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Cerebrotendinous Xanthomatosis Without Skin Changes: Diagnostic Delay and Confirmation by Genetic Analysis
Shilpa D Kulkarni1, Meenal Garg, Rafat Sayed
1Department of Pediatric Neurosciences, Bai Jerbai Wadia Hospital for Children, Mumbai, India. Correspondence to: Dr Shilpa Kulkarni, EEG room, 2nd floor, Department of Pediatric Neurosciences, Bai Jerbai Wadia Hospital for Children, Parel, Mumbai 400 012, Maharashtra, India. skulkarni.shilpa@gmail.com.
Background:
Cerebrotendinous xanthomatosis is an inherited lipid storage disease manifesting with infantile onset diarrhea, cataracts, xanthomas and adult-onset neurological dysfunction with cerebellar signs and neuropathy.
Case Characteristics:
10-year-old boy presented with progressive ataxia, neuropathy and cataracts. Over 6 years, he developed dementia, kyphoscoliosis with worsening ataxia, and neuropathy.
Outcome:
Sterol analysis and CYP27A1 sequencing confirmed the diagnosis.
Message:
The condition should be considered in childhood onset cerebellar ataxia with cataracts, even in the absence of skin signs.
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