A Girl with Farber Disease Treated with Bone Marrow Transplantation

Authors

1 Department of Pediatric, Shahid Sadoughi University of Medical Science, Yazd, Iran

2 Hematology and Oncology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

Abstract

Background: Farber disease is a very rare autosomal recessive disease of lipid metabolism caused by deficient activity of lysosomal acid ceramidase. Symptoms can begin in the first year of life by a triad of painful and swollen joints and subcutaneous nodules, progressive hoarseness and variable central nervous system involvement.
 
Case Report: A 5 months old girl with subcutaneous nodules in limbs, pain and swelling in her fingers, Knees, elbow and hoarseness was referred to our clinic. She had neurodevelopment delay in walking and talking. Genetic analysis was reported homozygosity for a c.830C>A mutation in exon 11 of N-Acylsphingosine Amidohydrolase 1 (ASAH1) gene. She diagnosed with Farber disease and treated with bone marrow transplantation. After that her signs and symptoms were improved and she could to walk.
 
Conclusion: Farber disease is associated with characteristics including swollen joints, subcutaneous nodules, progressive hoarseness and variable CNS involvement. Moreover, bone marrow transplantation improved these symptoms.

Keywords


1. Park JH, Schuchman EH. Acid ceramidase and human disease. Biochim Biophys Acta 2006; 1758(12): 2133-8.
2. Sands MS. Farber disease: understanding a fatal childhood disorder and dissecting ceramide biology. EMBO Mol Med 2013; 5(6): 799-801.
3. Kyriakie Sarafoglou K, Hoffmann G, Roth K. Pediatric endocrinology and inborn errors of
metabolism. 1st ed. New York, NY: McGraw-Hill Education; 2008. p. 745.
4. Ahmad A, Mazhar A, Anwar M. Farber disease: a rare neurodegenerative disorder. J Coll Physicians Surg Pak 2009; 19(1): 67-8.
5. Zappatini-Tommasi L, Dumontel C, Guibaud P, Girod C. Farber disease: an ultrastructural study. Virchows Archiv A PatholAnat 1992; 420(3): 281-90.
6. Kliegman RM, Stanton B, Geme J, Schor NF. Nelson text book of pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016; p. 714.
7. Moser HW, Linke T, Fensom AH, Levade T, Sandhoff K. Acid ceramidase deficiency: farber lipogranulomatosis. In: Valle D, Beaudet AL, Vogelstein B, Kinzler KW, Antonarakis SE, Ballabio A, et al. editors. The online metabolic and molecular bases of inherited diseases. New York, NY: McGrawHill Inc. 2001. p. 3573-88.
8. Ehlert K, Frosch M, Fehse N, Zander A, Roth J, Vormoor J. Farber disease: clinical presentation, pathogenesis and a new approach to treatment. Pediatr Rheumatol Online J 2007; 5: 15.
9. Fernandz J, Sundubrcy JM, van Bergeh G. Inborn metabolic diseases: diagnosis and treatment. 4th ed. New York, NY: Springer-Verlag; 2006.
10. Ehlert K, Frosch M, Fehse N, Zander A, Roth J, Vormoor J. Farber disease: clinical presentation, pathogenesis and a new approach to treatment. Pediatr Rheumatol Online J 2007; 5: 15.
Volume 1, Issue 1
July 2018
Pages 56-58
  • Receive Date: 24 July 2017
  • Revise Date: 23 August 2017
  • Accept Date: 26 December 2017
  • First Publish Date: 01 July 2018