Triple A (Allgrove) syndrome: an unusual association with syringomyelia

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dc.contributor.authorBizzarri, Carlaen
dc.contributor.authorBenevento, Danilaen
dc.contributor.authorTerzi, Cesareen
dc.contributor.authorHuebner, Angelaen
dc.contributor.authorCappa, Marcoen
dc.date.accessioned2013-07-08T11:19:23Zen
dc.date.available2013-07-08T11:19:23Zen
dc.date.issued2013-06-24en
dc.date.updated2013-07-08T11:19:23Zen
dc.description.abstractTriple A (Allgrove) syndrome was first described by Allgrove in 1978 in two pairs of siblings. Since then, about 100 cases have been reported, all of them displaying an autosomal recessive pattern of inheritance. Clinical picture is characterized by achalasia, alacrimia and ACTH-resistant adrenal failure. A progressive neurological syndrome including central, peripheral and autonomic nervous system impairment, and mild mental retardation is often associated. The triple A syndrome gene, designated AAAS, is localized on chromosome 12q13. It consists of 16 exons, encoding for a 546 aminoacid protein called ALADIN (Alacrimia-Achalasia-aDrenal Insufficiency Neurologic disorder).We report on a 13-year-old boy presenting with Addison’s disease, dysphagia, muscle weakness, excessive fatigue and recent onset gait ataxia. The analysis of the AAAS gene revealed a homozygous missense mutation in exon 12. It was a T > G transversion at nucleotide position 1224, resulting in a change of leucine at amino acid position 381 into arginine (Leu381Arg or L381R). Brain appearance was found normal at magnetic resonance imaging (MRI) and functional spectroscopy analysis showed normal levels of the main metabolites. Spine MRI showed a cystic cavity within the spinal cord (syringomyelia), localized between the sixth cervical vertebra and the first thoracic vertebra. Cerebellar tonsils descended 7-mm caudal to foramen magnum, consistently with a mild type 1 Chiari malformation. Mild posterior inter-vertebral disk protrusions were evident between T9 and T10 and between L4 and L5.To our knowledge, this is the first report describing type 1 Chiari malformation and multiple spinal cord abnormalities in a patient with Allgrove syndrome.en
dc.description.versionPublished versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationItalian Journal of Pediatrics. 2013 Jun 24;39(1):39en
dc.identifier.doihttps://doi.org/10.1186/1824-7288-39-39en
dc.identifier.urihttp://hdl.handle.net/10919/23292en
dc.language.isoenen
dc.rightsCreative Commons Attribution 4.0 Internationalen
dc.rights.holderCarla Bizzarri et al.; licensee BioMed Central Ltd.en
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en
dc.titleTriple A (Allgrove) syndrome: an unusual association with syringomyeliaen
dc.title.serialItalian Journal of Pediatricsen
dc.typeArticle - Refereeden
dc.type.dcmitypeTexten

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