-
Journal of Medical Genetics Oct 1996Until recently, the peroxisome was considered a "reactor chamber" for H2O2 producing oxidases, and it is now recognised as a versatile organelle performing complex... (Review)
Review
Until recently, the peroxisome was considered a "reactor chamber" for H2O2 producing oxidases, and it is now recognised as a versatile organelle performing complex catabolic and biosynthetic roles in the cell. Zellweger syndrome (ZS), the paradigm of human peroxisomal disorders, is characterised by neonatal hypotonia, severe neuro-developmental delay, hepatomegaly, renal cysts, senorineural deafness, retinal dysfunction, and facial dysmorphism. It is now clear that ZS is at the severe end of a phenotypic spectrum of Zellweger-like syndromes which may present for diagnosis later in childhood and even in adult life. It is important that clinical geneticists are aware of these milder clinical variants as the availability of sensitive and specific biochemical assays of peroxisomal function (for example, serum VLCFA ratios, platelet DHAP-AT activity) makes their diagnosis relatively straightforward.
Topics: Animals; Humans; Male; Microbodies; Phenotype; Zellweger Syndrome
PubMed: 8933342
DOI: 10.1136/jmg.33.10.863 -
Journal of Pediatric Endocrinology &... Jan 2014We present a 2-month-old male affected by Zellweger syndrome, a rare peroxisomal disorder. The diagnosis was supported by clinical and radiological findings and... (Review)
Review
We present a 2-month-old male affected by Zellweger syndrome, a rare peroxisomal disorder. The diagnosis was supported by clinical and radiological findings and established by biochemical tests. The characteristic radiological features included anomalous ossification (epiphyseal stippling). We also discuss main differential diagnoses of epiphyseal stippling and a brief literature review.
Topics: Epiphyses; Fetal Development; Growth; Humans; Infant; Male; Radiography; Zellweger Syndrome
PubMed: 24030027
DOI: 10.1515/jpem-2013-0184 -
Molecular Genetics and Metabolism Mar 2016Peroxisome biogenesis disorders in the Zellweger spectrum (PBD-ZSD) are a heterogeneous group of genetic disorders caused by mutations in PEX genes responsible for... (Review)
Review
Peroxisome biogenesis disorders in the Zellweger spectrum (PBD-ZSD) are a heterogeneous group of genetic disorders caused by mutations in PEX genes responsible for normal peroxisome assembly and functions. As a result of impaired peroxisomal activities, individuals with PBD-ZSD can manifest a complex spectrum of clinical phenotypes that typically result in shortened life spans. The extreme variability in disease manifestation ranging from onset of profound neurologic symptoms in newborns to progressive degenerative disease in adults presents practical challenges in disease diagnosis and medical management. Recent advances in biochemical methods for newborn screening and genetic testing have provided unprecedented opportunities for identifying patients at the earliest possible time and defining the molecular bases for their diseases. Here, we provide an overview of current clinical approaches for the diagnosis of PBD-ZSD and provide broad guidelines for the treatment of disease in its wide variety of forms. Although we anticipate future progress in the development of more effective targeted interventions, the current guidelines are meant to provide a starting point for the management of these complex conditions in the context of personalized health care.
Topics: Adult; Genetic Testing; Hearing Loss, Sensorineural; Humans; Membrane Proteins; Mutation; PHEX Phosphate Regulating Neutral Endopeptidase; Peroxisomal Disorders; Peroxisomes; Phenotype; Practice Guidelines as Topic; Precision Medicine; Retinal Dystrophies; Zellweger Syndrome
PubMed: 26750748
DOI: 10.1016/j.ymgme.2015.12.009 -
Progress in Lipid Research 1989
Review
Topics: Animals; Humans; Lipid Metabolism; Microbodies; Zellweger Syndrome
PubMed: 2682669
DOI: 10.1016/0163-7827(89)90006-4 -
AJNR. American Journal of Neuroradiology 1997To determine characteristic MR imaging features of Zellweger syndrome.
PURPOSE
To determine characteristic MR imaging features of Zellweger syndrome.
METHODS
Clinical records, laboratory records, and MR studies of six patients with Zellweger syndrome were reviewed retrospectively. MR studies were examined for the state of myelination; the presence, extent, and morphologic appearance of cerebral cortical anomalies; the status of the cerebellar cortex, basal nuclei, and brain stem; and the presence or absence of any regions of abnormal signal intensity.
