Chediak‐Higashi syndrome presenting as young‐onset levodopa‐responsive parkinsonism

Abstract

Chediak-Higashi syndrome (CHS) (OMIM #214500) is a rare autosomal recessive disorder caused by mutations in the lysosomal trafficking regulator gene, LYST, or CHS1. Typically, CHS presents, with variable degrees of oculocutaneous albinism, immunodeficiency, bleeding diathesis and hemophagocytic lymphohistiocytosis (HLH or the “accelerated phase”).1 Neurological involvement in CHS can include intellectual impairment, sensory-motor neuropathy, cerebellar disease, and dementia.2, 3 Parkinsonism and its response to dopaminergic therapy has rarely been reported.2,4,5 A subset of CHS patients have a muted pigmentary or hematological presentation while their neurological symptoms dominate their disease.6, 7 We a provide video illustration of his therapeutic response to levodopa along with skin pigment dilution features, brain imaging and leukocyte morphology in a young adult male with CHS whose clinical presentation is dominated by motor and non-motor parkinsonian symptoms with a brisk and sustained therapeutic response to levodopa therapy.