Sanfilippo syndrome: A mini-review |
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Authors: | M J Valstar G J G Ruijter O P van Diggelen B J Poorthuis F A Wijburg |
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Institution: | (1) Department of Pediatrics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands;(2) Department of Clinical Genetics, Erasmus University Medical Center, Rotterdam, The Netherlands;(3) Department of Medical Biochemistry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands;(4) Department of Pediatrics (G8-205), Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands |
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Abstract: | Summary Mucopolysaccharidosis type III (MPS III, Sanfilippo syndrome) is an autosomal recessive disorder, caused by a deficiency in
one of the four enzymes involved in the lysosomal degradation of the glycosaminoglycan heparan sulfate. Based on the enzyme
deficiency, four different subtypes, MPS IIIA, B, C, and D, are recognized. The genes encoding these four enzymes have been
characterized and various mutations have been reported. The probable diagnosis of all MPS III subtypes is based on increased
concentration of heparan sulfate in the urine. Enzymatic assays in leukocytes and/or fibroblasts confirm the diagnosis and
allow for discrimination between the different subtypes of the disease. The clinical course of MPS III can be divided into
three phases. In the first phase, which usually starts between 1 and 4 years of age, a developmental delay becomes apparent
after an initial normal development during the first 1–2 years of life. The second phase generally starts around 3–4 years
and is characterized by severe behavioural problems and progressive mental deterioration ultimately leading to severe dementia.
In the third and final stage, behavioural problems slowly disappear, but motor retardation with swallowing difficulties and
spasticity emerge. Patients usually die at the end of the second or beginning of the third decade of life, although survival
into the fourth decade has been reported. Although currently no effective therapy is yet available for MPS III, several promising
developments raise hope that therapeutic interventions, halting the devastating mental and behavioural deterioration, might
be feasible in the near future.
Competing interests: None declared
References to electronic databases: Mucopolysaccharidosis III: type A, OMIM #252900; type B, OMIM #252920; type C, OMIM #252930; type D, OMIM #252940. Heparan
N-sulfatase: EC 3.10.1.1. N-Acetyl-α-glucosaminidase: EC 3.2.1.50. Acetyl-CoA:α-glucosaminide N-acetyltransferase: EC 2.3.1.78. N-Acetylglucosamine 6-sulfatase: EC 3.1.6.14.
Presented at the Annual Symposium of the SSIEM, Hamburg, 4–7 September 2007. |
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