause of misdiagnosis. CONCLUSIONS:Diagnosis of ANCL remains challenging; expert pathologic analysis and recent molecular genetic advances revealed misdiagnoses in >1/3 of cases. We now have a refined group of cases that will facilitate identification of new causative genes.
journal_name
Neurologyjournal_title
Neurologyauthors
Berkovic SF,Staropoli JF,Carpenter S,Oliver KL,Kmoch S,Anderson GW,Damiano JA,Hildebrand MS,Sims KB,Cotman SL,Bahlo M,Smith KR,Cadieux-Dion M,Cossette P,Jedličková I,Přistoupilová A,Mole SE,ANCL Gene Discovery Consortiudoi
10.1212/WNL.0000000000002943subject
Has Abstractpub_date
2016-08-09 00:00:00pages
579-84issue
6eissn
0028-3878issn
1526-632Xpii
WNL.0000000000002943journal_volume
87pub_type
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