Cerebral Venous Sinus Thrombosis in a Child with Lesch-Nyhan Syndrome.

Abstract

Lesch-Nyhan syndrome is a rare neurometabolic condition characterized by progressive choreoathetosis, intellectual disability, and peculiar manifestations like self-mutilation. Occasional case reports in adults have suggested an association between Lesch-Nyhan syndrome and hypercoagulability; however, no such report of either a venous or arterial stroke in children with Lesch-Nyhan Syndrome exists in literature. We present a 3-year-old boy with global developmental delay, dystonic posturing, choreoathetoid movements, and self-mutilation involving fingers and lips. He had acute worsening of sensorium, recurrent seizures, and opisthotonous posturing. A diagnosis of Lesch-Nyhan Syndrome was confirmed by extremely low hypoxanthine-guanine phosphoribosyltransferase enzyme levels. In view of an acute neurological deterioration, magnetic resonance imaging brain and magnetic resonance venogram were done that showed sagittal and left transverse venous sinus thrombosis. This case is the first case report of cerebral venous sinus thrombosis in a child with Lesch-Nyhan Syndrome. It further strengthens the association between hypercoagulability and Lesch-Nyhan syndrome.

• Authors: Ranjith K Manokaran, Prashant Jauhari, Biswaroop Chakrabarty, Neerja Gupta, Atin Kumar, Sheffali Gulati
• Journal: Neurology India (Neurol India) 2021 Jul-Aug Vol. 69 Issue 4 Pg. 1021-1023 ISSN: 1998-4022 [Electronic] India
• PMID: 34507434 (Publication Type: Case Reports)

Chemical References

• Hypoxanthine Phosphoribosyltransferase

Topics

• Adult
• Child
• Child, Preschool
• Family
• Humans
• Hypoxanthine Phosphoribosyltransferase
• Lesch-Nyhan Syndrome
• Male
• Self Mutilation
• Sinus Thrombosis, Intracranial (complications, diagnostic imaging)