Skip to main content
Top
Published in: Journal of Medical Case Reports 1/2008

Open Access 01-12-2008 | Case report

Long-term tracking of neurological complications of encephalopathy and myopathy in a patient with nephropathic cystinosis: a case report and review of the literature

Authors: Marcus Müller, Andrea Baumeier, EB Ringelstein, IW Husstedt

Published in: Journal of Medical Case Reports | Issue 1/2008

Login to get access

Abstract

Introduction

Cystinosis is a hereditary storage disease resulting in intracellular accumulation of cystine and crystal formation that causes deterioration of the function of many organs. The major clinical symptom is renal failure, which progresses and necessitates renal transplantation at the beginning of the second decade of life. Encephalopathy and distal myopathy are important neurological long-term complications with a major impact on the quality of life of these patients. Application of cysteamine is the only specific therapy available; it decreases the intracellular cystine level and delays or may even prevent the failure of organ functions.

Case presentation

We present the case of a 38-year-old woman with cystinosis and the long-term tracking of her neurological symptoms under cysteamine treatment.

Conclusion

This case report describes a long observation period of neurological complications in a person with cystinosis who had strikingly different courses of encephalopathy and myopathy while on cysteamine treatment. Although encephalopathy was initially suspected, this did not develop, but distal myopathy progressed continuously despite specific therapy.
Appendix
Available only for authorised users
Literature
2.
go back to reference Jonas AJ, Conley SB, Marshall R, Johnson RA, Marks M, Rosenberg H: Nephropathic cystinosis with central nervous system involvement. Am J Med. 1987, 83: 966-970. 10.1016/0002-9343(87)90661-9.CrossRefPubMed Jonas AJ, Conley SB, Marshall R, Johnson RA, Marks M, Rosenberg H: Nephropathic cystinosis with central nervous system involvement. Am J Med. 1987, 83: 966-970. 10.1016/0002-9343(87)90661-9.CrossRefPubMed
3.
go back to reference Fink JK, Brouwers P, Barton N, Malekzadeh MH, Sato S, Hill S, Cohen WE, Fivush B, Gahl WA: Neurologic complications in long-standing nephropathic cystinosis. Arch Neurol. 1989, 46: 543-548.CrossRefPubMed Fink JK, Brouwers P, Barton N, Malekzadeh MH, Sato S, Hill S, Cohen WE, Fivush B, Gahl WA: Neurologic complications in long-standing nephropathic cystinosis. Arch Neurol. 1989, 46: 543-548.CrossRefPubMed
4.
go back to reference Broyer M, Tete MJ, Guest G, Bertheleme JP, Labrousse F, Poisson M: Clinical polymorphism of cystinosis encephalopathy. Results of treatment with cysteamine. J Inherit Metab Dis. 1996, 19: 65-75. 10.1007/BF01799350.CrossRefPubMed Broyer M, Tete MJ, Guest G, Bertheleme JP, Labrousse F, Poisson M: Clinical polymorphism of cystinosis encephalopathy. Results of treatment with cysteamine. J Inherit Metab Dis. 1996, 19: 65-75. 10.1007/BF01799350.CrossRefPubMed
5.
go back to reference Gahl WA, Dalakas MC, Charnas L, Chen KT, Pezeshkpour GH, Kuwabara T, Davis SL, Chesney RW, Fink J, Hutchison HT: Myopathy and cystine storage in muscles in a patient with nephropathic cystinosis. N Engl J Med. 1988, 319: 1461-1464.CrossRefPubMed Gahl WA, Dalakas MC, Charnas L, Chen KT, Pezeshkpour GH, Kuwabara T, Davis SL, Chesney RW, Fink J, Hutchison HT: Myopathy and cystine storage in muscles in a patient with nephropathic cystinosis. N Engl J Med. 1988, 319: 1461-1464.CrossRefPubMed
6.
go back to reference Harper GS, Bernardini I, Hurko O, Zuurveld J, Gahl WA: Cystine storage in cultured myotubes from patients with nephropathic cystinosis. Biochem J. 1987, 243: 841-845.CrossRefPubMedPubMedCentral Harper GS, Bernardini I, Hurko O, Zuurveld J, Gahl WA: Cystine storage in cultured myotubes from patients with nephropathic cystinosis. Biochem J. 1987, 243: 841-845.CrossRefPubMedPubMedCentral
