Sjögren-Larsson Sendromu: İki Olgu Sunumu

Sjögren Larsson sendromu; otozomal resesif geçişli, yağ aldehit dehidrogenaz enzimini kodlayan ALDH3A2 genindeki mutasyon sonucu oluşan nörokutanöz bir hastalıktır. Görülme sıklığının 1/250.000 olduğu tahmin edilmektedir. Sendrom konjenital iktiyozis, spastik dipleji ve mental retardasyon ile karakterizedir. Klinik bulgular prenatal dönemde ve bebeklik döneminde ortaya çıkar. Hastalığın tanısı deri fibroblast kültürlerinde yağ asidi aldehit dehidrogenaz ya da yağ alkol oksidoredüktaz enzim aktivitesinin ölçülmesi ile konur. Tanı genetik olarak da ALDH3A2 geninin mutasyon analizi ile doğrulanabilir. Bu yazıda iktiyozis, gelişme geriliği ve spastik diplejisi olan iki olgu tariflenmiştir. Bu iki olguyu iktiyozis ve spastik diplejinin birlikteliğinde, ayırıcı tanıda bu sendromun da düşünülmesi gerektiğini vurgulamak amacıyla sunduk. Anahtar kelimeler: Sjögren-Larrson Sendromu; İktiyozis; Spastik Dipleji.

Sjögren-Larsson Syndrome: Report of Two Cases

Sjögren-Larsson syndrome is an autosomal recessive neurocutaneous disease caused by mutations in the ALDH3A2 gene that is encoding fatty aldehyde dehydrogenase. Prevalence is estimated at 1/250,000. The syndrome is characterized by congenital ichthyosis, spastic diplegia and mental retardation. Clinical features develop prenatally and during infancy. The diagnosis of Sjögren-Larrson syndrome is confirmed by measuring fatty acid aldeyhde dehydrogenase or fatty alcohol oxidoreductase activity in cultured fibroblasts from skin biopsies. Diagnosis can be confirmed by mutation analysis of the ALDH3A2 gene. In this article two patients with ichthyosis, developmental delay, spastic diplegia were described. We reported these cases because Sjögren-Larrson syndrome is a very rare disease and should be kept in mind in the differantial diagnosis of coexisting ichtyosis and spastic diplegia. Key words: Sjögren-Larrson Syndrome, İchtiyosis, Spastic Diplegia.

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  • Bolognia JL, Jorizzo JL, Rapini RP. Dermatology. 2nd ed. v. 1. Nova York: Mosby Elsevier; 2008. p.361-2.
  • Turgut Özal Tıp Merkezi Dergisi
  • Rizzo WB, Carney G, Lin Z. The molecular basis of Sjögren- Larsson syndrome: mutation analysis of the fatty aldehyde dehydrogenase gene. Am J Hum Genet 1999;65:1547-60.
  • Rizzo WB. Sjögren-Larsson sendrome: Moleculer genetics and biochemical pathogenesis of fatty aldehyde dehidrogenase deficiency. Mol Genet Metab 2007;90:1-9.
  • Nakayama M, Tavora DG, Alvim TC, Araşjo AC, Gama RL. MRI and 1H-MRS findings of three patients with Sjögren- Larsson syndrome. Arq Neuropsiquiatr 2006;64:398-401.
  • Özgen Ü, Şenol M, Özcan C, Bölük A, Karabiber H, Göğcüoğlu M,ve ark. Sjogren Larsson sendromu: vaka takdimi. J Turgut Ozal Med Cent 1994;1:207-9.
  • Ganemo A, Jagell S, Vahlquist A. Sjogren-larsson syndrome: a study of clinical symptoms and dermatological treatment in 34 Swedish patients. Acta Derm Venereol 2009;89:68-73.
  • Nadim F, Walid H, Adib J. The differential diagnosis of crystals in the retina. International Ophthalmology 2002;24:113-21.
  • Pirgon O, Aydın K, Atabek ME. Proton magnetic resonance spectroscopy findings and clinical effects of montelukast sodium in a case with Sjögren-Larsson syndrome. J Child Neurol 2006;21:1092-5.
  • Willemsen MA, Van der Graaf M, Van der Knaap MS, Heerschap A, Van Domburg PH, Gabreëls FJ et al. R imaging and proton MR spectroscopic studies in Sjögren– Larsson syndrome: characterization of the leukoencephalopathy. AJNR AM J Neuroradiol 2004;25:649–57.
  • Fuijkschot J, Theelen T, Seyger MM, Van der Graaf M, De Groot IJ, Wevers RA, et al. Sjögren-Larsson syndrome in clinical practice. J Inherit Metab Dis 2012;35:955-62.