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Archivos de Pediatría del Uruguay
Print version ISSN 0004-0584On-line version ISSN 1688-1249
Abstract
CIBILS, Lucía et al. Association of dermal melanocytosis with lysosomal storage diseases. Arch. Pediatr. Urug. [online]. 2016, vol.87, n.4, pp.342-346. ISSN 0004-0584.
Introduction: dermal melanocytosis includes a spectrum of skin lesions, mongolian spots being one of them. Lysosomal storage diseases are characterized by the accumulation of partially degraded insoluble metabolites in lysosomal compartments due to enzyme deficiency. Deficiency in b-galactosidosisis is the cause of GM1 gangliosidosis and deficiency in a-L-iduronidasa of mucopolysaccharidosis type I. Both have similar clinical presentations. Association of dermal melanocytosis and lysosomal storage diseases is uncommon and misunderstood. Objective: to report the case of two patients with this rare association. Clinical cases: the study presents two boys, 3 and 9 months old, with no remarkable family, pregnancy or delivery history. Both had repeated respiratory tract infections. They presented with developmental delay, central hypotonia and swallowing disorder. Upon clinical examination they showed hepatomegaly, coarse facies and extensive dermal melanocytosis. They were diagnosed with GM1 gangliosidosis and mucopolysaccharidosis type I. Discussion: the cause of this association is not well known. It is hypothesized that accumulation of gangliosides and heparan sulfates stimulates tyrosine-kinase neuronal growth factor receptor, stopping dermal melanocytosis migration. Therefore extensive dermal melanocytosis, in an appropriate clinical setting, may contribute to diagnosing lysosomal storage diseases.
Keywords : DERMAL MELANOCYTOSIS; LYSOSOMAL STORAGE DISEASES; GANGLIOSIDOSIS GM 1; MUCOPOLYSACCHARIDOSIS I.