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$Unique_ID{BRK04015}
$Pretitle{}
$Title{Multiple Sulfatase Deficiency}
$Subject{Multiple Sulfatase Deficiency DOC 13 (Multiple Sulfatase Deficiency)
Disorder of Cornification 13 (Multiple Sulfatase Deficiency) Mucosulfatidosis
Multiple Sulfatase Deficiency Syndrome Sulfatidosis, Juvenile, Austin Type
Maroteaux-Lamy Syndrome (Arylsulfatase-B Deficiency; Mucopolysaccharidosis VI;
Polydystrophic Dwarfism) Metachromatic Leukodystrophy (Arylsulfatase-A
Deficiency; Metachromatic Form of Diffuse Cerebral Sclerosis; Cerebroside
Sulfatase Deficiency; Metachromatic Leukoencephalopathy; Sulfatide Lipidosis;
Sulfatidosis) }
$Volume{}
$Log{}
Copyright (C) 1988, 1989, 1990 National Organization for Rare Disorders,
Inc.
552:
Multiple Sulfatase Deficiency
** IMPORTANT **
It is possible the main title of the article (Multiple Sulfatase
Deficiency) is not the name you expected. Please check the SYNONYMS listing
on the next page to find alternate names and disorder subdivisions covered by
this article.
Synonyms
DOC 13 (Multiple Sulfatase Deficiency)
Disorder of Cornification 13 (Multiple Sulfatase Deficiency)
Mucosulfatidosis
Multiple Sulfatase Deficiency Syndrome
Sulfatidosis, Juvenile, Austin Type
Information on the following disorders can be found in the Related
Disorders section of this report:
Maroteaux-Lamy Syndrome (Arylsulfatase-B Deficiency; Mucopolysaccharidosis
VI; Polydystrophic Dwarfism)
Metachromatic Leukodystrophy (Arylsulfatase-A Deficiency; Metachromatic
Form of Diffuse Cerebral Sclerosis; Cerebroside Sulfatase Deficiency;
Metachromatic Leukoencephalopathy; Sulfatide Lipidosis; Sulfatidosis)
General Discussion
** REMINDER **
The information contained in the Rare Disease Database is provided for
educational purposes only. It should not be used for diagnostic or treatment
purposes. If you wish to obtain more information about this disorder, please
contact your personal physician and/or the agencies listed in the "Resources"
section of this report.
Multiple Sulfatase Deficiency is a very rare hereditary metabolic
disorder characterized by impairment of all known sulfatase enzymes. Major
symptoms include coarse facial features, deafness, and an enlarged liver and
spleen (hepatosplenomegaly). Abnormalities of the skeleton may occur such as
curvature of the spine (lumbar kyphosis) and in the breast bone. The skin is
usually dry and scaly (ichthyosis). Before symptoms are noticeable, children
with this disorder usually develop more slowly than normal. They may not
learn to walk or speak as quickly as other children.
Symptoms
Symptoms of Multiple Sulfatase Deficiency usually start during the first or
second year of life. Children with this disorder usually have coarse facial
features and they are often deaf. The liver and spleen are usually enlarged.
Curvature of the lower portion of the spine, and an abnormal breast bone
usually also occur. In addition, the skin is dry, scaly and itchy
(ichthyosis). Development is usually delayed in children with this disorder.
Children with Multiple Sulfatase Deficiency may not walk normally and their
speech is usually impaired.
Laboratory tests show abnormalities in cells of the bone marrow and in
white blood cells. The bone behind the nasal bones (sella turcica) is J-
shaped and the little bones of fingers and toes (phalanges) are broader than
normal. Levels of dermatan sulfate and heparan sulfate in the urine are
higher than normal. A deficiency of several enzymes (arylsulfatase A, B, and
C, two steroid sulfatases and four other sulfatases) occurs. In normal
concentration, these enzymes are needed to break down certain carbohydrates
known as "mucopolysaccharides".
Causes
Multiple Sulfatase Deficiency is a hereditary disorder transmitted through
autosomal recessive genes. (Human traits including the classic genetic
diseases, are the product of the interaction of two genes for that condition,
one received from the father and one from the mother. In recessive
disorders, the condition does not appear unless a person inherits the same
defective gene from each parent. If one receives one normal gene and one
gene for the disease, the person will be a carrier for the disease, but
usually will show no symptoms. The risk of transmitting the disease to the
children of a couple, both of whom are carriers for a recessive disorder, is
twenty-five percent. Fifty percent of their children will be carriers, but
healthy as described above. Twenty-five percent of their children will
receive both normal genes, one from each parent and will be genetically
normal.) Symptoms are caused by a deficiency of the enzyme arylsulfatase A,
B, and C, 2 steroid sulfatases, and 4 other sulfatases that are needed for
the breakdown of certain carbohydrates known as "mucopolysaccharides".
Affected Population
Multiple Sulfatase Deficiency is present at birth, although symptoms of this
disorder don't become noticeable until the first or second year of life. It
is a very rare disorder affecting males and females in equal numbers.
