Coexistence of acid sphingomyelinase deficiency type A/B and Arnold-Chiari malformation: a novel case report

BackgroundAcid sphingomyelinase deficiency (ASMD) type A/B, a rare lysosomal storage disorder caused by biallelic mutations in the SMPD1 gene, presents with variable visceral and neurological manifestations. Arnold-Chiari malformation is a structural defect of the cerebellum and brainstem with disti...

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Main Authors: Aelita Kamalova, Razilya Rakhmaeva, Gulnara Sageeva, Rezeda Safiullina, Adelina Raimova, Elena Gaichik, Dalal Nasr, Ayman A. Gobarah, Ahmed Arafat
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Pediatrics
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Online Access:https://www.frontiersin.org/articles/10.3389/fped.2025.1649007/full
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author Aelita Kamalova
Aelita Kamalova
Razilya Rakhmaeva
Razilya Rakhmaeva
Gulnara Sageeva
Rezeda Safiullina
Adelina Raimova
Elena Gaichik
Dalal Nasr
Ayman A. Gobarah
Ayman A. Gobarah
Ahmed Arafat
Ahmed Arafat
author_facet Aelita Kamalova
Aelita Kamalova
Razilya Rakhmaeva
Razilya Rakhmaeva
Gulnara Sageeva
Rezeda Safiullina
Adelina Raimova
Elena Gaichik
Dalal Nasr
Ayman A. Gobarah
Ayman A. Gobarah
Ahmed Arafat
Ahmed Arafat
author_sort Aelita Kamalova
collection DOAJ
description BackgroundAcid sphingomyelinase deficiency (ASMD) type A/B, a rare lysosomal storage disorder caused by biallelic mutations in the SMPD1 gene, presents with variable visceral and neurological manifestations. Arnold-Chiari malformation is a structural defect of the cerebellum and brainstem with distinct pathogenesis and clinical course. To our knowledge, the coexistence of these two conditions has not been previously reported.Case presentationWe report the case of a 13-year-old patient diagnosed with ASMD type A/B in combination with Arnold-Chiari type I malformation, and secondary interstitial lung disease. The case presented a diagnostic challenge due to overlapping neurological features common to both conditions. The patient exhibited isolated cerebellar signs without MRI evidence of central nervous system involvement typically associated with ASMD. These findings, along with the radiological identification of cerebellar tonsillar herniation, supported Arnold-Chiari I malformation as the primary contributor to the patient's neurological deficits.ConclusionThis is the first documented case of concurrent ASMD type A/B and Arnold-Chiari malformation. The clinical overlap in neurological manifestations complicates differential diagnosis and highlights the need for careful neuroimaging assessment in patients with ASMD presenting with atypical or progressive neurological symptoms. This unique co-occurrence may suggest a broader phenotypic spectrum or a coincidental association requiring further investigation.
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issn 2296-2360
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publisher Frontiers Media S.A.