RESULTS
The diagnosis of Zellweger syndrome was established in all patients by clinical findings combined with laboratory and MR results. All patients had impaired myelination and diffusely abnormal cortical gyral patterns that consisted of regions of microgyria (primarily in the frontal and perisylvian cortex) together with regions of thickened pachygyric cortex (primarily perirolandic and occipital). The pachygyric regions were in the form of deep cortical infoldings. Germinolytic cysts were visible in the caudothalamic groove in all patients, seen best on coronal or sagittal T1-weighted images. One patient had T1 shortening in the bilateral globus pallidus, presumably related to hepatic dysfunction and hyperbilirubinemia.
CONCLUSION
The combination of hypomyelination, cortical malformations that are most severe in the perisylvian and perirolandic regions, and germinolytic cysts are highly suggestive of Zellweger syndrome in the proper clinical setting.
Topics: Basal Ganglia; Brain Stem; Cerebellar Cortex; Cerebral Cortex; Diagnosis, Differential; Female; Humans; Infant; Infant, Newborn; Magnetic Resonance Imaging; Male; Nerve Fibers, Myelinated; Retrospective Studies; Sensitivity and Specificity; Zellweger Syndrome
PubMed: 9194444
DOI: No ID Found -
Journal of Inherited Metabolic Disease Dec 2009The peroxisomal biogenesis disorders (PBDs) comprise the Zellweger spectrum disorders (i.e., Zellweger syndrome, neonatal adrenoleukodystrophy, and infantile Refsum... (Review)
Review
The peroxisomal biogenesis disorders (PBDs) comprise the Zellweger spectrum disorders (i.e., Zellweger syndrome, neonatal adrenoleukodystrophy, and infantile Refsum disease) and rhizomelic chondrodysplasia punctata. Peroxisomal biogenesis disorders can be caused by mutations in any of 13 currently known PEX genes, which encode peroxins involved in peroxisomal protein import and/or assembly of the organelle. We report here on a Turkish patient who presented with unusual clinical findings, that included non-immune hydrops, dermal erythropoiesis and hypoplastic toenails, as well as common dysmorphic features of Zellweger syndrome. The patient has also pulmonary hypoplasia, which has been reported in only a few patients with Zellweger syndrome. A peroxisomal biogenesis disorder was confirmed by enzyme analysis and abnormal very long-chain fatty acid (VLCFA) profiles in plasma and fibroblast and immunofluorescence microscopy studies. Subsequent molecular genetic analysis revealed a homozygous c.856C>T mutation (R268X) in the PEX3 gene, which made this patient the third to have a defect in this gene. In contrast to those of the two previously reported patients, the cells of this patient still contained peroxisomal membrane structures (ghosts), seen by immunofluorescence microscopy analysis. The case presented here and the two previously reported cases point out that a PEX3 gene defect may present with fairly heterogeneous clinical findings. This case also raises a possibility that hydrops fetalis may be associated with a PEX3 gene defect and that peroxisomal disorders can be considered in the etiology of hydrops fetalis as well as other cell organelle disorders when one is considering yet undiscovered complementation groups in peroxisomal disorders.
Topics: Erythropoiesis; Fatal Outcome; Homozygote; Humans; Hydrops Fetalis; Infant, Newborn; Lipoproteins; Male; Membrane Proteins; Nails, Malformed; Peroxins; Point Mutation; Zellweger Syndrome
PubMed: 20033294
DOI: 10.1007/s10545-009-9010-0 -
Advances in Experimental Medicine and... 2020Zellweger syndrome disorders (ZSD) is the principal group of peroxisomal disorders characterized by a defect of peroxisome biogenesis due to mutations in one of the 13...
Zellweger syndrome disorders (ZSD) is the principal group of peroxisomal disorders characterized by a defect of peroxisome biogenesis due to mutations in one of the 13 PEX genes. The clinical spectrum is very large with a continuum from antenatal forms to adult presentation. Whereas biochemical profile in body fluids is classically used for their diagnosis, the revolution of high-throughput sequencing has extended the knowledge about these disorders. The aim of this review is to offer a large panorama on molecular basis, clinical presentation and treatment of ZSD, and to update the diagnosis strategy of these disorders in the era of next-generation sequencing (NGS).
