| Author |
Romanello, Milena Zampieri, Stefania Bortolotti, Nadia Deroma, Laura Sechi, Annalisa Fiumara, Agata Parini, Rossella Borroni, Barbara Brancati, Francesco Bruni, Amalia Russo, Cinzia V. Bordugo, Andrea Bembi, Bruno Dardis, Andrea |
| Description |
Author Affiliation: Romanello M ( Regional Coordinator Centre for Rare Diseases, University Hospital Santa Maria della Misericordia, Udine, Italy. Electronic address: romanello.milena@aoud.sanita.fvg.it.); Zampieri S ( Regional Coordinator Centre for Rare Diseases, University Hospital Santa Maria della Misericordia, Udine, Italy. Electronic address: zampieri.stefania@aoud.sanita.fvg.it.); Bortolotti N ( Clinical Pathology Institute, University Hospital Santa Maria della Misericordia, Udine, Italy. Electronic address: bortolotti.nadia@aoud.sanita.fvg.it.); Deroma L ( Regional Coordinator Centre for Rare Diseases, University Hospital Santa Maria della Misericordia, Udine, Italy. Electronic address: deroma.laura@aoud.sanita.fvg.it.); Sechi A ( Regional Coordinator Centre for Rare Diseases, University Hospital Santa Maria della Misericordia, Udine, Italy. Electronic address: sechi.annalisa@aoud.sanita.fvg.it.); Fiumara A ( Department of Pediatrics, Regional Referral Center for Inherited Metabolic Disease, University of Catania, Catania, Italy. Electronic address: agatafiumara@yahoo.it.); Parini R ( Rare Metabolic Diseases Unit, Pediatric Clinic, San Gerardo Hospital, Monza, Italy. Electronic address: rossella.parini@unimib.it.); Borroni B ( Centre for Ageing Brain and Neurodegenerative Disorders, Neurology Unit, University of Brescia, Brescia, Italy. Electronic address: barbara.borroni@unibs.it.); Brancati F ( Medical Genetics Unit, Tor Vergata University, Roma, Italy. Electronic address: f.brancati@igenetica.com.); Bruni A ( Regional Neurogenetic Centre, ASPCZ, Lamezia Terme, Italy. Electronic address: bruni@arn.it.); Russo CV ( Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University, Naples, Italy. Electronic address: cinziavaleria@hotmail.it.); Bordugo A ( Regional Centre for Newborn Screening, Diagnosis and Treatment of Inherited Metabolic Disorders and Inherited Metabolic Diseases Unit, Department of Pediatrics, Verona, Italy. Electronic address: abordugo@hotmail.com.); Bembi B ( Regional Coordinator Centre for Rare Diseases, University Hospital Santa Maria della Misericordia, Udine, Italy. Electronic address: bembi.bruno@aoud.sanita.fvg.it.); Dardis A ( Regional Coordinator Centre for Rare Diseases, University Hospital Santa Maria della Misericordia, Udine, Italy. Electronic address: dardis.andrea@aoud.sanita.fvg.it.) |
| Abstract |
Niemann-Pick C disease (NPCD) is a rare autosomal recessive neurovisceral disorder with a heterogeneous clinical presentation. Cholestan-3ß,5 ,6ß-triol and 7-ketocholesterol have been proposed as biomarkers for the screening of NPCD. In this work, we assessed oxysterols levels in a cohort of Italian patients affected by NPCD and analyzed the obtained results in the context of the clinical, biochemical and molecular data. In addition, a group of patients affected by Niemann-Pick B disease (NPBD) were also analyzed. NPC patients presented levels of both oxysterols way above the cut off value, except for 5 siblings presenting the variant biochemical phenotype who displayed levels of 3ß,5 ,6ß-triol below or just above the cut-off value; 2 of them presented also normal levels of 7-KC. Both oxysterols were extremely high in a patient presenting the neonatal systemic lethal phenotype. All NPB patients showed increased oxysterols levels. In conclusion, the reported LC-MS/MS assay provides a robust non-invasive screening tool for NPCD. However, false negative results can be obtained in patients expressing the variant biochemical phenotype. These data strengthen the concept that the results should always be interpreted in the context of the patients' clinical picture and filipin staining and/or genetic studies might still be undertaken in patients with normal levels of oxysterols if symptoms are highly suggestive of NPCD. Both oxysterols are significantly elevated in NPB patients; thus a differential diagnosis should always be performed in patients presenting isolated hepatosplenomegaly, a common clinical sign of both NPCD and NPBD. |
