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An X-linked disease of the nervous system with disordered copper metabolism and features differing from Menkes disease

Department of Paediatrics and Neonatal Medicine, Hammersmith Hospital (Drs Haas and Dubowitz), The Hospital for Sick Children (Dr Evans), and the National Hospital for Nervous Diseases (Dr Lascelles), London, and the Wythenshawe Hospital (Dr Robinson), Manchester, Great Britain.

we studied 2 of 4 affected boys with a new disease associated with abnormalities of copper metabolism. The four cases occurred in two generations of a family. This syndrome was similar to Menkes disease in some respects: X-linked recessive inheritance, marked psychomotor retardation with seizures, low serum copper and ceruloplasmin levels, and a block in gut copper absorption. There were also striking differences from Menkes disease. Patients had normal birthweight at term, no hypothermia, and survived beyond the usual Menkes age group with static neurologic disease including hypotonia and choreoathetosis. In addition, general examination of both children was unremarkable apart from undescended testes and growth retardation. The hair, facies, and skin were normal and there was no radiologic evidence of bony changes. Detailed studies of copper absorption were performed.

Address correspondence and reprint requests to Dr Haas, Pediatric Neurology, Box C229, University of Colorado Health Sciences Center, 4200 East Ninth Avenue, Denver, CO 80262.

Accepted for publication September 29, 1980.

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