Topics: Adult; High-Throughput Nucleotide Sequencing; Humans; Infant, Newborn; Infant, Newborn, Diseases; Mutation; Peroxisomes; Zellweger Syndrome
PubMed: 33417208
DOI: 10.1007/978-3-030-60204-8_6 -
Zhonghua Er Ke Za Zhi = Chinese Journal... Jan 2024To summarize the clinical features and genetic characteristics of Zellweger spectrum disorder caused by PEX6 gene variation. This was a case series research. Clinical... (Review)
Review
To summarize the clinical features and genetic characteristics of Zellweger spectrum disorder caused by PEX6 gene variation. This was a case series research. Clinical date and genetic results of 2 neonatal cases of Zellweger syndrome caused by PEX6 gene variation in Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science & Technology and Affiliated Hospital of Guangdong Medical University from July 2021 to July 2022 were retrospectively collected and analyzed. Literature up to August 2023 was searched from electronic databases of China National Knowledge Infrastructure (CNKI), Wanfang Data and PubMed with the combined keywords of "Zellweger syndrome" "Zellweger spectrum disorder", and "PEX6 gene" both in Chinese and English. The main clinical features and genetic characteristics of Zellweger spectrum disorder caused by PEX6 gene variation were summarized. The 2 male neonates both developed clinical manifestations as dyspnea, hypotonia, feeding difficulties, enlarged fontanelle, and high palatine arch after birth. Biochemical parameters indicated elevated bile acids, and the cranial ultrasound showed the enlarged bilateral ventricles and subependymal cyst in both 2 neonates. Zellweger syndrome was confirmed by whole exome sequencing, and the results revealed PEX6 gene variation in the 2 neonates, including compound heterozygous variants c.315G>A and c.2095-3T>G, and homozygous variant c.506_507del. Case 1 was hospitalized for 5 days, and case 2 for 32 days; they both died shortly after being discharged (the specific time is unknown). Literature review found 26 patients, including 2 neonates in this study, with Zellweger spectrum disorder caused by PEX6 gene defect reported in 1 Chinese article and 11 English articles. Clinical features included hearing loss (19 cases), developmental delay (19 cases), vision impairment (19 cases), elevated very long chain fatty acids (17 cases), brain malformations (15 cases), hypotonia (12 cases), hepatic insufficiency (12 cases), distinctive facies (10 cases), and dental impairment (9 cases). Compound heterozygous variations dominated the variation types (15 cases), and the frameshift variations (16 cases) were the main pathogenic variations. Zellweger spectrum disorder should be considered when neonates show hypotonia, feeding difficulty, distinctive facial appearance, brain malformations and failure of hearing screening, or when older children show retinitis pigmentosa, sensorineural hearing loss, amelogenesis imperfecta and developmental delays. Detection of genetic variation in the PEX gene is crucial for definitive diagnosis.
Topics: Child; Infant, Newborn; Humans; Male; Adolescent; Zellweger Syndrome; Muscle Hypotonia; Retrospective Studies; Frameshift Mutation; Exome Sequencing; Mutation; ATPases Associated with Diverse Cellular Activities
PubMed: 38154976
DOI: 10.3760/cma.j.cn112140-20230914-00191 -
Metabolic, Pediatric, and Systemic... 1989Progresses in biochemistry permit one to distinguish three biochemical forms of Zellweger Syndrome: 1) hyperpipecolic acidemia, 2) neonatal adrenoleukodystrophy, and 3)...
Progresses in biochemistry permit one to distinguish three biochemical forms of Zellweger Syndrome: 1) hyperpipecolic acidemia, 2) neonatal adrenoleukodystrophy, and 3) infantile Refsum's disease, which have similar clinical manifestations. A seven-month-old male patient with Zellweger Syndrome is presented. He had absence of peroxismes in the liver and elevated pipecolic acids and abnormal levels of bile acids in the blood. The child had a typical neurologic clinical manifestation with hepatomegaly. The ophthalmoscopy revealed grey disks and retinitis pigmentosa with extinguished ERG and law and delayed VEP. The importance of the constant retinal involvement in Zellweger Syndrome is discussed.
Topics: Bile Acids and Salts; Electroretinography; Fundus Oculi; Humans; Infant; Male; Pipecolic Acids; Retinitis Pigmentosa; Zellweger Syndrome
PubMed: 2628705
DOI: No ID Found -
Ryoikibetsu Shokogun Shirizu 2001