| Background: Niemann–Pick is a rare metabolic disease distinguished by lysosomal storage defects. This disease is
characterized by sphingomyelinase acid defciency, causing its accumulation in various organs such as the kidneys,
spleen, liver, brain, and nerves. Niemann–Pick disease is categorized into four groups: A, B, C, and D. Peripheral neuropathy is an extremely rare complication in patients with Niemann–Pick type C, which certainly leads to neurologic
deterioration.
Case presentation: We report a case of Niemann–Pick type C disease in a 3-year-old Iranian Azeri female patient
who was hospitalized twice. The frst time was at 1 month of age with symptoms of splenomegaly, jaundice, and
elevated liver enzymes, and the second time was at around age 2 for loss of mental and physical abilities. The patient
presented with failure to thrive. According to paraclinical examinations, mildly delayed myelination along with a
nonspecifc periventricular hypersignal intensity was seen. Interestingly, the patient’s Niemann–Pick type C enzymatic
function was evaluated twice and was negative on both occasions, while she was positive for NPC1 and NPC2 gene
examinations.
Conclusions: In this study, despite the enzymatic study being negative, Niemann–Pick type C disease was fnally
confrmed, revealing the importance of mutations in Niemann–Pick type C pathogenesis. Besides, peripheral neuropathy was diagnosed in this patient as a very rare symptom of Niemann–Pick type C. |