Title: Friedreich’s Ataxia with Type I Diabetes and Cardiomyopathy in an Adolescent Girl- A Rare Case Study

Authors: Dr Upasana Patra, Dr Chinmayee Mohanty, Dr Budhia Majhi, Dr Lal mohan Alada

 DOI: https://dx.doi.org/10.18535/jmscr/v9i1.21

Abstract

Friedreich’s ataxia is an autosomal recessive spinocerebellar ataxia involving neuromuscular and endocrine system. Usual presentation include progressive gait ataxia, absent deep tendon reflexes, extensor plantar response, cerebellar dysarthria, optic atrophy, neuropathy and loss of proprioception  and vibration . Only few reports have documented the disease onset in childhood , so we are presenting a case of 13year female child with progressive unsteadiness of gait , increased urination, appetite, thirst which was ultimately diagnosed to have friedreich’s ataxia with associated  diabetes and cardiomyopathy. Currently, no definitive therapy is available. Screening, evaluation awareness of underlying endocrinopathies in friedreich’s ataxia may provide new therapeutic targets for preventing Friedreich’s ataxia associated cardiac dysfunction.

Keywords: Friedreich’s ataxia; cerebellar dysarthria; cardiomyopathy; endocrinopathy; autosomal recessive.

References

  1. Swaiman f.kenneth, Ashwal Stephen, ferriro m donna, pediatric neurology, principles and practice; cerebellum and the hereditary ataxia,6th edition; 689-94.
  2. Nelson textbook of paediatrics,21st edition: ataxia: 3150-54
  3. Harding AE. Friedreich ataxia: A clinical and genetic study of 90 families with an analysis of early diagnostic criteria and intrafamilial clustering of clinical features. Brain 1981;104(3):589-620.
  4. Filla A , De Michele G, Cavalcanti F, Pianese L, Monticelle A, Campanella G. The relationship between trinucleotide (GAA) repeat length and clinical features in Friedreich’s ataxia. Am J Hum Genet 1996; 59(3):559-560.
  5. Koeppen AH .F riedreich’s ataxia: Pathology, pathogenesis and molecular genetics. J Neurol Sci.2011;303:1-29
  6. Geoffroy G, Barbeau A ,Breton G, Lemieux B, Aube M, Leger C, et al. Clinical description and roentgenologic evaluation of patients with Friedreich’s ataxia. Can J Neurol Sci 1976;3;279-86
  7. Pandolfo, M. Friedreich ataxia: The clinical picture. J Neurol.2009;256 (suppl 1):3-8.google scholar
  8. Weidemann F, Rummey C, Bijnens B, Stork S, Jasaityte R, Dhooge J, et al. The Heart in Friedreich Ataxia: Definition of cardiomyopathy, disease severity, and correlation with neurological symptoms. Circulation 2012;125(13):1626-34.

Corresponding Author

Dr Upasana Patra

Junior Resident, Dept of Paediatrics, MKCG Medical College, Berhampur, Odisha