eMedicine Specialties > Pediatrics: Genetics and Metabolic Disease > Genetics
Niemann-Pick Disease: Follow-up
Updated: Jan 12, 2010
Follow-up
Further Inpatient Care
- Pulmonary infections occur frequently in patients with Niemann-Pick disease (NPD) types A and B.
- Patients with type A disease may develop respiratory decompensation, requiring inpatient care for stabilization during severe episodes.
Complications
- Splenic rupture: Patients with Niemann-Pick disease type B are at risk for splenic rupture and should avoid contact sports.
- Liver failure: A small number of patients with Niemann-Pick disease type B develop liver failure and may be candidates for liver transplantation.
- Pulmonary disease: Pulmonary disease is progressive in patients with type B disease and may result in oxygen dependence.
Prognosis
- Type A disease is fatal in early childhood.
- Prognosis in patients with type B disease varies widely and presumably is related to the underlying mutations in the gene coding for sphingomyelinase.
Patient Education
- Counsel families regarding genetic risk and the availability of prenatal testing.
- For excellent patient education resources, visit eMedicine's Cholesterol Center and Statins Center. Also, see eMedicine's patient education articles High Cholesterol, Cholesterol FAQs, and Atorvastatin (Lipitor).
Miscellaneous
Medicolegal Pitfalls
- The availability of prenatal diagnosis must be discussed with at-risk families.
More on Niemann-Pick Disease |
| Overview: Niemann-Pick Disease |
| Differential Diagnoses & Workup: Niemann-Pick Disease |
| Treatment & Medication: Niemann-Pick Disease |
Follow-up: Niemann-Pick Disease |
| Multimedia: Niemann-Pick Disease |
| References |
| Further Reading |
| « Previous Page | Next Page » |
References
Camoletto PG, Vara H, Morando L, et al. Synaptic vesicle docking: sphingosine regulates syntaxin1 interaction with Munc18. PLoS ONE. 2009;4(4):e5310. [Medline].
Jenkins RW, Canals D, Hannun YA. Roles and regulation of secretory and lysosomal acid sphingomyelinase. Cell Signal. Jun 2009;21(6):836-46. [Medline].
Ambrosio C, Serra S, Alexandre M, Malcata A. [Arthralgia, bone pain, positive antinuclear antibodies and thrombocytopenia...diagnosis: Niemann-Pick disease]. Acta Reumatol Port. Jan-Mar 2009;34(1):102-5. [Medline].
Cho YU, Chae JD, Lee WM, et al. [A Case of a Korean Adult Affected by Type B Niemann-Pick Disease: Secondary Sea-blue Histiocytosis and Molecular Characterization.]. Korean J Lab Med. Apr 2009;29(2):97-103. [Medline].
Rodriguez-Pascau L, Gort L, Schuchman EH, Vilageliu L, Grinberg D, Chabas A. Identification and characterization of SMPD1 mutations causing Niemann-Pick types A and B in Spanish patients. Hum Mutat. Mar 18 2009;[Medline].
[Guideline] Langlois S, Wilson RD. Carrier screening for genetic disorders in individuals of Ashkenazi Jewish descent. J Obstet Gynaecol Can. Apr 2006;28(4):324-43. [Medline]. [Full Text].
Simonaro CM, Desnick RJ, McGovern MM, Wasserstein MP, Schuchman EH. The demographics and distribution of type B Niemann-Pick disease: novel mutations lead to new genotype/phenotype correlations. Am J Hum Genet. Dec 2002;71(6):1413-9. [Medline].
Bayever E, August CS, Kamani N, et al. Allogeneic bone marrow transplantation for Niemann-Pick disease (type IA). Bone Marrow Transplant. 1992;10 Suppl 1:85-6. [Medline].
Fernandez-Burriel M, Pena L, Ramos JC, et al. The R608del mutation in the acid sphingomyelinase gene (SMPD1) is the most prevalent among patients from Gran Canaria Island with Niemann-Pick disease type B. Clin Genet. Mar 2003;63(3):235-6. [Medline].
Hellani A, Schuchman EH, Al-Odaib A, et al. Preimplantation genetic diagnosis for Niemann-Pick disease type B. Prenat Diagn. Dec 15 2004;24(12):943-8. [Medline].
McGovern MM, Aron A, Brodie SE, Desnick RJ, Wasserstein MP. Natural history of type A Niemann-pPck disease; Possible endpoints for therapeutic trials. Neurology. Jan 24/2006;66(2):228-232. [Medline].
McGovern MM, Wasserstein MP, Giugliani R, et al. A prospective, cross-sectional survey study of the natural history of Niemann-Pick disease type B. Pediatrics. Aug 2008;122(2):e341-9. [Medline].
Mendelson DS, Wasserstein MP, Desnick RJ, Glass R, Simpson W, Skloot G, et al. Type b niemann-pick disease: findings at chest radiography, thin-section CT, and pulmonary function testing. Radiology. Nov 22/2006;238(1):339-345. [Medline].
Schuchman EH. The pathogenesis and treatment of acid sphingomyelinase-deficient Niemann-Pick disease. J Inherit Metab Dis. Oct 2007;30(5):654-63. [Medline].
Shah AJ, Kapoor N, Crooks GM, et al. Successful hematopoietic stem cell transplantation for Niemann-Pick disease type B. Pediatrics. Oct 2005;116(4):1022-5. [Medline].
Takahashi T, Suchi M, Desnick RJ, et al. Identification and expression of five mutations in the human acid sphingomyelinase gene causing types A and B Niemann-Pick disease. Molecular evidence for genetic heterogeneity in the neuronopathic and non-neuronopathic forms. J Biol Chem. Jun 25 1992;267(18):12552-8. [Medline].
Further Reading
- Carrier screening guidelines for genetic disorders in individuals of Ashkenazi Jewish descent have been established.
- Related clinical trials include the following:
- Related eMedicine articles include the following:
Keywords
Niemann-Pick disease, NPD, acid sphingomyelinase deficiency, sphingomyelinase, enzyme deficiencies, neurodegenerative disease, failure to thrive, hepatosplenomegaly, sphingomyelin accumulation, lipid storage disorder, treatment, diagnosis
Follow-up: Niemann-Pick Disease