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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    European archives of psychiatry and clinical neuroscience 224 (1977), S. 379-387 
    ISSN: 1433-8491
    Keywords: Adult metachromatic leukodystrophy ; Schizophrenic psychosis ; Demyelination ; Sulfatides ; Adulte metachromatische Leukodystrophie ; Schizophrene ; Psychose ; Demyelination ; Sulfatide
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Bericht über eine autoptisch verifizierte Beobachtung von adulter metachromatischer Leukodystrophie (MLD) unter dem klinischen Bild einer schizophrenen Psychose. Der 50jährige Mann entwickelte rund 10 Jahre vor dem Tode progrediente psychische Wesensänderung sowie ein schizophrenes Syndrom ohne neurologische Ausfälle oder EEG-Anomalien und starb an Urämie. Neuropathologisch bestand eine MLD mit bifrontal akzentuierten Entmarkungen sowie reichlich metachromatischen Depositen in den übrigen, relativ intakten zerebralen Markabschnitten. Die neurochemische Untersuchung der entmarkten Frontalregion ergab erniedrigte Cerebrosid- und Sulfatidkonzentrationen sowie erniedrigten Gesamtlipidgehalt im Gewebe bzw. einen erhöhten Sulfatid-, insbesondere Cerebronsulfatidgehalt im Lipidextrakt. Die Problematik der langlaufenden Erwachsenenform der MLD mit besonderer Berücksichtigung der unter psychiatrischen Syndromen verlaufenden Fälle wird diskutiert.
    Notes: Summary An autopsy case of adult metachromatic leukodystrophy (MLD) manifested clinically as schizophrenic psychosis is reported. A 50-year-old man developed progressive mental changes 10 years before his death, and later manifested a schizophrenic syndrome without neurologic deficits or EEG changes. After his death from uremia neuropathology disclosed MLD with demyelination accentuated in the frontal lobes and abundant metachromatic deposits in the preserved areas of cerebral white matter. Neurochemical examination of the demyelinated frontal area showed reduced concentration of cerebrosides and sulfatides, decreased amounts of total lipids in the tissue, and an increase of sulfatides, and particularly of their cerebron fractions in lipid extract. The problems of adult forms of MLD with prolonged course are discussed with special reference to cases showing mainly psychiatric syndromes.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Journal of neurology 235 (1987), S. 1-9 
    ISSN: 1432-1459
    Keywords: Adrenoleukodystrophy ; Demyelination ; Very long chain fatty acids ; Schilder's disease
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A 43-year-old female with adrenoleukodystrophy (ALD) is described, who developed spastic tetraparesis, suffered grand mal seizures, and became stuporous and demented during the last 5 years of her life. Computed tomography revealed symmetrical hypodense lesions in the peritrigonal regions. Adrenal insufficiency was not evident except for skin pigmentation. The ultrastructure of a rectal biopsy specimen showed inclusions with lamellae and interspersed clefts in macrophages of the submucosal layer. At autopsy, the adrenals were found to contain large foam cells filled with similar inclusions. The brain cortex and the spinal cord were histologically normal. However, cerebral white matter exhibited widespread demyelination which spared only the arcuate fibres. In regions of less severe demyelination scattered inflammatory cells were seen. On electron microscopy, aggregates of typical paired leaflets with distinct intermediate lines were demonstrated in perivascular macrophages. Histochemical study showed these cells to contain free as well as esterified cholesterol. Gas chromatographic analysis of very long chain fatty acids (VLFA) from the demyelinated cerebral white matter showed a marked increase of C26:0 fatty acid in cholesterol esters and above-normal values for C24:0 and C24:1 in gangliosides. It is suggested that the condition was a heterozygote form of X-linked ALD. Patients with neurodegenerative symptoms with or without adrenal insufficiency can easily be screened for X-linked ALD by VLFA analysis in blood or cultured fibroblasts.
    Type of Medium: Electronic Resource
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