Refsum’s disease: clinical features

Evidence-based neurology checklist on refsum’s disease: clinical features: Genetics and pathology This is a peroxisomal disorder It is caused by mutations in the PHYH and PEX7 genes The mutation causes elevation of plasma phytanic acid levels This leads to phytanic acid accumulation in tissues:…

Genetics and pathology

  • This is a peroxisomal disorder
  • It is caused by mutations in the PHYH and PEX7 genes
  • The mutation causes elevation of plasma phytanic acid levels
  • This leads to phytanic acid accumulation in tissues: nerves, brain, and fat
  • Pristanic acid levels are reduced

Tapetoretinal degeneration: features

Other ophthalmic features

Skeletal malformations

Neurological features

Systemic features

Triggers for deterioration

Clinical differentials

Differentials of raised phytanic acid

References

  1. Ruether K, Baldwin E, Casteels M, et al. Adult Refsum's disease: a form of taporetinal dystrophy accessible to therapy. Surv Ophthalmol 2010; 55:531-538.
  2. Jayaram H, Downes SM. Midlife diagnosis of Refsum's disease in siblings with retinitis pigmentosa-the footprint is the clue: a case report. J Med Case Reports 2008; 2:80.
  3. Embiruçu EK, Martyn ML, Schlesinger D, Kok F. Autosomal recessive ataxias: 20 types, and counting. Arq Neuropsiquiatr 2009; 67:1143-1156.
  4. Fogel BL, Perlman S. Clinical features and molecular genetics of autosomal recessive cerebellar ataxias. Lancet Neurol 2007; 6:245-257.
  5. Poll-The BT, Gärtner J. Clinical diagnosis, biochemical findings and MRI spectrum of peroxisomal disorders. Biochim Biophys Acta 2012; 1822:1421-1429. 
  6. And 2 more. Subscribe to see the full list

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