A Case of Menkes disease with Infantile Spasm.

Ahn,  So Hyun; Park,  Sin Young; Kang,  Sung Gil; Lee,  Ji Eun; Kwon,  Young Se; Son,  Byung Kwan; Yoo,  Han Wook

Case Report

Journal of the Korean Child Neurology Society 2007;15(2):199-204.
Published online November 30, 2007.

A Case of Menkes disease with Infantile Spasm.

So Hyun Ahn, Sin Young Park, Sung Gil Kang, Ji Eun Lee, Young Se Kwon, Byung Kwan Son, Han Wook Yoo

¹Department of Pediatrics, College of Medicine, Inha University, Incheon, Korea. ysped@inha.ac.kr
²Department of Pediatrics, College of Medicine, Ulsan University, Seoul, Korea.

Abstract

Menkes disease, so called kinky-hair syndrome, is a rare, genetic and progressive neurodegenerative disorder. It is caused by a mutation in the ATP7A gene, which codes for the copper transporting ATPase in the cell organelles. The dysfunction of many copper-dependent enzymes results in low concentration of copper in some tissues and accumulation of copper in others. We report a boy presented with kinky hairs, developmental delay, hypotonia and connective tissue abnormalities at the age of 4 months. Despite the treatment with various antiepileptic drugs, atonic seizures still persisted. At the age of 7 months, his atonic seizures was changed into extensor spasms with modified hypsarrhythmia for some years. The seizure were controlled by topiramate and vigabatrin. At the age of 22 months, serum copper and ceruloplasmin rechecked as 17 ug/dL(80-150 ug/dL) and 7.3 mg/dL(20-46 mg/ dL) respectively. The gene study showed ATP7A mutation and the patient was diagnosed as Menkes disease so that copper-histidine was daily injected. We experienced a case of a 4-month-old boy with Menkes disease and infantile spasm, confirmed by ATP7A mutation.

Key Words: Menkes disease, Infantile spasm, ATP7A mutation