7.
go back to reference Charnas LR, Luciano CA, Dalakas M, Gilliatt RW, Bernardini I, Ishak K, Cwik VA, Fraker D, Brushart TA, Gahl WA: Distal vacuolar myopathy in nephropathic cystinosis. Ann Neurol. 1994, 35: 181-188. 10.1002/ana.410350209.CrossRefPubMed Charnas LR, Luciano CA, Dalakas M, Gilliatt RW, Bernardini I, Ishak K, Cwik VA, Fraker D, Brushart TA, Gahl WA: Distal vacuolar myopathy in nephropathic cystinosis. Ann Neurol. 1994, 35: 181-188. 10.1002/ana.410350209.CrossRefPubMed
8.
go back to reference Sonies BC, Ekman EF, Andersson HC, Adamson MD, Kaler SG, Markello TC, Gahl WA: Swallowing dysfunction in nephropathic cystinosis. N Engl J Med. 1990, 323: 565-570.CrossRefPubMed Sonies BC, Ekman EF, Andersson HC, Adamson MD, Kaler SG, Markello TC, Gahl WA: Swallowing dysfunction in nephropathic cystinosis. N Engl J Med. 1990, 323: 565-570.CrossRefPubMed
9.
go back to reference Vester U, Schubert M, Offner G, Brodehl J: Distal myopathy in nephropathic cystinosis. Pediatr Nephrol. 2000, 14: 36-38. 10.1007/s004670050009.CrossRefPubMed Vester U, Schubert M, Offner G, Brodehl J: Distal myopathy in nephropathic cystinosis. Pediatr Nephrol. 2000, 14: 36-38. 10.1007/s004670050009.CrossRefPubMed
10.
go back to reference Gahl WA: Early oral cysteamine therapy for nephropathic cystinosis. Eur J Pediatr. 2003, 162 (Suppl 1): S38-41. 10.1007/s00431-003-1349-x.CrossRefPubMed Gahl WA: Early oral cysteamine therapy for nephropathic cystinosis. Eur J Pediatr. 2003, 162 (Suppl 1): S38-41. 10.1007/s00431-003-1349-x.CrossRefPubMed
11.
go back to reference Sonies BC, Almajid P, Kleta R, Bernardini I, Gahl WA: Swallowing dysfunction in 101 patients with nephropathic cystinosis: benefit of long-term cysteamine therapy. Medicine. 2005, 84: 137-146. 10.1097/01.md.0000164204.00159.d4.CrossRefPubMed Sonies BC, Almajid P, Kleta R, Bernardini I, Gahl WA: Swallowing dysfunction in 101 patients with nephropathic cystinosis: benefit of long-term cysteamine therapy. Medicine. 2005, 84: 137-146. 10.1097/01.md.0000164204.00159.d4.CrossRefPubMed
12.
go back to reference Levine S, Paparo G: Brain lesions in a case of cystinosis. Acta Neuropathol. 1982, 57: 217-220. 10.1007/BF00685392.CrossRefPubMed Levine S, Paparo G: Brain lesions in a case of cystinosis. Acta Neuropathol. 1982, 57: 217-220. 10.1007/BF00685392.CrossRefPubMed
13.
go back to reference Geelen JM, Monnens LA, Levtchenko EN: Follow-up and treatment of adults with cystinosis in the Netherlands. Nephrol Dial Transplant. 2002, 17: 1766-1770. 10.1093/ndt/17.10.1766.CrossRefPubMed Geelen JM, Monnens LA, Levtchenko EN: Follow-up and treatment of adults with cystinosis in the Netherlands. Nephrol Dial Transplant. 2002, 17: 1766-1770. 10.1093/ndt/17.10.1766.CrossRefPubMed
14.
go back to reference Thoene JG, Oshima RG, Crawhall JC, Olson DL, Schneider JA: Cystinosis. Intracellular cystine depletion by aminothiols in vitro and in vivo. J Clin Invest. 1976, 58: 180-189. 10.1172/JCI108448.CrossRefPubMedPubMedCentral Thoene JG, Oshima RG, Crawhall JC, Olson DL, Schneider JA: Cystinosis. Intracellular cystine depletion by aminothiols in vitro and in vivo. J Clin Invest. 1976, 58: 180-189. 10.1172/JCI108448.CrossRefPubMedPubMedCentral
15.
Metadata
Title
Long-term tracking of neurological complications of encephalopathy and myopathy in a patient with nephropathic cystinosis: a case report and review of the literature
Authors
Marcus Müller
Andrea Baumeier
EB Ringelstein
IW Husstedt
Publication date
01-12-2008
Publisher
BioMed Central
Published in
Journal of Medical Case Reports / Issue 1/2008
Electronic ISSN: 1752-1947
DOI
https://doi.org/10.1186/1752-1947-2-235

Other articles of this Issue 1/2008

Journal of Medical Case Reports 1/2008 Go to the issue