NIEMANN-PICK DISEASE

inherited metabolic disorder in which a deficiency of the enzyme sphingomyelinase impairs the breakdown of the phospholipids lecithin and sphingomyelin, causing them to accumulate in various body tissues. Symptoms consist of extreme liver and spleen enlargement, mental retardation, and a brownish-yellow skin discoloration; foamy cells containing phospholipids are found in several organs. There are five distinct varieties of the disease, the most common of which is the acute infantile form (type A). Affected infants are retarded in growth; they lose weight and undergo a decline in mental and neurologic functions, usually dying by age four. In the chronic visceral form (type B), development is normal for several years until poor muscle coordination and liver enlargement become apparent; there are no mental or other neurologic symptoms. Type C, which appears in adolescence, is similar to the acute infantile form, as is type D, which is found among a small group of people whose common ancestry is traced to Nova Scotia. The rare adult form (type E) resembles chronic visceral disease, but symptoms leading to diagnosis do not become apparent until adulthood.