Lowe Syndrome – Complex Diagnostics by Imaging Methods
Lisý J.1, Bláhová K.2, Petrák B.3, Stará V.2, Neuwirth J.1
Klinika zobrazovacích metod 2. LF UK a FN Motol, Praha1 přednosta prof. MUDr. J. Neuwirth, CSc. Pediatrická klinika 2. LF UK a FN Motol, Praha2 přednosta prof. MUDr. J. Vavřinec, CSc. Klinika dětské neurologie 2. LF UK a FN Motol, Praha3 přednosta doc. MUDr. V. Komárek, CSc. |
|
Summary:
Oculocerebrorenal or Lowe syndrome is a hereditary gonosomal recessive disease caused by
mutation of the OCRP gene on X chromosome. The ensuing deficit of inositol phosphatase results
in the extracellular storage of lysosomal enzymes in the eyes, brain and kidney. It becomes manifest
as a cataract, delayed psychomotor development with mental retardation. Renal tubular
acidosis with proteinuria follows to compensatory decalcification of bones and hypophosphate
rickets. Hypercalciuria results in nephrocalcinosis and nephrolithiasis.
The authors describe a broad spectrum of changes in a patient with Lowe syndrome using various
imaging methods. The simple X-ray picture of the left hand and forearm in 6 months of age
indicate rachitic changes, which disappeared after one year of treatment. Ultrasound of the abdomen
demonstrated frequent calcifications on the corticomedullar border of both kidneys which
correspond to nephrocalcinosis.
Ultrasonographic examination of the brain reveals gradual regression of a minute cyst in periventricular
left frontal region within the framework of changes in periventricular leukomalacia
(PVL), the finding being accompained by extension of the frontal horn of lateral ventricle.
Magnetic resonance (MR) of the brain in general anesthesia demonstrated diffuse tail-like foci
in periventricular, but also subcortical localization, a light cortical atrophy and changes after the
operation on ocular lenses for cataract.
The present case report substantiates the necessity of complex diagnostic approach with a wide
spectrum of imaging methods in patients with disorder of the function of the kidney and bones.
Key words:
Lowe syndrome, MR of the brain, nephrocalcinosis, rickets
|