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

Open Access 01-12-2008 | Case report

Midlife diagnosis of Refsum Disease in siblings with Retinitis Pigmentosa – the footprint is the clue: a case report

Authors: Hari Jayaram, Susan M Downes

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

Login to get access

Abstract

Introduction

Refsum disease is a potentially lethal and disabling condition associated with retinitis pigmentosa in which early treatment can prevent some of the systemic manifestations.

Case presentation

We present the cases of two brothers with a diagnosis of retinitis pigmentosa from childhood in whom Refsum disease was subsequently diagnosed midlife, after routine enquiry into hand and feet abnormalities. Subsequent treatment through dietary modification stabilised visual impairment and has prevented development of neurological complications to date.

Conclusion

It is therefore important to consider the diagnosis of Refsum disease in any patient with autosomal recessive or simplex retinitis pigmentosa, and to enquire about the presence of "unusual" feet or hands in such patients.
Appendix
Available only for authorised users
Literature
1.
go back to reference Haim M, Holm NV, Rosenberg T: Prevalence of retinitis pigmentosa and allied disorders in Denmark. I Main results. Acta Ophthalmol (Copenh). 1992, 70 (2): 178-186.CrossRef Haim M, Holm NV, Rosenberg T: Prevalence of retinitis pigmentosa and allied disorders in Denmark. I Main results. Acta Ophthalmol (Copenh). 1992, 70 (2): 178-186.CrossRef
2.
go back to reference Eldjarn L, Stokke O, Try K: Alpha-oxidation of branched chain fatty acids in man and its failure in patients with Refsum's disease showing phytanic acid accumulation. Scand J Clin Lab Invest. 1966, 18 (6): 694-695. 10.3109/00365516609049057.CrossRefPubMed Eldjarn L, Stokke O, Try K: Alpha-oxidation of branched chain fatty acids in man and its failure in patients with Refsum's disease showing phytanic acid accumulation. Scand J Clin Lab Invest. 1966, 18 (6): 694-695. 10.3109/00365516609049057.CrossRefPubMed
3.
go back to reference Mihalik SJ, Morrell JC, Kim D, Sacksteder KA, Watkins PA, Gould SJ: Identification of PAHX, a Refsum disease gene. Nat Genet. 1997, 17 (2): 185-189. 10.1038/ng1097-185.CrossRefPubMed Mihalik SJ, Morrell JC, Kim D, Sacksteder KA, Watkins PA, Gould SJ: Identification of PAHX, a Refsum disease gene. Nat Genet. 1997, 17 (2): 185-189. 10.1038/ng1097-185.CrossRefPubMed
4.
go back to reference van den Brink DM, Brites P, Haasjes J, Wierzbicki AS, Mitchell J, Lambert-Hamill M, de Belleroche J, Jansen GA, Waterham HR, Wanders RJ: Identification of PEX7 as the second gene involved in Refsum disease. Am J Hum Genet. 2003, 72 (2): 471-477. 10.1086/346093.CrossRefPubMedPubMedCentral van den Brink DM, Brites P, Haasjes J, Wierzbicki AS, Mitchell J, Lambert-Hamill M, de Belleroche J, Jansen GA, Waterham HR, Wanders RJ: Identification of PEX7 as the second gene involved in Refsum disease. Am J Hum Genet. 2003, 72 (2): 471-477. 10.1086/346093.CrossRefPubMedPubMedCentral
5.
go back to reference Kahlert S, Schonfeld P, Reiser G: The Refsum disease marker phytanic acid, a branched chain fatty acid, affects Ca2+ homeostasis and mitochondria, and reduces cell viability in rat hippocampal astrocytes. Neurobiol Dis. 2005, 18 (1): 110-118. 10.1016/j.nbd.2004.08.010.CrossRefPubMed Kahlert S, Schonfeld P, Reiser G: The Refsum disease marker phytanic acid, a branched chain fatty acid, affects Ca2+ homeostasis and mitochondria, and reduces cell viability in rat hippocampal astrocytes. Neurobiol Dis. 2005, 18 (1): 110-118. 10.1016/j.nbd.2004.08.010.CrossRefPubMed
6.
go back to reference Skjeldal OH, Stokke O, Refsum S, Norseth J, Petit H: Clinical and biochemical heterogeneity in conditions with phytanic acid accumulation. J Neurol Sci. 1987, 77 (1): 87-96. 10.1016/0022-510X(87)90209-7.CrossRefPubMed Skjeldal OH, Stokke O, Refsum S, Norseth J, Petit H: Clinical and biochemical heterogeneity in conditions with phytanic acid accumulation. J Neurol Sci. 1987, 77 (1): 87-96. 10.1016/0022-510X(87)90209-7.CrossRefPubMed
