Skip to main content
Top
Published in: European Journal of Pediatrics 3/2009

01-03-2009 | Original Paper

Early neurological impairment and severe anemia in a newborn with Pearson syndrome

Authors: Anne-Sophie Morel, Nadia Joris, Reto Meuli, Sébastien Jacquemont, Diana Ballhausen, Luisa Bonafé, Sarah Fattet, Jean-François Tolsa

Published in: European Journal of Pediatrics | Issue 3/2009

Login to get access

Abstract

Background

Pearson marrow-pancreas syndrome (PS) is usually a fatal mitochondrial disease, mostly diagnosed during infancy or postmortem. PS is caused by the deletions or duplications of mitochondrial DNA (mtDNA). The tissue distribution and relative proportions of expressed abnormal mtDNA determine the phenotype and the clinical course.

Materials and methods

We describe the case of a term baby boy who was diagnosed with PS early in the neonatal period due to severe aregenerative anemia and persistent lactic acidosis.

Results

His neurological examination was abnormal since birth. Brain magnetic resonance imaging (MRI) at term was abnormal, indicating that mitochondrial encephalopathy in PS can be already manifested in the neonatal period. To our knowledge, neonatal encephalopathy in PS has not been previously described.

Conclusion

PS is a rare condition diagnosed in the newborn. It should be suspected in the presence of severe anemia and persistent lactic acidosis, and may manifest with early encephalopathy.
Literature
1.
go back to reference de Lonlay P, Fenneteau O, Touati G, Mignot C, Billette de Villemeur T, Rabier D, Blanche S, Ogier de Baulny H, Saudubray JM (2002) Hematologic manifestations of inborn errors of metabolism. Arch Pediatr 9:822–835PubMedCrossRef de Lonlay P, Fenneteau O, Touati G, Mignot C, Billette de Villemeur T, Rabier D, Blanche S, Ogier de Baulny H, Saudubray JM (2002) Hematologic manifestations of inborn errors of metabolism. Arch Pediatr 9:822–835PubMedCrossRef
2.
go back to reference Elsås T, Rinck PA, Isaksen C, Nilsen G, Schjetne OB (1988) Cerebral nuclear magnetic resonance (MRI) in Kearns syndrome. Acta Ophthalmol (Copenh) 66:469–473CrossRef Elsås T, Rinck PA, Isaksen C, Nilsen G, Schjetne OB (1988) Cerebral nuclear magnetic resonance (MRI) in Kearns syndrome. Acta Ophthalmol (Copenh) 66:469–473CrossRef
3.
go back to reference Giese A, Kirschner-Schwabe R, Blumchen K, Wronski L, Shalapour S, Prada J, Hernáiz Driever P, Brauer M, Schuelke M, Henze G, Seeger K (2007) Prenatal manifestation of pancytopenia in Pearson marrow-pancreas syndrome caused by a mitochondrial DNA deletion. Am J Med Genet A 143:285–288PubMed Giese A, Kirschner-Schwabe R, Blumchen K, Wronski L, Shalapour S, Prada J, Hernáiz Driever P, Brauer M, Schuelke M, Henze G, Seeger K (2007) Prenatal manifestation of pancytopenia in Pearson marrow-pancreas syndrome caused by a mitochondrial DNA deletion. Am J Med Genet A 143:285–288PubMed
4.
go back to reference Jacobs LJAM, Jongbloed RJE, Wijburg FA, de Klerk JBC, Geraedts JPM, Nijland JG, Scholte HR, de Coo IFM, Smeets HJM (2004) Pearson syndrome and the role of deletion dimers and duplications in the mtDNA. J Inherit Metab Dis 27:47–55PubMedCrossRef Jacobs LJAM, Jongbloed RJE, Wijburg FA, de Klerk JBC, Geraedts JPM, Nijland JG, Scholte HR, de Coo IFM, Smeets HJM (2004) Pearson syndrome and the role of deletion dimers and duplications in the mtDNA. J Inherit Metab Dis 27:47–55PubMedCrossRef
5.
go back to reference Knerr I, Metzler M, Niemeyer CM, Holter W, Gerecke A, Baumann I, Trollmann R, Repp R (2003) Hematologic features and clinical course of an infant with Pearson syndrome caused by a novel deletion of mitochondrial DNA. J Pediatr Hematol Oncol 25:948–951PubMedCrossRef Knerr I, Metzler M, Niemeyer CM, Holter W, Gerecke A, Baumann I, Trollmann R, Repp R (2003) Hematologic features and clinical course of an infant with Pearson syndrome caused by a novel deletion of mitochondrial DNA. J Pediatr Hematol Oncol 25:948–951PubMedCrossRef
