Journal
EUROPEAN JOURNAL OF PAEDIATRIC NEUROLOGY
Volume 20, Issue 2, Pages 331-335Publisher
ELSEVIER SCI LTD
DOI: 10.1016/j.ejpn.2015.11.008
Keywords
Peroxisomal biogenesis disorder; Zellweger spectrum disorder; PEX6; Polimicrogyria; VLCFA
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Analysis of the plasma levels of very long chain fatty acids (VLCFA) is a primary screening method for peroxisomal disorders and usually identifies severe peroxisomal biogenesis defects reliably. We report a patient presenting with typical facial stigmata, a treatment resistant seizure disorder and polymicrogyria, whose plasma VLCFA levels were within normal limits until the age of 18 months. Only thereafter an elevation was found. Subsequent enzymatic and molecular genetic analysis revealed compound heterozygous mutations in the PEX6 gene. In conclusion, normal VLCFA levels do not necessarily exclude global peroxisomal biogenesis defects and the analysis should be repeated subsequently. Persisting clinical suspicion justifies further enzymatic and molecular evaluation. (C) 2015 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.
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