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Triple A syndrome in Japan.
[triple a syndrome]
Triple
A
syndrome
is
an
autosomal
recessive
disease
,
characterized
by
esophageal
achalasia
,
alacrima
,
and
adrenal
insufficiency
,
as
well
as
involvement
of
the
central
,
peripheral
,
and
autonomic
nervous
systems
.
This
disease
mimics
amyotrophic
lateral
sclerosis
in
some
patients
.
The
causative
gene
encodes
ALADIN
,
a
nuclear
pore
complex
(
NPC
)
component
.
Only
5
patients
have
been
reported
in
Japan
.
We
conducted
the
first
nationwide
survey
of
triple
A
syndrome
.
Identified
mutants
were
expressed
as
GFP-
fusion
proteins
in
cultured
cells
.
T
wo
new
patients
were
identified
,
and
1
had
a
novel
mutation
(
p
.
Ser
182
fsX
19
)
.
All
mutant
proteins
tested
were
mislocalized
from
NPC
to
cytoplasm
.
The
most
consistent
neurological
manifestation
of
triple
A
syndrome
in
Japanese
patients
was
progressive
bulbospinal
muscular
atrophy
with
both
upper
and
lower
motor
neuron
involvement
,
which
mimicked
motor
neuron
disease
,
similar
to
that
seen
in
patients
in
Western
countries
.
The
identification
of
the
new
patients
suggests
that
more
cases
are
undiagnosed
in
Japan
.
Diseases
Validation
Diseases presenting
"consistent neurological manifestation"
symptom
triple a syndrome
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