Absence of biochemical evidence at an early age delays diagnosis in a patient with a clinically severe peroxisomal biogenesis disorder

作者：Luesebrink Natalia; Porto Luciana; Waterham Hans R; Ferdinandusse Sacha; Rosewich Hendrik; Kurlemann Gerd; Kieslich Matthias

来源：European Journal of Paediatric Neurology, 2016, 20(2): 331-335.

DOI：10.1016/j.ejpn.2015.11.008

• Peroxisomal biogenesis disorder
• Zellweger spectrum disorder
• PEX6
• Polimicrogyria
• VLCFA

Analysis of the plasma levels of very long chain fatty acids (VLCFA) is a primary screening method for peroxisomal disorders and usually identifies severe peroxisomal biogenesis defects reliably. We report a patient presenting with typical facial stigmata, a treatment resistant seizure disorder and polymicrogyria, whose plasma VLCFA levels were within normal limits until the age of 18 months. Only thereafter an elevation was found. Subsequent enzymatic and molecular genetic analysis revealed compound heterozygous mutations in the PEX6 gene. In conclusion, normal VLCFA levels do not necessarily exclude global peroxisomal biogenesis defects and the analysis should be repeated subsequently. Persisting clinical suspicion justifies further enzymatic and molecular evaluation.

• 出版日期2016-3