Mistake in diagnosis, Diagnostic / therapeutic accidents, Unusual setting of medical care, Rare disease, Congenital defects / diseases, Educational Purpose (only if useful for a systematic review or synthesis)
Marta Navratil, Vlasta Đuranović, Boro Nogalo, Alen Švigir, Iva Dumbović Dubravčić, Mirjana Turkalj
Department of Allergy and Immunology, Srebrnjak Children’s Hospital, Zagreb, Croatia
Am J Case Rep 2015; 16:631-636
Ataxia-telangiectasia (A-T) is an autosomal recessive disease that consists of progressive cerebellar ataxia, variable immunodeficiency, sinopulmonary infections, oculocutaneous telangiectasia, radiosensitivity, early aging, and increased incidence of cancer.
CASE REPORT: We report the case of an 8-year-old boy affected by A-T. At 12 months of age, he had a waddling gait, with his upper body leaning forward. Dystonic/dyskinetic cerebral palsy was diagnosed at the age of 3 years. At age 6 he was diagnosed with asthma based on recurrent wheezing episodes. A-T was confirmed at the age 8 years on the basis of clinical signs and laboratory findings (increased alpha fetoprotein - AFP, immunodeficiency, undetectable ataxia-telangiectasia mutated (ATM) protein on immunoblotting, and identification A-T mutation, 5932G>T).
CONCLUSIONS: The clinical and immunological presentation of ataxia-telangiectasia (A-T) is very heterogeneous and diagnostically challenging, especially at an early age, leading to frequent misdiagnosis.
Keywords: Ataxia Telangiectasia Mutated Proteins - metabolism, Ataxia Telangiectasia - genetics, Cerebral Palsy - etiology, Child, DNA - genetics, DNA Mutational Analysis, Diagnosis, Differential, Genetic Markers, Humans, Male, Mutation, Respiratory Sounds - etiology