Related Disorders
Symptoms of the following disorders can resemble those of Multiple Sulfatase
Deficiency. Comparisons may be useful for a differential diagnosis:
Maroteaux-Lamy Syndrome (Arylsulfatase-B Deficiency;
Mucopolysaccharidosis VI; Polydystrophic Dwarfism) is a form of
mucopolysaccharidosis. These are a group of genetic disorders caused by the
deficiency of one of ten specific lysosomal enzymes, resulting in an
inability to metabolize certain complex carbohydrates (mucopolysaccharides)
into simpler molecules. The accumulation of these large, undegraded
mucopolysaccharides in the cells of the body causes a number of symptoms.
This syndrome can occur as a severe type, an intermediate type, and a mild
type. Growth retardation generally occurs from 2-3 years of age, with
coarsening of facial features and abnormalities in the bones of hands and
spine. Joint stiffness also occurs. The intellect is usually normal.
(Choose "Maroteaux-Lamy" as your search term in the Rare Disease Database.)
Metachromatic Leukodystrophy (Arylsulfatase-A Deficiency; Metachromatic
Form of Diffuse Cerebral Sclerosis; Cerebroside Sulfatase Deficiency;
Metachromatic Leukoencephalopathy; Sulfatide Lipidosis; Sulfatidosis) is a
hereditary disorder transmitted through autosomal recessive genes. It
affects the brain and spinal cord. The disorder is characterized by
progressive paralysis and dementia. It can appear in a late infantile,
juvenile, or an adult form. (Choose "Metachromatic Leukodystrophy" as your
search term in the Rare Disease Database.)
Ichthyosis can be a symptom of Multiple Sulfatase Deficiency.
"Ichthyoses" or "Disorders of Cornification" are general terms describing a
group of scaly skin disorders. They are characterized by an abnormal
accumulation of large amounts of dead skin cells (squames) in the top layer
of the skin. The conversion of an abnormally large number of epidermal cells
into squamous cells is thought to be caused by a defect in the metabolism of
skin cells known as "corneocytes" or of the fat-rich matrix around these
cells. The cells can be thought of as bricks, while the matrix would be the
mortar holding these cells together. (Use "Ichthyosis" as your search term
in the Rare Disease Database.)
Therapies: Standard
Treatment for the symptoms of skeletal abnormalities in Multiple Sulfatase
Deficiency is symptomatic and supportive. An orthopedist can provide
treatment for curvature of the spine. Dermatologic symptoms (ichthyosis) are
treated by applying skin softening (emollient) ointments, preferably plain
petroleum jelly. This can be especially effective after bathing while the
skin is still moist. Salicylic acid gel is another particularly effective
ointment. The skin should be covered at night with an airtight, waterproof
dressing when this ointment is used. Lactate lotion can also be an effective
treatment.
Therapies: Investigational
This disease entry is based upon medical information available through March
1990. Since NORD's resources are limited, it is not possible to keep every
entry in the Rare Disease Database completely current and accurate. Please
check with the agencies listed in the Resources section for the most current
information about this disorder.
Resources
For more information on Multiple Sulfatase Deficiency, please contact:
National Organization for Rare Disorders (NORD)
P.O. Box 8923
New Fairfield, CT 06812-1783
(203) 746-6518
NIH/National Institute of Neurological Disorders & Stroke (NINDS)
9000 Rockville Pike
Bethesda, MD 20892
(301) 496-5751
(800) 352-9424
National Tay-Sachs and Allied Diseases Association, Inc.
2001 Beacon St, Rm. 304
Brookline, MA 02164
(617) 277-4463 or 277-3965
Research Trust for Metabolic Diseases in Children
Golden Gates Lodge, Weston Rd.
Crewe CW1 1XN, England
Telephone: (0270) 250244
Association Europeenne contre les Leucodystrophies
7 Rue Pasteur
54000 NANCY
France
For genetic information and genetic counseling referrals, please contact:
March of Dimes Birth Defects Foundation
1275 Mamaroneck Avenue
White Plains, NY 10605
(914) 428-7100
Alliance of Genetic Support Groups
35 Wisconsin Circle, Suite 440
Chevy Chase, MD 20815
(800) 336-GENE
(301) 652-5553
References
THERAPEUTIC ACTIVITY OF LACTATE 12% LOTION IN THE TREATMENT OF ICHTHYOSIS.
ACTIVE VERSUS VEHICLE AND ACTIVE VERSUS A PETROLEUM CREAM: M. Buxman, et al.;
Journal Am Acad Dermatol (December 1986: issue 15(6)). Pp. 1253-1258.
THE METABOLIC BASIS OF INHERITED DISEASE, 5th ed.: John B. Stanbury, et
al., eds.; McGraw Hill, 1983. Pp. 888-889.
VARIOUS SULFATASE ACTIVITIES IN LEUKOCYTES AND CULTURED SKIN FIBROBLASTS
FROM HETEROZYGOTES FOR THE MULTIPLE SULFATASE DEFICIENCY (MUCOSULFATIDOSIS):
Y. Eto, et al.; Pediatr Res (February 1983: issue 17(2)). Pp. 97-100.
MULTIPLE DEFICIENCY OF MUCOPOLYSACCHARIDE SULFATASES IN MUCOSULFATIDOSIS: R.
Basner, et al.; Pediatr Res (December 1979: issue 13(12)). Pp. 1316-1318.