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Retinal dystrophy with leukodystrophy(RDLKD)

MedGen UID:
1715138
Concept ID:
C5394315
Disease or Syndrome
Synonyms: RDLKD; RETINAL DYSTROPHY WITH LEUKODYSTROPHY
 
Gene (location): ACBD5 (10p12.1)
 
Monarch Initiative: MONDO:0030026
OMIM®: 618863

Definition

Retinal dystrophy and leukodystrophy (RDLKD) is a peroxisomal enzyme deficiency caused by impaired very long chain fatty acid (VLCFA) metabolism. Patients exhibit ataxia and spastic paraparesis as well as developmental delay, and may show facial dysmorphism (Ferdinandusse et al., 2017). [from OMIM]

Clinical features

From HPO
Prominent ear helix
MedGen UID:
892712
Concept ID:
C4024165
Finding
Abnormally prominent ear helix.
Dysarthria
MedGen UID:
8510
Concept ID:
C0013362
Mental or Behavioral Dysfunction
Dysarthric speech is a general description referring to a neurological speech disorder characterized by poor articulation. Depending on the involved neurological structures, dysarthria may be further classified as spastic, flaccid, ataxic, hyperkinetic and hypokinetic, or mixed.
Falls
MedGen UID:
39084
Concept ID:
C0085639
Finding
A sudden movement downward, usually resulting in injury.
Waddling gait
MedGen UID:
66667
Concept ID:
C0231712
Finding
Weakness of the hip girdle and upper thigh muscles, for instance in myopathies, leads to an instability of the pelvis on standing and walking. If the muscles extending the hip joint are affected, the posture in that joint becomes flexed and lumbar lordosis increases. The patients usually have difficulties standing up from a sitting position. Due to weakness in the gluteus medius muscle, the hip on the side of the swinging leg drops with each step (referred to as Trendelenburg sign). The gait appears waddling. The patients frequently attempt to counteract the dropping of the hip on the swinging side by bending the trunk towards the side which is in the stance phase (in the German language literature this is referred to as Duchenne sign). Similar gait patterns can be caused by orthopedic conditions when the origin and the insertion site of the gluteus medius muscle are closer to each other than normal, for instance due to a posttraumatic elevation of the trochanter or pseudarthrosis of the femoral neck.
Dysmetria
MedGen UID:
68583
Concept ID:
C0234162
Finding
A type of ataxia characterized by the inability to carry out movements with the correct range and motion across the plane of more than one joint related to incorrect estimation of the distances required for targeted movements.
Delayed speech and language development
MedGen UID:
105318
Concept ID:
C0454644
Finding
A degree of language development that is significantly below the norm for a child of a specified age.
Motor delay
MedGen UID:
381392
Concept ID:
C1854301
Finding
A type of Developmental delay characterized by a delay in acquiring motor skills.
Truncal titubation
MedGen UID:
382380
Concept ID:
C2674512
Finding
Tremor of the trunk in an anterior-posterior plane at 3-4 Hz.
CNS hypomyelination
MedGen UID:
892446
Concept ID:
C4025616
Finding
Reduced amount of myelin in the central nervous system resulting from defective myelinogenesis.
Proximal muscle weakness
MedGen UID:
113169
Concept ID:
C0221629
Finding
A lack of strength of the proximal muscles.
Gowers sign
MedGen UID:
65865
Concept ID:
C0234182
Finding
A phenomenon whereby patients are not able to stand up without the use of the hands owing to weakness of the proximal muscles of the lower limbs.
Progressive microcephaly
MedGen UID:
340542
Concept ID:
C1850456
Anatomical Abnormality
Progressive microcephaly is diagnosed when the head circumference falls progressively behind age- and gender-dependent norms.
Very long chain fatty acid accumulation
MedGen UID:
481027
Concept ID:
C3279397
Finding
Cleft palate
MedGen UID:
756015
Concept ID:
C2981150
Congenital Abnormality
Cleft palate is a developmental defect of the palate resulting from a failure of fusion of the palatine processes and manifesting as a separation of the roof of the mouth (soft and hard palate).
Rotary nystagmus
MedGen UID:
116106
Concept ID:
C0240595
Disease or Syndrome
A form of nystagmus in which the eyeball makes rotary motions around the axis.
Hypotelorism
MedGen UID:
96107
Concept ID:
C0424711
Finding
Interpupillary distance less than 2 SD below the mean (alternatively, the appearance of an decreased interpupillary distance or closely spaced eyes).
Bilateral ptosis
MedGen UID:
356120
Concept ID:
C1865916
Disease or Syndrome
Rod-cone dystrophy
MedGen UID:
1632921
Concept ID:
C4551714
Disease or Syndrome
An inherited retinal disease subtype in which the rod photoreceptors appear to be more severely affected than the cone photoreceptors. Typical presentation is with nyctalopia (due to rod dysfunction) followed by loss of mid-peripheral field of vision, which gradually extends and leaves many patients with a small central island of vision due to the preservation of macular cones.

Recent clinical studies

Etiology

Rossi-Espagnet MC, Lucignani M, Pasquini L, Napolitano A, Pro S, Romano A, Diodato D, Martinelli D, Longo D
Neuroradiology 2020 Feb;62(2):241-249. Epub 2019 Nov 4 doi: 10.1007/s00234-019-02302-0. PMID: 31680196
Saneto RP, Friedman SD, Shaw DW
Mitochondrion 2008 Dec;8(5-6):396-413. Epub 2008 May 23 doi: 10.1016/j.mito.2008.05.003. PMID: 18590986Free PMC Article

Diagnosis

Rudaks LI, Triplett J, Morris K, Reddel S, Worgan L
Am J Med Genet A 2024 Feb;194(2):346-350. Epub 2023 Oct 3 doi: 10.1002/ajmg.a.63433. PMID: 37789430
Moscatelli M, Ardissone A, Lamantea E, Zorzi G, Bruno C, Moroni I, Erbetta A, Chiapparini L
Neurol Sci 2022 Mar;43(3):2081-2084. Epub 2022 Jan 14 doi: 10.1007/s10072-022-05881-8. PMID: 35031921
Berio A, Piazzi A, Traverso CE
Pediatr Med Chir 2017 Dec 15;39(4):169. doi: 10.4081/pmc.2017.169. PMID: 29502391
Saneto RP, Friedman SD, Shaw DW
Mitochondrion 2008 Dec;8(5-6):396-413. Epub 2008 May 23 doi: 10.1016/j.mito.2008.05.003. PMID: 18590986Free PMC Article
Steinlin M, Boltshauser E, Steinmann B, Wichmann W, Niemeyer G
Eur J Pediatr 1989 Oct;149(1):40-2. doi: 10.1007/BF02024332. PMID: 2606126

Recent systematic reviews

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