Summary:
The authors described a case of the adult form of Krabbe’s leukodystrophy (A-KLS), a rare autosomal
recessive disease usually manifested in early childhood and caused by a mutation of the lysozomal
enzyme galactocerebrosidase. Krabbe’s leukodystrophy with a late onset in adult age is extremely rare
and in the literature so far only few cases were described. The described case was manifested by the
slow development of spastic paraparesis of the lower extremities and a disorder of sphincteric and
sexual functions from the end of the second decade. Pathognomic for KLD was the finding of disappe-
arance of galactocerebrosidase activity in leucocytes and the finding of lipid accumulation in the
dermal sweat glands and cytoplasm of Schwann cells of the sural nerve. Magnetic resonance of the
brain revealed a non-specific finding of diffuse affection of the central myelin. Abnormalities of
somatosensory and motor evoked potentials, corespondong to diffuse affection of the central somato-
sensory and motor pathways of the demyelinating type, correlated with this finding. The cerebrospinal
fluid did not suggest an autoimmune inflammatory process such as multiple sclerosis.
Key words:
Krabbe’s leukodystrophy, adult form, galactocerebrosidase
|