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Metachromatic leukodystrophy
Etiology
An autosomally recessively inherited white matter dysmyelination due to absence or decrease of of the enzyme Arylsulphatase A.
Pathogenesis
The lack of arylsulfatase A, a lysosomal enzyme, causes build up of cerebroside sulfatides which be produce demyelination although the exact mechanism is not known.,
Epidemiology
The disease is seen in infants, juveniles and adults. It is quite rare.
General Gross Description
The white matter of the cerebral and cerebellar hemispheres has a chalky white to greyish appearance which is firm in texture.
•Examples:
General Microscopic Description
Microscopically there is loss of myelin and collections of cerebroside sulfatides inside and outside of macrophages. The sulfatides stain with PAS and metachromatically brown with acid cresyl violet. Metachromasia means staining a different color than expected - that is, acid cresyl violet usually stains cells violet but in this case it stains them brown. Proliferation of reactive astrocytes is also seen.
•Examples:
Metachromatic Leukodystrophy (low power) Metachromatic Leukodystrophy (low power) Metachromatic Leukodystrophy (high power)
References
1. Graham and Lantos. Greenfield's Neuropathology 1997. pp 689-691. 2. Cotran, Kumar and Robbins. Pathologic Basis of Disease 5th edition. pp 1338.

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Metachromatic leukodystrophy
Synopsis by: Dr ML Grunnet (TX2000D14110)[604]
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