Korean J Pediatr.  2008 May;51(5):538-541. 10.3345/kjp.2008.51.5.538.

A case of Menkes disease with unusual hepatomegaly

• Jeong GU
• Cho A
• Hwang H
• Hwang YS
• Kim KJ
• Chae JH
• Seo JK

• KMID: 2280463
• DOI: http://doi.org/10.3345/kjp.2008.51.5.538

Abstract

Menkes disease is an X-linked recessive copper transport disorder characterized by neurological deterioration, connective-tissue damage, and abnormal hair growth. It is caused by the mutation of the ATP7A gene. This report describes a four-month-old boy with neurological symptoms typical of Menkes disease plus unusual liver involvement. He developed seizures at three months of age and exhibited hypotonia, cephalhematoma, a sagging face, redundant and hypopigmented skin, and abnormal hair growth. In addition, he had unexplained hepatomegaly and high hepatic transaminase. We confirmed the diagnosis of Menkes disease by mutation analysis of the ATP7A gene. To exclude other possible causes for the hepatic abnormalities, a liver biopsy was performed, revealing intracytoplasmic cholestasis, focal spotty necrosis, and minimal lobular activity. The patient's liver involvement may be an underestimated complication of Menkes disease.

Keyword

Menkes disease; ATP7A gene; Heptomegaly; Infantile spasm

MeSH Terms

Biopsy
Cholestasis
Copper
Hair
Hepatomegaly
Infant
Infant, Newborn
Liver
Menkes Kinky Hair Syndrome
Muscle Hypotonia
Necrosis
Seizures
Skin
Spasms, Infantile
Copper