La maladie de Niemann-Pick de type C

Niemann-Pick disease type C is a lysosomal storage disease transmitted by recessive autosomal inheritance related to an accumulation of non-esterified cholesterol. Two genes, NPC1 and NPC2 coding for intracellular cholesterol transport proteins are involved. Adult forms are rare, but probably underdiagnosed. The most common inaugural signs include psychiatric disorders, cerebellous ataxia, cognitive impairment and, more rarely, epilepsia or abnormal movements. Nearly three-quarters of patients developed vertical supranuclear ophthalmoplegia, an element strongly favoring diagnosis. Hepatosplenomegalia is rare in adults and adolescents. The diagnosis is based on the Filipine test conducted on cultured fibroblasts, which demonstrates perinuclear vesicles filled with cholesterol. Treatment is symptomatic. Miglustat can be prescribed to stabilize or retard the inevitable progression.