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Absence of Acanthocytosis in Huntington’s Disease-like 2: A Prospective Comparison with Huntington’s Disease

Authors:

David G. Anderson ,

Department of Neurology, The University of the Witwatersrand Donald Gordon Medical Center, Johannesburg; Division of Human Genetics, University of the Witwatersrand, Johannesburg, ZA
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Sergio Carmona,

Department of Molecular Medicine and Haematology, University of the Witwatersrand, Johannesburg, ZA
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Kubendran Naidoo,

Department of Molecular Medicine and Haematology, University of the Witwatersrand, Johannesburg, ZA
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Theresa L. Coetzer,

Department of Molecular Medicine and Haematology, University of the Witwatersrand, Johannesburg, ZA
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Jonathan Carr,

Department of Neurology, University of Stellenbosch, Cape Town, ZA
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Dobrila D. Rudnicki,

Office of Special Initiatives, National Center for Advancing Translational Sciences, NIH, Bethesda, MD; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, US
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Ruth H. Walker,

Department of Neurology, James J. Peters Veterans Affairs Medical Center, New York, NY; Department of Neurology, Mount Sinai School of Medicine, New York City, NY, US
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Russell L. Margolis,

Departments of Psychiatry and Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, US
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Amanda Krause

Division of Human Genetics, University of the Witwatersrand, Johannesburg; Division of Human Genetics, National Health Laboratory Service, Johannesburg, ZA
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Abstract

Background: Huntington’s Disease-like 2 (HDL2) is classified as a neuroacanthocytosis; however, this remains unverified. We aim to determine if acanthocytes are present in HDL2 and whether acanthocytes can differentiate HDL2 from Huntington’s disease (HD).

Methods: We prospectively compared 13 HD and 12 HDL2 cases against 21 unaffected controls in Johannesburg. Blood smears were prepared using international standards and reviewed by at least two blinded reviewers. An acanthocytosis rate of greater than 1.2% in the dry smear or greater than 3.7% in the wet smear was designated a priori as the threshold for clinical significance based on previously established standards. Flow cytometry was performed on all but four of the cases. Red cell membrane protein analysis was performed on all participants.

Results: There were 12 HDL2, 13 HD, and 21 controls enrolled. None of the HD or HDL2 participants had defined acanthocytosis or other morphological abnormalities. None of the HD or HDL2 cases had evidence of an abnormal band 3.

Discussion: Acanthocytosis was not identified in either HDL2 or HD in our patient population. Our results, based on the first prospective study of acanthocytes in HDL2 or HD, suggest that screening for acanthocytes will not help establish the diagnosis of HD or HDL2, nor differentiate between the two disorders and raises the question if HDL2 should be placed within the neuroacanthocytosis syndromes.

How to Cite: Anderson DG, Carmona S, Naidoo K, Coetzer TL, Carr J, Rudnicki DD, et al.. Absence of Acanthocytosis in Huntington’s Disease-like 2: A Prospective Comparison with Huntington’s Disease. Tremor and Other Hyperkinetic Movements. 2017;7:512. DOI: http://doi.org/10.7916/D81J9PDX
Published on 05 Dec 2017.
Peer Reviewed

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