7.
go back to reference Gibberd FB, Feher MD, Sidey MC, Wierzbicki AS: Smell testing: an additional tool for identification of adult Refsum's disease. J Neurol Neurosurg Psychiatry. 2004, 75 (9): 1334-1336. 10.1136/jnnp.2003.026690.CrossRefPubMedPubMedCentral Gibberd FB, Feher MD, Sidey MC, Wierzbicki AS: Smell testing: an additional tool for identification of adult Refsum's disease. J Neurol Neurosurg Psychiatry. 2004, 75 (9): 1334-1336. 10.1136/jnnp.2003.026690.CrossRefPubMedPubMedCentral
8.
go back to reference Plant GR, Hansell DM, Gibberd FB, Sidey MC: Skeletal abnormalities in Refsum's disease (heredopathia atactica polyneuritiformis). Br J Radiol. 1990, 63 (751): 537-541.CrossRefPubMed Plant GR, Hansell DM, Gibberd FB, Sidey MC: Skeletal abnormalities in Refsum's disease (heredopathia atactica polyneuritiformis). Br J Radiol. 1990, 63 (751): 537-541.CrossRefPubMed
9.
go back to reference Ramsay BC, Meeran K, Woodrow D, Judge M, Cream JJ, Clifford Rose F, Gibberd FB: Cutaneous aspects of Refsum's disease. J R Soc Med. 1991, 84 (9): 559-560.PubMedPubMedCentral Ramsay BC, Meeran K, Woodrow D, Judge M, Cream JJ, Clifford Rose F, Gibberd FB: Cutaneous aspects of Refsum's disease. J R Soc Med. 1991, 84 (9): 559-560.PubMedPubMedCentral
10.
go back to reference Leys D, Petit H, Bonte-Adnet C, Millaire A, Fourrier F, Dubois F, Rosseaux M, Ducloux G: Refsum's disease revealed by cardiac disorders. Lancet. 1989, 1 (8638): 621-10.1016/S0140-6736(89)91654-1.CrossRefPubMed Leys D, Petit H, Bonte-Adnet C, Millaire A, Fourrier F, Dubois F, Rosseaux M, Ducloux G: Refsum's disease revealed by cardiac disorders. Lancet. 1989, 1 (8638): 621-10.1016/S0140-6736(89)91654-1.CrossRefPubMed
11.
go back to reference Brown PJ, Mei G, Gibberd FB: Diet and Refsum's Disease. J Hum Nutr Dietet. 1993, 6: 295-305.CrossRef Brown PJ, Mei G, Gibberd FB: Diet and Refsum's Disease. J Hum Nutr Dietet. 1993, 6: 295-305.CrossRef
12.
go back to reference Harari D, Gibberd FB, Dick JP, Sidey MC: Plasma exchange in the treatment of Refsum's disease (heredopathia atactica polyneuritiformis). J Neurol Neurosurg Psychiatry. 1991, 54 (7): 614-617.CrossRefPubMedPubMedCentral Harari D, Gibberd FB, Dick JP, Sidey MC: Plasma exchange in the treatment of Refsum's disease (heredopathia atactica polyneuritiformis). J Neurol Neurosurg Psychiatry. 1991, 54 (7): 614-617.CrossRefPubMedPubMedCentral
13.
go back to reference Gutsche HU, Siegmund JB, Hoppmann I: Lipapheresis: an immunoglobulin-sparing treatment for Refsum's disease. Acta Neurol Scand. 1996, 94 (3): 190-193.CrossRefPubMed Gutsche HU, Siegmund JB, Hoppmann I: Lipapheresis: an immunoglobulin-sparing treatment for Refsum's disease. Acta Neurol Scand. 1996, 94 (3): 190-193.CrossRefPubMed
14.
go back to reference Gibberd FB, Billimoria JD, Goldman JM, Clemens ME, Evans R, Whitelaw MN, Retsas S, Sherratt RM: Heredopathia atactica polyneuritiformis: Refsum's disease. Acta Neurol Scand. 1985, 72 (1): 1-17.CrossRefPubMed Gibberd FB, Billimoria JD, Goldman JM, Clemens ME, Evans R, Whitelaw MN, Retsas S, Sherratt RM: Heredopathia atactica polyneuritiformis: Refsum's disease. Acta Neurol Scand. 1985, 72 (1): 1-17.CrossRefPubMed
15.
go back to reference Goldman JM, Clemens ME, Gibberd FB, Billimoria JD: Screening of patients with retinitis pigmentosa for heredopathia atactica polyneuritiformis (Refsum's disease). Br Med J (Clin Res Ed). 1985, 290 (6475): 1109-1110.CrossRef Goldman JM, Clemens ME, Gibberd FB, Billimoria JD: Screening of patients with retinitis pigmentosa for heredopathia atactica polyneuritiformis (Refsum's disease). Br Med J (Clin Res Ed). 1985, 290 (6475): 1109-1110.CrossRef
Metadata
Title
Midlife diagnosis of Refsum Disease in siblings with Retinitis Pigmentosa – the footprint is the clue: a case report
Authors
Hari Jayaram
Susan M Downes
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/10.1186/1752-1947-2-80

Other articles of this Issue 1/2008

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