• Takayuki Katayama, Kae Takahashi, Osamu Yahara, Jun Sawada, Ken-Ichi Ishida, Asuka Asanome, Hisako Endo, Tsukasa Saito, Naoyuki Hasebe, Mari Kishibe, Harumi Kanno, Satoshi Ishiko, and Jun Sone.
• Department of Neurology, Asahikawa City Hospital, Japan.
• Medicine (Baltimore). 2023 May 12; 102 (19): e33789e33789.

IntroductionNeuronal intranuclear inclusion disease (NIID) is a neurodegenerative disorder that produces a broad spectrum of clinical conditions such as dementia, upper motor neuron involvement, extrapyramidal symptoms, and neuropathy. Some studies have reported ophthalmological conditions associated with the disease; however, the details of these conditions remain unclear.Patient ConcernsWe report a 63-year-old Japanese female with cognitive decline, blurred vision, photophobia, and color blindness at 52 years of age who was diagnosed with cone dystrophy. She also had anxiety, insomnia, depression, delusions, hallucinations, a wide-based gait with short steps, and urinary incontinence.Diagnoses, Interventions, And OutcomesMagnetic resonance imaging revealed diffuse cerebral white matter changes and subcortical hyperintensity on diffusion-weighted imaging. Skin biopsy showed p62-positive intranuclear inclusions in sweat glands. NOTCH2NLC gene analysis revealed abnormal GGC expansion; therefore, NIID was diagnosed.ConclusionNOTCH2NLC mutation-positive NIID may be associated with retinal dystrophy. Brain magnetic resonance imaging and skin biopsy are helpful diagnostic clues, and gene analysis is crucial for accurate diagnosis and appropriate management.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.

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