KRABBE DISEASE IN PEDIATRIC PRACTICE
DOI:
https://doi.org/10.11603/24116-4944.2019.2.10916Keywords:
Krabbe disease, clinical signs, diagnostics, childrenAbstract
Krabbe disease (globe-cell leukodystrophy) is a rapidly progressive demyelinating degenerative disease of the central nervous system. The type of inheritance is autosomal recessive. At the heart of the disease is a decrease in the activity of the enzyme galactosylceramide-β-galactosidase, which normally splits galactose cerebroside to ceramide and galactose. Krabbe disease is caused by mutations in the GALC gene, which is located on the 14 chromosome (14q31). This mutation results in a deficiency of the enzyme galactosylceramidase. Depending on the age at which the disease appeared, the following clinical forms of galactosylceramide lipidosis are distinguished: infantile or classical (the development of the disease begins from 3–6 months); late infantile (6–18 months); juvenile; adult. For diagnosis use biochemical tests (blood or skin cells), which are to determine the level of the enzyme galactoceramidase or to detect an increased level of psychosine, reducing the activity of galactosylceramide-β-galactosidase.
Specific treatment hasn’t been developed. Currently, the treatment is under development – scientists are exploring the possibility of delivery of the Galc-gene to the patient’s cells with the help of viruses (gene therapy), but this method has not been fully understood. In the early stages of the disease or in slow-progressing forms, a bone marrow transplant derived from cord blood cells (hematopoietic stem cells) is a very effective method of treatment, which helps to stabilize the patient and reduce symptoms. In many cases, transplantation in the early stages leads to complete cure of Crabbe disease.
This research is a case study. The child was diagnosed with Krabbe disease. Since this pathology is related to hereditary diseases, the only possible prevention is genetic analysis in the presence of Krabbe disease in close relatives. To prevent the birth of a second child with a similar disease and the earliest method of diagnosis is a molecular genetic examination (prenatal diagnosis), in which the activity of the enzyme galactose cerebrosidase and galactosylceramide-β-galactosidase in cultured cells of amniotic fluid and in cells is determined.
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