How long can you live with Niemann-Pick type C?
Niemann-Pick type C is always fatal. However, life expectancy depends on when symptoms begin. If symptoms appear in infancy, your child isn't likely to live past the age of 5. If symptoms appear after 5 years of age, your child is likely to live until about 20 years of age.
What causes Niemann-Pick Type C?
What causes Niemann-Pick disease type C in children? Niemann-Pick disease type C is caused by a mutation in either the NPC1 or NPC2 genes, which provide instructions for the production of special proteins in lysosomes that are responsible for the movement of cholesterol and other fats.
How do you get Niemann-Pick disease?
Niemann-Pick disease (NPD) is a group of diseases passed down through families (inherited) in which fatty substances called lipids collect in the cells of the spleen, liver, and brain.
Is Niemann-Pick disease curable?
No cure exists for Niemann-Pick disease. No effective treatment is available to people with type A or B. For people with mild to moderate type C, a drug called miglustat (Zavesca) may be an option.
What happens to the body with Niemann-Pick disease?
Niemann-Pick is a rare, inherited disease that affects the body's ability to metabolize fat (cholesterol and lipids) within cells. These cells malfunction and, over time, die. Niemann-Pick disease can affect the brain, nerves, liver, spleen, bone marrow and, in severe cases, lungs.
Is Pick's disease hereditary?
There's also some evidence that Pick's disease can run in families. Researchers have found evidence that connects it with at least three specific gene mutations. However, most cases of Pick's disease are “sporadic,” meaning the condition wasn't inherited.
What is the life expectancy of someone with Pick's disease?
Although some cases proceed slowly, Pick's disease usually proceeds more rapidly than AD, on average taking only four to six years from diagnosis to death. Patients with behavioral changes tend to pursue a more rapid course.
How common is Niemann-Pick Type C disease?
Abstract. Niemann-Pick C disease (NP-C) is a neurovisceral atypical lysosomal lipid storage disorder with an estimated minimal incidence of 1/120 000 live births. The broad clinical spectrum ranges from a neonatal rapidly fatal disorder to an adult-onset chronic neurodegenerative disease.
What causes Pick's disease?
People with FTD have abnormal substances (called tangles, Pick bodies, Pick cells, and tau proteins) inside nerve cells in the damaged areas of the brain. The exact cause of the abnormal substances is unknown. Many different abnormal genes have been found that can cause FTD.
When was Niemann-Pick disease discovered?
The German pediatrician Albert Niemann described the first NPD patient in 1914 in an Ashkenazi Jewish infant who presented with massive hepatosplenomegaly and a rapidly progressive neurodegenerative course that led to her death at 18 months of age [1].
What is Pick's disease?
Pick's disease is a kind of dementia similar to Alzheimer's but far less common. It affects parts of the brain that control emotions, behavior, personality, and language. It's also a type of disorder known as frontotemporal dementia (FTD) or frontotemporal lobar degeneration (FTLD).
What is the enzyme deficiency in Niemann-Pick disease?
Niemann-Pick disease (NPD) is a lysosomal storage disease caused by acid sphingomyelinase deficiency (ASMD), which catalyzes the hydrolysis of sphingomyelin (SM) to ceramide and phosphocholine.
How many people have Niemann-Pick?
Niemann-Pick disease types A and B is estimated to affect 1 in 250,000 individuals. Niemann-Pick disease type A occurs more frequently among individuals of Ashkenazi (eastern and central European) Jewish descent than in the general population.
Why do Ashkenazi have genetic diseases?
Researchers think Ashkenazi genetic diseases arise because of the common ancestry many Jews share. While people from any ethnic group can develop genetic diseases, Ashkenazi Jews are at higher risk for certain diseases because of specific gene mutations.
Who discovered Niemann-Pick disease?
The German pediatrician Albert Niemann described the first NPD patient in 1914 in an Ashkenazi Jewish infant who presented with massive hepatosplenomegaly and a rapidly progressive neurodegenerative course that led to her death at 18 months of age [1].
What is Niemann type C?
Type C. Niemann-Pick type C is a rare inherited disease. The genetic mutations of this type cause cholesterol and other fats to accumulate in the liver, spleen or lungs. The brain is eventually affected too. By Mayo Clinic Staff.
What are the three types of Niemann pick?
Niemann-Pick signs and symptoms may include: The three main types of Niemann-Pick are types A, B and C. The signs and symptoms you experience depend on the type and severity of your condition. Some infants with type A will show signs and symptoms within the first few months of life.
