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Query: UMLS:C0009443 (
cold
)
92,137
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
A case of
hereditary sensory neuropathy
is described resembling Dyck's Type I
hereditary sensory neuropathy
. Sensory testing revealed marked pain impairment in feet and hands shading at mid calf to normal at mid thigh and shading above the wrist to normal at the elbow. Other sensory modalities including temperature were intact except painful heat and painful
cold
and they produced very little if any discomfort. Stimuli at 0 degrees C or 45 degrees to 70 degrees C elicited a temperature response but not pain. Sural nerve biopsy findings (including electromicroscopy) were consistent with a diagnosis of Type I
hereditary sensory neuropathy
, but also showed evidence of abortive axonal regeneration and profound Schwann cell vacuolation.
...
PMID:Hereditary sensory neuropathy: a case with pain and temperature dissociation. 693 Mar 14
Hereditary sensory neuropathy
type 1 (HSAN1) may be the first genetic neuropathy amenable to a specific mechanism-based treatment, as L-serine supplementation can be used to lower the neurotoxic levels of 1-deoxysphingolipids (1-deoxySL) that cause the neurodegeneration. The treatment is so far untested in HSAN1C caused by variants in the serine palmitoyl transferase subunit 2 (
SPTLC2
) gene. The aim of this study was to establish whether oral L-serine lowers 1-deoxySL in a patient with HSAN1C, to perform a dose escalation to find the minimal effective dose, and to assess the safety profile and global metabolic effects of the treatment. Our patient underwent a 52-wk treatment in which the L-serine dose was titrated up to 400 mg/kg/day. She was followed up by repeated clinical examination, nerve conduction testing, and skin biopsies to document effects on small nerve fibers. Serum was assayed for 1-deoxySL and metabolomics analysis of 111 metabolites. We found a robust lowering of 1-deoxySL, which correlated in a near-linear fashion with increased serum L-serine levels. Metabolomics analysis showed a modest elevation in glycine and a marked reduction in the level of cytosine, whereas most of the other assayed metabolites did not change. There were no direct side effects from the treatment, but the patient developed a transitory toe ulceration during the course of the study. The Charcot-Marie-Tooth neuropathy score increased by 1 point. We conclude that oral supplementation of L-serine decreases 1-deoxySL in HSAN1C without major global effects on metabolism. L-serine is therefore a potential treatment for HSAN1C.
Cold
Spring Harb Mol Case Stud 2017 Nov
PMID:Clinical and metabolic consequences of L-serine supplementation in hereditary sensory and autonomic neuropathy type 1C. 2904 46