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- $Unique_ID{BRK04169}
- $Pretitle{}
- $Title{Refsum Syndrome}
- $Subject{Refsum Syndrome Refsum Disease Disorder of Cornification 11 Phytanic
- Acid Type DOC 11 Phytanic Acid Type Heredopathia Atactica Polyneuritiformis
- Hypertrophic Neuropathy of Refsum Phytanic Acid Storage Disease Acanthocytosis
- Tay Sachs Disease Gaucher's Disease Niemann-Pick Disease}
- $Volume{}
- $Log{}
-
- Copyright (C) 1987, 1988, 1990 National Organization for Rare Disorders, Inc.
-
- 348:
- Refsum Syndrome
-
- ** IMPORTANT **
- It is possible the main title of the article (Refsum Syndrome) is not the
- name you expected. Please check the SYNONYMS listing to find the alternate
- names, disorder subdivisions, and related disorders covered by this article.
-
- Synonyms
-
- Refsum Disease
- Disorder of Cornification 11 (Phytanic Acid Type
- DOC 11 (Phytanic Acid Type)
- Heredopathia Atactica Polyneuritiformis
- Hypertrophic Neuropathy of Refsum
- Phytanic Acid Storage Disease
-
- Information on the following diseases can be found in the Related
- Disorders section of this report:
-
- Acanthocytosis
- Tay Sachs Disease
- Gaucher's Disease
- Niemann-Pick Disease
-
- 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.
-
-
- Refsum Syndrome is a rare disorder of lipid metabolism inherited as a
- recessive trait. Symptoms may include a degenerative nerve disease
- (peripheral neuropathy), failure of muscle coordination (ataxia), retinitis
- pigmentosa (a progressive vision disorder), and bone and skin changes. This
- disorder is believed to be due to the absence of phytanic acid hydroxylase in
- the blood, an enzyme needed for the metabolism of phytanic acid (found in
- dairy products, beef, lamb and some seafoods). Refsum Syndrome is
- characterized by a marked accumulation of phytanic acid in the plasma and
- tissues. Prolonged treatment with a diet deficient in phytanic acid can be
- beneficial. This slowly progressive disorder is most common in children and
- young adults of Scandinavian heritage. Phytanic Acid is a derivative of
- phytol, a component of chlorophyll.
-
- Symptoms
-
- Symptoms of Refsum Syndrome may include progressive nerve deafness, dry scaly
- skin (ichthyosis), and night blindness possibly due to degenerative changes
- in the retina of the eye.
-
- Skin problems associated with Refsum Syndrome include an unusual burning
- or prickling sensation (paresthesia) of arms and legs. Neurological symptoms
- include unsteady walking with frequent falls (ataxia), and peripheral
- neuropathy (characterized by sensory, motor, and reflex changes). (For more
- information, choose "ataxia" and "neuropathy" as your search terms in the
- Rare Disease Database).
-
- Causes
-
- Refsum Syndrome is inherited as a recessive trait. A defect in the
- metabolism of phytanic acid leads to an accumulation of phytanic acid in the
- blood plasma and tissues of the body. (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.)
-
- Affected Population
-
- Refsum Syndrome is usually found in children and young adults of Scandinavian
- heritage. This disorder can affect more than one person in a single family
- and occurs in males and females in equal numbers.
-
- Related Disorders
-
- There are many disorders caused by abnormal lipid metabolism.
- Acanthocytosis, also known as Lipoprotein Deficiency, is inherited as a
- recessive trait, and tends to occur more than once in families where it is
- found. This rare disorder usually begins in the first year of life and is
- marked by malnutrition, growth retardation, abdominal distention, and
- progressive neurological dysfunction. Curvature of the spine, muscle
- coordination impairment (ataxia), and eye problems including pigmentary
- retinal degeneration beginning at about ten years of age may also be
- symptomatic of Acanthocytosis.
-
- Gaucher's Disease is an inherited disease of lipid metabolism caused by
- the failure to produce the enzyme glucocerebrosidase. It is the most common
- of the fourteen known lipid storage disorders which includes Tay-Sachs
- Disease, Fabry's Disease, and Niemann-Pick Disease. There are three types of
- Gaucher's Disease - Type I, II, and III. All three are characterized by the
- presence of Gaucher (lipid-laden) cells in the bone marrow and other organs
- such as the spleen and liver.
-
- Tay-Sachs Disease is an infantile form of Ceroid-Lipofuscinosis. Tay-Sachs is
- a genetic disorder that causes the progressive destruction of the central
- nervous system. It is generally found among children of Eastern European
- Jewish heritage and becomes clinically apparent at about six months of age.
-
- Niemann-Pick Disease is a rare, familial disorder of lipid metabolism
- characterized by the accumulation of sphingomyelin and cholesterol in the
- reticuloendothelial cells. There are at least five different forms of this
- type of lipidosis.
-
- (For more information on these disorders, choose "Gaucher," "Tay-Sachs,"
- "Fabry," "Niemann," and "Acanthocytosis" as your search terms in the Rare
- Disease Database).
-
- Therapies: Standard
-
- Treatment of Refsum Syndrome involves following a strict diet low in phytanic
- acid (found in dairy products, beef, lamb and some seafoods) and high in
- calories. Other treatment is symptomatic and supportive.
-
- Therapies: Investigational
-
- Plasmapheresis as a treatment for Refsum Syndrome is being tested by
- scientists and appears to hold promise in improving the neurological and
- muscle coordination problems associated with this disorder. Plasmapheresis
- (plasma exchange) is a method for removing unwanted substances (toxins,
- metabolic substances, and plasma parts) from the blood. It is performed by
- removing blood, separating the plasma from the other blood products, and
- replacing the patient's plasma with other human plasma. More investigation
- is necessary, however, before this treatment can gain acceptance as a
- standard treatment for Refsum Syndrome.
-
- 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 Refsum Syndrome, please contact:
-
- National Organization for Rare Disorders (NORD)
- P.O. Box 8923
- New Fairfield, CT 06812-1783
- (203) 746-6518
-
- United Leukodystrophy Foundation
- 2304 Highland Drive
- Sycamore, IL 60178
- (815) 895-3211
- (800) 728-5483
-
- RP Foundation Fighting Blindness
- 1401 Mt. Royal Avenue, 4th Floor
- Baltimore, MD 21217-4245
- (800) 638-2300
- (301) 225-9400
- TDD (301) 225-9409 (for the deaf)
-
- NIH/National Institute of Neurological Disorders & Stroke (NINDS)
- 9000 Rockville Pike
- Bethesda, MD 20892
- (301) 496-5751
- (800) 352-9424
-
- Association Europeenne contre les Leucodystrophies
- 7 Rue Pasteur
- 54000 NANCY
- France
-
- Research Trust for Metabolic Diseases in Children
- Golden Gates Lodge, Weston Rd.
- Crewe CW1 1XN, England
- Telephone: (0270) 250244
-
- For information on genetics 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
-
- HEREDOPATHIA ATACTICA POLYNEURITIFORMIS (REFSUM'S DISEASE) TREATED BY DIET
- AND PLASMA-EXCHANGE : F.B. Gibberd, et. al.; Lancet. (1986, Issue 1 (8116)).
- Pp. 575-578.
-
- CLINICAL PICTURE AND PATHOGENESIS OF THE REFSUM SYNDROME: A.M.
- Shevchenko; Zh Nevropatol Psikhiatr (1977, issue 77(6)). Pp. 832-837.
-
-