Summary
Progressive dementia had developed since the age of 55 in a male patient, who had worked as an aluminum refiner for 30 years. Balint's syndrome was observed from at 60 and he died of bronchopneumonia at 65. Neuropathological examination revealed characteristic features of Alzheimer's disease with marked atrophy of the occipito-temporal lobes and senile plaques of the cerebellum. Wavelength-dispersive X-ray microanalysis disclosed focal aluminum accumulation within the nucleus and cytoplasm of the tangle-bearing neurons. Microanalysis by the same method failed to disclose aluminum accumulation in the tangle-bearing neurons in a case of senile dementia of Alzheimer's type who had no possible inhalation of aluminum.
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References
Burks JS, Alfrey AC, Huddlestone J, Norenberg MD, Lewin E (1976) A fatal encephalopathy in chronic hemodialysis patients. Lancet 1:764–768
Crapper DR, Krishnan SS, Dalton AJ (1973) Brain aluminum distribution in Alzheimer's disease and experimental neurofibrillary degeneration. Science 180:511–513
Crapper DR, Krishnan SS, Quittkat S (1976) Aluminium, neurofibrillary degeneration and Alzheimer's disease. Brain 99:67–80
Crapper DR, Quittkat S, Krishnan SS, Dalton AJ, De Boni U (1980) Intranuclear aluminum content in Alzheimer's disease, dialysis encephalopathy, and experimental aluminum encephalopathy. Acta Neuropathol (Berl) 50:19–24
De Boni U, Otvos A, Scott JW, Crapper DR (1976) Neurofibrillary degeneration induced by systemic aluminum. Acta Neuropathol (Berl) 35:285–294
Hamanaka T, Nakae I, Ikemura Y, Ohashi H (1967) Ein Fall eigenartiger präseniler Demenz mit isolierter optischer Agnosie — Ein Beitrag zum Problem der sogenannten „occipitalen Form Pickscher Krankheit”. Rinsho Shinkeigaku 9:19–27
Hécaen H, De Ajuriaguerra J (1954) Balint's syndrome (psychic paralysis of visual fixation) and its minor forms. Brain 77:373–400
Klatzo I, Wisniewski H, Streicher E (1965) Experimental production of neurofibrillary degeneration. I. Light microscopic observations. J Neuropathol Exp Neurol 24:187–199
Lifshin E, Ciccarelli MF (1973) Present trends in X-ray analysis with the SEM. In: Johari O, Corvin I (eds) Scanning electron microscopy. IIT Research Institute, Chicago, pp 89–96
McDermott JR, Smith AI, Ward MK, Parkinson IS, Kerr DNS (1978) Brain-aluminium concentration in dialysis encephalopathy. Lancet I:901–904
McDermott JR, Smith AI, Iqbal K, Wisniewski HM (1979) Brain aluminum in aging and Alzheimer disease. Neurology 29:809–814
McLaughlin AIG, Kazantzis G, King E, Teare D, Porter RJ, Owen R (1962) Pulmonary fibrosis and encephalopathy associated with the inhalation of aluminium dust. Br J Ind Med 19:253–263
Mitsuyama Y, Murayama Y, Ata K (1984) An autopsy case of Alzheimer's disease with senile plaques in the cerebellum. Kyushu Neuro-Psychiatry 30:274–285
Perl DP, Brody AR (1980) Alzheimer's disease: X-ray spectrometric evidence of aluminum accumulation in neurofibrillary tangle-bearing neurons. Science 208:297–299
Perl DP, Gajdusek DC, Garruto RM, Yanagihara RT, Gibbs CJ (1982) Intraneuronal aluminum accumulation in amyotrophic lateral sclerosis and parkinsonism-dementia of Guam. Science 217:1053–1055
Pro JD, Smith CH, Sumi SM (1980) Presenile Alzheimer disease: amyloid plaques in the cerebellum. Neurology 30:820–825
Scherp HW, Church CF (1937) Neurotoxic action of aluminum salts. Proc Soc Exp Biol Med 32:851–853
Terry RD, Pena C (1965) Experimental production of neurofibrillary degeneration. 2. Electron microscopy, phosphatase histochemistry and electron probe analysis. J Neuropathol Exp Neurol 24:200–210
Utsuyama M, Kimula Y (1980) Application of histological sections to wavelength-dispersive X-ray microanalysis. J Electron Microsc (Tokyo) 29:199–201
Wisniewski H, Terry RD, Hirano A (1970) Neurofibrillary pathology. J Neuropathol Exp Neurol 29:163–176
Wisniewski HM, Korthals JK, Kopeloff LM, Ferszt R, Chusid JC, Terry RD (1977) Neurotoxicity of aluminum. In: Roizin L, Shiraki H, Grćević N (eds) Neurotoxicology. Raven Press, New York, pp 313–315
Wisniewski HM, Sturman JA, Shek JW (1980) Aluminum chloride induced neurofibrillary changes in the developing rabbit: a chronic animal model. Ann Neurol 8:479–490
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Kobayashi, S., Hirota, N., Saito, K. et al. Aluminum accumulation in tangle-bearing neurons of Alzheimer's disease with Balint's syndrome in a long-term aluminum refiner. Acta Neuropathol 74, 47–52 (1987). https://doi.org/10.1007/BF00688337
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DOI: https://doi.org/10.1007/BF00688337