What organs do Niemann pick affect?
These cells malfunction and, over time, die. Niemann-Pick disease can affect the brain, nerves, liver, spleen, bone marrow and, in severe cases, lungs. People with this condition experience symptoms related to progressive loss of function of nerves, the brain and other organs.
What causes type A and type B?
Types A and B are caused by a missing or malfunctioning enzyme called sphingomyelinase. This affects the body's ability to metabolize fat (cholesterol and lipids), resulting in a buildup of fat in cells. This causes cell dysfunction and, over time, cell death. Type A occurs mainly in infants, who show severe, progressive brain disease. There is no cure, so most children do not live beyond their first few years. Type B usually occurs later in childhood and is not associated with primary brain disease. Most people affected with type B survive into adulthood.
Is Niemann Pick a progressive disease?
This means that both the mother and the father must pass on the defective form of the gene for the child to be affected. Niemann-Pick is a progressive disease, and there is no cure. It can occur at any age.
Overview
Niemann–Pick type C (NPC) (colloquially, "Childhood Alzheimer's" ) is a lysosomal storage disease associated with mutations in NPC1 and NPC2 genes. Niemann–Pick type C affects an estimated 1:150,000 people. Approximately 50% of cases present before 10 years of age, but manifestations may first be recognized as late as the sixth decade.
Signs and symptoms
Niemann–Pick type C has a wide clinical spectrum. Affected individuals may have enlargement of the spleen (splenomegaly) and liver (hepatomegaly), or enlarged spleen or liver combined (hepatosplenomegaly), but this finding may be absent in later onset cases. Prolonged jaundice or elevated bilirubin can present at birth. In some cases, however, enlargement of the spleen or liver does not occur for months or years – or not at all. Enlargement of the spleen or liver frequently b…
Genetics
Approximately 95% of Niemann–Pick type C cases are caused by genetic mutations in the NPC1 gene, referred to as type C1; 5% are caused by mutations in the NPC2 gene, referred to as type C2. The clinical manifestations of types Niemann–Pick types C1 and C2 are similar because the respective genes are both involved in egress of lipids, particularly cholesterol, from late endosomes or lysosomes. The NPC1 gene is located on chromosome 18 (18q11-q12) and was d…
Pathophysiology
Niemann–Pick type C is biochemically, genetically and clinically distinct from Niemann–Pick Types A or and B. In Types A and B, there is complete or partial deficiency of the lysosomal enzyme called acid sphingomyelinase. In Niemann–Pick type C, the protein product of the major mutated gene NPC1 is not an enzyme but appears to function as a transporter in the endosomal-lysosomal system, which moves large water-insoluble molecules through the cell. The protein co…
Diagnosis
Niemann–Pick type C is diagnosed by assaying cultured fibroblasts for cholesterol esterification and staining for unesterified cholesterol with filipin. The fibroblasts are grown from a small skin biopsy taken from a patient with suspected NPC. The diagnosis can be confirmed by identifying mutations in the NPC1 or NPC2 genes in 80–90% of cases. This specialized testing is available at Thomas Jefferson University Lysosomal Disease Testing Lab and the Mayo Clinic.
Treatment
There is no known cure for Niemann–Pick type C, nor is there any FDA-standard approved disease modifying treatment. Supportive care is essential and substantially improves the quality of life of people affected by NPC. The therapeutic team may include specialists in neurology, pulmonology, gastroenterology, psychiatrist, orthopedics, nutrition, physical therapy and occupational therapy. Standard medications used to treat symptoms can be used in NPC patients. As patients develo…
Prognosis
The lifespan of patients with NPC is usually related to the age of onset. Children with antenatal or infantile onset usually succumb in the first few months or years of life, whereas adolescent and adult onset forms of Niemann–Pick type C have a more insidious onset and slower progression, and affected individuals may survive to the seventh decade. Adult cases of NPC are being recognized with increasing frequency. It is suspected that many patients affected by NPC are un…
Research directions
Loss of myelin in the central nervous system is considered to be a main pathogenic factor. Research uses animal models carrying the underlying mutation for Niemann–Pick disease, e.g. a mutation in the NPC1 gene Niemann–Pick type C disease. In this model the expression of Myelin gene Regulatory Factor (MRF) has been shown to be significantly decreased. MRF is a transcription factor of critical importance in the development and maintenance of myelin sheaths. A perturbati…