Niemann-Pick disease type C (NPC) is a slow-progressing disorder in which the primary hallmark is accumulation of lipids in lysosomes. Symptoms are age dependent. Clinical signs during infancy are limited to the viscera, with hepatosplenomegaly, jaundice, and (in some instances) pulmonary infiltrates. Beyond late infancy, neurological symptoms begin to manifest. Classic presentation occurs in mid-to-late childhood with onset of ataxia, vertical supranuclear gaze palsy, and dementia. Dystonia and seizures are common features. Adults are likely to present with dementia or psychiatric symptoms.
Most NPC1 cases involve compound heterozygotes of single-nucleotide variants.12 So far, over 511 variants have been described in NPC1 that cause Niemann Pick disease type C, and over 27 different variants in NPC2. 3
1Park, Walter D et al. “Identification of 58 novel mutations in Niemann-Pick disease type C: correlation with biochemical phenotype and importance of PTC1-like domains in NPC1.” Human mutation vol. 22,4 (2003): 313-25. doi:10.1002/humu.10255
2Millat, Gilles et al. “Niemann-Pick C disease: use of denaturing high performance liquid chromatography for the detection of NPC1 and NPC2 genetic variations and impact on management of patients and families.” Molecular genetics and metabolism vol. 86,1-2 (2005): 220-32. doi:10.1016/j.ymgme.2005.07.007
3Chikh, Karim et al. “Niemann-Pick type C disease: subcellular location and functional characterization of NPC2 proteins with naturally occurring missense mutations.” Human mutation vol. 26,1 (2005): 20-8. doi:10.1002/humu.20173
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