Transplantation of Umbilical Blood in a 4-year Boy with Adrenoleukodystrophy
Bound to Chromosome X
Horáková J.1, Lukáč J.1, Šufliarska S.1, Boďová I.1, Mydliar M.1, Sýkora P.2, Vasil M.3, Belan J.4, Hřebík M.5
2. detská klinika LFUK a DFNsP, Bratislava1 prednosta prof. MUDr. L. Kovács, DrSc., MPH Klinika detskej neurológie LFUK a DFNsP, Bratislava2 prednosta doc. MUDr. P. Sýkora, CSc. Neštátne samostatné zariadenie SULZ – GEN + M, s.r.o., Humenné3 vedúci MUDr. M. Vasil Rádiodiagnostická klinika – pracovisko magnetickej rezonancie, Dérerova nemocnica s poliklinikou, Bratislava4 prednosta doc. MUDr. J. Belan, CSc. Ústav dědičných metabolických poruch 1. LF UK a VFN, Praha5 vedúci doc. MUDr. M. Elleder, DrSc. |
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Summary:
The authors describe the family, whose two sons were proved to suffer from children cerebral
form of adrenoleukodystrophy bound to chromosome X. In the first-born son the diagnosis was
established only after the development of neurological symptoms, in the second son s early as
before the evolution of clinical picture of the disease on the basis of familial anamnesis. In the
metabolic examination, high levels of very long-chain fatty acids with were detected in serum.
The genetic analysis confirmed the same mutation of ALD gene in both sons as well as in their
mother – a healthy carrier. At the beginning of the third pregnancy prenatal diagnosis was made
in the mother. The biopsy of chorion villi enabled to confirm a conceptus of female sex without
carriership of the disease-related gene. After a physiological delivery of healthy daughter the
umbilical blood with sufficient amount of stem hematopoietic cells with confirmed antigens of Ist
and Ind class of the HLA system with the younger son was established. At the age of four years
the HLA-identical sibling transplantation of umbilical blood was made in the younger son. The
transplantation was indicated before the development of neurological symptoms after the detection
of leukodystrophic foci on MRI of the brain (Loes score 4).
Key words:
adrenoleukodystrophy bound to chromosome X, diagnostics, therapy, transplantation
of hematopoietic cells
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