Congenital CLN disease in two siblings

Wien Med Wochenschr. 2015 May;165(9-10):210-3. doi: 10.1007/s10354-015-0359-4. Epub 2015 Jun 10.

Abstract

Background: Neuronal ceroid lipofuscinoses (NCL) is characterized by a combination of retinopathy, dementia, and epilepsy. As a group, they encompass ten distinct biological and clinical entities and are the most common type of childhood neurodegenerative disease.

Patients and methods: Case reports.

Results: We demonstrate the clinical course of two neonates (brother and sister) with infantile neuronal ceroid lipofuscinoses (NCL) (CLN 10 disease) presenting with intractable seizures and respiratory insufficiency immediately after birth. Characteristic clinical, radiological and pathological findings of this form of NCL are presented.

Conclusions: We conclude that the diagnosis of CLN10 should be kept in mind as a differential diagnosis in newborns presenting with respiratory insufficiency and severe epilepsy that is largely refractory to anti-epileptic drugs (AED) treatment. Because of the severity of CLN10 disease and futility of treatment, important ethical issues arise when caring for children with this clinical entity.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Brain / abnormalities
  • Brain / pathology
  • Cathepsin D / deficiency*
  • Cathepsin D / genetics
  • Chromosome Aberrations
  • Consanguinity
  • Diagnosis, Differential
  • Ethics, Medical
  • Euthanasia, Passive / ethics
  • Female
  • Genes, Recessive / genetics
  • Genetic Carrier Screening
  • Humans
  • Infant, Newborn
  • Male
  • Neuronal Ceroid-Lipofuscinoses / diagnosis
  • Neuronal Ceroid-Lipofuscinoses / genetics*
  • Neuronal Ceroid-Lipofuscinoses / therapy
  • Palliative Care / ethics

Substances

  • Cathepsin D

Supplementary concepts

  • Ceroid Lipofuscinosis, Neuronal, 10