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spelling doaj-art-9f32166f1e4f46f9928505590bf478b02025-08-25T05:25:33ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602025-08-011310.3389/fped.2025.16490071649007Coexistence of acid sphingomyelinase deficiency type A/B and Arnold-Chiari malformation: a novel case reportAelita Kamalova0Aelita Kamalova1Razilya Rakhmaeva2Razilya Rakhmaeva3Gulnara Sageeva4Rezeda Safiullina5Adelina Raimova6Elena Gaichik7Dalal Nasr8Ayman A. Gobarah9Ayman A. Gobarah10Ahmed Arafat11Ahmed Arafat12Pediatrics Department, Kazan State Medical University of the Ministry of Health of the Russian Federation, Kazan, RussiaPediatric Department of the State Autonomous Heath Institution, Children’s Republican Clinical Hospital (CPCH) of the Ministry of Health of the Russian Federation, Kazan, RussiaPediatrics Department, Kazan State Medical University of the Ministry of Health of the Russian Federation, Kazan, RussiaPediatric Department of the State Autonomous Heath Institution, Children’s Republican Clinical Hospital (CPCH) of the Ministry of Health of the Russian Federation, Kazan, RussiaPediatric Department of the State Autonomous Heath Institution, Children’s Republican Clinical Hospital (CPCH) of the Ministry of Health of the Russian Federation, Kazan, RussiaPediatric Department of the State Autonomous Heath Institution, Children’s Republican Clinical Hospital (CPCH) of the Ministry of Health of the Russian Federation, Kazan, RussiaPediatrics Department, Kazan State Medical University of the Ministry of Health of the Russian Federation, Kazan, RussiaPediatrics Department, Kazan State Medical University of the Ministry of Health of the Russian Federation, Kazan, RussiaPediatrics Department, Kids Heart Medical Center, Abu Dhabi, United Arab EmiratesPediatrics Department, Faculty of Medicine, Suez Canal University, Ismailia, EgyptPediatrics Department, Dubai Academic Health Corporation, Dubai, United Arab EmiratesPediatrics Department, Kazan State Medical University of the Ministry of Health of the Russian Federation, Kazan, RussiaPediatrics Department, Jiahui International Hospital, Shanghai, ChinaBackgroundAcid sphingomyelinase deficiency (ASMD) type A/B, a rare lysosomal storage disorder caused by biallelic mutations in the SMPD1 gene, presents with variable visceral and neurological manifestations. Arnold-Chiari malformation is a structural defect of the cerebellum and brainstem with distinct pathogenesis and clinical course. To our knowledge, the coexistence of these two conditions has not been previously reported.Case presentationWe report the case of a 13-year-old patient diagnosed with ASMD type A/B in combination with Arnold-Chiari type I malformation, and secondary interstitial lung disease. The case presented a diagnostic challenge due to overlapping neurological features common to both conditions. The patient exhibited isolated cerebellar signs without MRI evidence of central nervous system involvement typically associated with ASMD. These findings, along with the radiological identification of cerebellar tonsillar herniation, supported Arnold-Chiari I malformation as the primary contributor to the patient's neurological deficits.ConclusionThis is the first documented case of concurrent ASMD type A/B and Arnold-Chiari malformation. The clinical overlap in neurological manifestations complicates differential diagnosis and highlights the need for careful neuroimaging assessment in patients with ASMD presenting with atypical or progressive neurological symptoms. This unique co-occurrence may suggest a broader phenotypic spectrum or a coincidental association requiring further investigation.https://www.frontiersin.org/articles/10.3389/fped.2025.1649007/fullArnold-Chiari anomalychildrenacid sphingomyelinase deficiency (ASMD) type A/Blysosomal diseasescentral nervous system (CNS)
spellingShingle Aelita Kamalova
Aelita Kamalova
Razilya Rakhmaeva
Razilya Rakhmaeva
Gulnara Sageeva
Rezeda Safiullina
Adelina Raimova
Elena Gaichik
Dalal Nasr
Ayman A. Gobarah
Ayman A. Gobarah
Ahmed Arafat
Ahmed Arafat
Coexistence of acid sphingomyelinase deficiency type A/B and Arnold-Chiari malformation: a novel case report
Frontiers in Pediatrics
Arnold-Chiari anomaly
children
acid sphingomyelinase deficiency (ASMD) type A/B
lysosomal diseases
central nervous system (CNS)
title Coexistence of acid sphingomyelinase deficiency type A/B and Arnold-Chiari malformation: a novel case report
title_full Coexistence of acid sphingomyelinase deficiency type A/B and Arnold-Chiari malformation: a novel case report
title_fullStr Coexistence of acid sphingomyelinase deficiency type A/B and Arnold-Chiari malformation: a novel case report
title_full_unstemmed Coexistence of acid sphingomyelinase deficiency type A/B and Arnold-Chiari malformation: a novel case report
title_short Coexistence of acid sphingomyelinase deficiency type A/B and Arnold-Chiari malformation: a novel case report
title_sort coexistence of acid sphingomyelinase deficiency type a b and arnold chiari malformation a novel case report
topic Arnold-Chiari anomaly
children
acid sphingomyelinase deficiency (ASMD) type A/B
lysosomal diseases
central nervous system (CNS)
url https://www.frontiersin.org/articles/10.3389/fped.2025.1649007/full
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