Abstract

Alexander disease (AD) is a rare neurodegenerative disorder characterized by megalencephaly, leukoencephalopathy, and Rosenthal fibers within astrocytes. This report describes the case of a female patient with sonography-detected ventriculomegaly at 32 weeks' gestation and distinctive MR imaging features at 33 and 36 weeks' gestation, at birth, and at 2 months of age, which led to the suggested diagnosis of Alexander disease. Molecular analysis confirmed a missense mutation in the GFAP gene. The literature contains little information on the fetal MR imaging findings that may allow prenatal diagnosis of AD.

Highlights

  • The most distinctive histologic feature of Alexander disease (AD) is the presence of countless Rosenthal fibers throughout the CNS

  • Presence of prenatal hydrocephalus and abnormal frontal white matter make us rule out AD

  • Infantile AD is the most common, accounting for approximately 80% of cases

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Summary

CASE REPORT

SUMMARY: Alexander disease (AD) is a rare neurodegenerative disorder characterized by megalencephaly, leukoencephalopathy, and Rosenthal fibers within astrocytes. This report describes the case of a female patient with sonography-detected ventriculomegaly at weeks’ gestation and distinctive MR imaging features at and 36 weeks’ gestation, at birth, and at 2 months of age, which led to the suggested diagnosis of Alexander disease. Molecular analysis confirmed a missense mutation in the GFAP gene.

Findings
PEDIATRICS CASE REPORT
Discussion
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