Krabbe disease

Causes and Risks:
Krabbe disease is inherited as an autosomal recessive trait. It has a higher incidence among people of Scandinavian descent. Absence of the enzyme galactocerebroside beta-galactosidase causes the accumulation of galactocerebroside in the nervous tissue. Accumulating galactocerebroside results in increasing destruction of myelin . The end result is a progressive destruction of the nervous system.

Krabbe disease, like many other storage diseases, has an early onset form and a late onset form. In the early form, symptoms begin in the first months of life with feeding problems and failure to thrive , unexplained fevers, and vomiting . Changes in muscle tone are frequent, and seizures may begin very early and are severe. Visual and hearing losses are progressive. Affected children eventually assume a rigid unusual body position called decerebrate posturing. Death follows shortly thereafter, usually before the second year of life.

The late onset form of the disease begins in late childhood or early adolescence . Visual problems progressing to blindness may be the first symptom. Gait disturbance ( ataxia ) and muscle rigidity lead to progressive disability.

Prevention:
Genetic counseling is recommended for prospective parents with a family history of Krabbe disease. Carrier states may be recognized by decreased galactocerebroside beta-galactosidase levels in their white blood cells or skin fibroblasts. Prenatal diagnosis is possible by measuring galactocerebroside beta-galactosidase levels in cultured amniotic fluid cells or from cultured chorionic villi cells.

Symptoms:



Signs and Tests:
Examination of the retina may show optic atrophy. Abnormal posturing may be evident ( opisthotonos and decerebrate posturing) in late stages of the disorder. There may be signs of deafness .

Tests:



Treatment:
There is no specific treatment for Krabbe disease. Treatment lies in prevention.

Prognosis:
The outcome is likely to be poor.

Complications:
Progressive central nervous system degeneration occurs; the disease is ultimately fatal.

Call Your Healthcare Provider:
Call your health care provider if your child develops symptoms of this disorder. Seizures and change in muscle tone are emergency symptoms, as is a loss of consciousness or abnormal posturing .