Background: Xanthomas are rare, non-neoplastic lesions which occur due to defect in the LDL receptors leading to their accumulation in tendons and synovium. The prevalence of heterozygous familial hypercholesterolaemi...Background: Xanthomas are rare, non-neoplastic lesions which occur due to defect in the LDL receptors leading to their accumulation in tendons and synovium. The prevalence of heterozygous familial hypercholesterolaemia (HFH) is approximately 1 in 500. Aim: To study a rare case of bilateral achilles tendon xanthoma and its functional outcome. Case Presentation: We presented a case of xanthoma over posterior aspect of both lower third legs just above the heel in an 18-year-old female, and diagnosis was confirmed by clinical examination ultrasound and MRI, for which subtotal resection was planned and further followed up. Postoperative treatment consisted of six weeks long leg cast immobilization. After 10 weeks the patient started walking without any difficulties. Conclusion: Subtotal resection of achilles tendon xanthoma has given a good functional outcome. There is no need for reconstruction of tendon in every case.展开更多
BACKGROUND Cerebrotendinous xanthomatosis is an autosomal recessive disorder of lipid metabolism caused by the mutation of the CYP27A1 gene encoding sterol 27-hydroxylase,an essential enzyme for the conversion of chol...BACKGROUND Cerebrotendinous xanthomatosis is an autosomal recessive disorder of lipid metabolism caused by the mutation of the CYP27A1 gene encoding sterol 27-hydroxylase,an essential enzyme for the conversion of cholesterol to chenodeoxycholic and cholic acids.Cerebrotendinous xanthomatosis is a rare neurological dis-ease with a wide range of clinical symptoms that are easily misdiagnosed.CASE SUMMARY Here we report the clinical,biochemical,and molecular characterization of a 33-year-old female patient with cerebrotendinous xanthomatosis.The patient developed ataxia and had the typical symptoms of juvenile cataracts,tendon xanthomata,and progressive nervous system dysfunction.Magnetic resonance imaging of the brain revealed bilateral dentate nucleus lesions and white matter abnormalities.This patient was misdiagnosed for 2 years resulting in severe neurological complications.After 2 years of chenodeoxycholic acid treatment,she still presented with ataxia and dysarthria.The pathogenic sites of CYP27A1 were identified as c.255+1G>T and c.1263+1G>T,which were both caused by shear denaturation.CONCLUSION Cerebrotendinous xanthomatosis requires a multidisciplinary diagnosis that must be made early to avoid progressive neurological degeneration.c.1263+1G>T is a known mutation,but c.255+1G>T is a rare mutation site.展开更多
文摘Background: Xanthomas are rare, non-neoplastic lesions which occur due to defect in the LDL receptors leading to their accumulation in tendons and synovium. The prevalence of heterozygous familial hypercholesterolaemia (HFH) is approximately 1 in 500. Aim: To study a rare case of bilateral achilles tendon xanthoma and its functional outcome. Case Presentation: We presented a case of xanthoma over posterior aspect of both lower third legs just above the heel in an 18-year-old female, and diagnosis was confirmed by clinical examination ultrasound and MRI, for which subtotal resection was planned and further followed up. Postoperative treatment consisted of six weeks long leg cast immobilization. After 10 weeks the patient started walking without any difficulties. Conclusion: Subtotal resection of achilles tendon xanthoma has given a good functional outcome. There is no need for reconstruction of tendon in every case.
基金Supported by the Key project of Education Department of Anhui Province,No. KJ2019A0096Huainan science and technology planning project,No. 2016A26(3)Project Research Fund of Anhui University of Science and Technology,No. fsyyyb2020-03。
文摘BACKGROUND Cerebrotendinous xanthomatosis is an autosomal recessive disorder of lipid metabolism caused by the mutation of the CYP27A1 gene encoding sterol 27-hydroxylase,an essential enzyme for the conversion of cholesterol to chenodeoxycholic and cholic acids.Cerebrotendinous xanthomatosis is a rare neurological dis-ease with a wide range of clinical symptoms that are easily misdiagnosed.CASE SUMMARY Here we report the clinical,biochemical,and molecular characterization of a 33-year-old female patient with cerebrotendinous xanthomatosis.The patient developed ataxia and had the typical symptoms of juvenile cataracts,tendon xanthomata,and progressive nervous system dysfunction.Magnetic resonance imaging of the brain revealed bilateral dentate nucleus lesions and white matter abnormalities.This patient was misdiagnosed for 2 years resulting in severe neurological complications.After 2 years of chenodeoxycholic acid treatment,she still presented with ataxia and dysarthria.The pathogenic sites of CYP27A1 were identified as c.255+1G>T and c.1263+1G>T,which were both caused by shear denaturation.CONCLUSION Cerebrotendinous xanthomatosis requires a multidisciplinary diagnosis that must be made early to avoid progressive neurological degeneration.c.1263+1G>T is a known mutation,but c.255+1G>T is a rare mutation site.