6.
go back to reference Lee HF, Lee HJ, Chi CS, Tsai CR, Chang TK, Wang CJ (2007) The neurological evolution of Pearson syndrome: case report and literature review. Eur J Paediatr Neurol 11(4):208–214PubMedCrossRef Lee HF, Lee HJ, Chi CS, Tsai CR, Chang TK, Wang CJ (2007) The neurological evolution of Pearson syndrome: case report and literature review. Eur J Paediatr Neurol 11(4):208–214PubMedCrossRef
7.
go back to reference Pearson HA, Lobel JS, Kocoshis SA, Naiman JL, Windmiller J, Lammi AT, Hoffman R, Marsh JC (1979) A new syndrome of refractory sideroblastic anemia with vacuolization of marrow precursors and exocrine pancreatic dysfunction. J Pediatr 95:976–984PubMedCrossRef Pearson HA, Lobel JS, Kocoshis SA, Naiman JL, Windmiller J, Lammi AT, Hoffman R, Marsh JC (1979) A new syndrome of refractory sideroblastic anemia with vacuolization of marrow precursors and exocrine pancreatic dysfunction. J Pediatr 95:976–984PubMedCrossRef
8.
go back to reference Rötig A, Cormier V, Blanche S, Bonnefont JP, Ledeist F, Romero N, Schmitz J, Rustin P, Fischer A, Saudubray JM, Munnich A (1990) Pearson’s marrow-pancreas syndrome. A multisystem mitochondrial disorder in infancy. J Clin Invest 86:1601–1608PubMedCrossRef Rötig A, Cormier V, Blanche S, Bonnefont JP, Ledeist F, Romero N, Schmitz J, Rustin P, Fischer A, Saudubray JM, Munnich A (1990) Pearson’s marrow-pancreas syndrome. A multisystem mitochondrial disorder in infancy. J Clin Invest 86:1601–1608PubMedCrossRef
9.
go back to reference Rötig A, Bourgeron T, Rustin P, Munnich A (1995) Phenotypic expression of mitochondrial genotypes in cultured skin fibroblasts and in Epstein-Barr virus-transformed lymphocytes in Pearson syndrome. Muscle Nerve 3:S159–S164PubMedCrossRef Rötig A, Bourgeron T, Rustin P, Munnich A (1995) Phenotypic expression of mitochondrial genotypes in cultured skin fibroblasts and in Epstein-Barr virus-transformed lymphocytes in Pearson syndrome. Muscle Nerve 3:S159–S164PubMedCrossRef
10.
go back to reference Superti-Furga A, Schoenle E, Tuchschmid P, Caduff R, Sabato V, DeMattia D, Gitzelmann R, Steinmann B (1993) Pearson bone marrow-pancreas syndrome with insulin-dependent diabetes, progressive renal tubulopathy, organic aciduria and elevated fetal haemoglobin caused by deletion and duplication of mitochondrial DNA. Eur J Pediatr 152:44–50PubMedCrossRef Superti-Furga A, Schoenle E, Tuchschmid P, Caduff R, Sabato V, DeMattia D, Gitzelmann R, Steinmann B (1993) Pearson bone marrow-pancreas syndrome with insulin-dependent diabetes, progressive renal tubulopathy, organic aciduria and elevated fetal haemoglobin caused by deletion and duplication of mitochondrial DNA. Eur J Pediatr 152:44–50PubMedCrossRef
11.
go back to reference Valanne L, Ketonen L, Majander A, Suomalainen A, Pihko H (1998) Neuroradiologic findings in children with mitochondrial disorders. Am J Neuroradiol 19:369–377PubMed Valanne L, Ketonen L, Majander A, Suomalainen A, Pihko H (1998) Neuroradiologic findings in children with mitochondrial disorders. Am J Neuroradiol 19:369–377PubMed
Metadata
Title
Early neurological impairment and severe anemia in a newborn with Pearson syndrome
Authors
Anne-Sophie Morel
Nadia Joris
Reto Meuli
Sébastien Jacquemont
Diana Ballhausen
Luisa Bonafé
Sarah Fattet
Jean-François Tolsa
Publication date
01-03-2009
Publisher
Springer-Verlag
Published in
European Journal of Pediatrics / Issue 3/2009
Print ISSN: 0340-6199
Electronic ISSN: 1432-1076
DOI
https://doi.org/10.1007/s00431-008-0756-4

Other articles of this Issue 3/2009

European Journal of Pediatrics 3/2009 Go to the issue