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Hepatic lipidosis in dairy cows is the result of a disturbed balance between the uptake of non-esterified fatty acids (NEFA), their metabolism in the hepatocytes, and the limited efflux of TG as very-low-density lipoprotein (VLDL). Lipidosis and the associated risk for ketosis represents a consequence of selecting dairy cows primarily for milk production without considering the basic physiological mechanisms of this trait. The overall risk for lipidosis and ketosis possesses a genetic background and the recently released new breeding value of the German Holstein Friesian cows now sets the path for correction of this risk and in that confirms the assumed genetic threat. Ectopic fat deposition in the liver is the result of various steps including lipolysis, uptake of fat by the liver cell, its metabolism, and finally release as very-low-density lipoprotein (VLDL). These reactions may be modulated directly or indirectly and hence, serve as basis for prophylactic measures. The pertaining methods are described in order to support an improved understanding of the pathogenesis of lipidosis and ketosis. They consist of feeding a glucogenic diet, restricted feeding during the close-up time as well as supplementation with choline, niacin, carnitine, or the reduction of milking frequency. Prophylactic measures for the prevention of ketosis are also included in this discussion., Competing Interests: Es liegt kein Interessenkonflikt vor., (Thieme. All rights reserved.)

Metabolic disorders of energy production characterise the group of rare, mainly autosomal recessively inherited metabolic muscular diseases which are often associated with multi-systemic symptoms. In this report, an update on the clinics, pathophysiology, pathomorphology and current treatment options of metabolic myopathies will be given. Beyond classic phenotypes of these disorders, one should be aware of oligosymptomatic patients who can be easily missed. The relevant gene mutations and the pathophysiology and pathomorphology they cause are now known for almost all these metabolic diseases. Establishing the correct diagnosis has become even more important since highly specific therapy options are now available for at least some of these inherited disorders, e.g. enzyme replacement therapy in Pompe disease.

A short survey on the sphingolipid storage diseases is presented. The chemical nature of the accumulated substances is related to the genetically induced enzymic blocks on their biodegradation. Two disorders are stressed with alter the nervous system: metachromatic leukodystrophy and familiar infantile amaurotic idiocy (GM2-gangliosidosis). The difficulties in the causal interpretation of three variants of the latter disease due to the involvement of isoenzymes are dealt with. The relationship between the enzyme defect in these disorders and their time of clinical onset is discussed. Finally, the diagnostic possibilities are presented which are a prerequisite for preventing a further dissemination of these therapy-resistent inborn errors of metabolism.

This report deals with the description of a typical case of hyalinosis cutis et mucosae Urbach-Wiethe and with the clinical and histological differential diagnosis to erythropoetic protoporphyria.

A daughter and two sons of possibly consangineous parents died after motor and mental deterioration at 18, 16 and 15 months of age. Spongy degeneration of the CNS (Canavan-van-Bogaert-Bertrand type) was diagnosed on neuropathological examinationtion; the histological findings were almost identical in the patients. Own clinical experiences are compared with reports from the literature; data important in clinical and differential diagnosis are reviewed. Pathogenetical and etiological aspects are discussed; autosomal recessive inheritance has to be considered in genetic counselling.

After positive prenatal enzymic diagnosis of different neurolipidoses therapeutic abortion was carried out in the 19th to 25th week of pregnancy. Ten delivered fetuses were studied ultrastructurally and in nine of them positive results were obtained, although in some cases one had to accept relatively poor structural conservation of fetal tissues. The ultrastructure of the quantitatively small lipid storage effects qualitatively resembled that of the postnatal stages with some exceptions of localization. In fetal GM2-gangliosidosis type 2 (variant 0) concentric membranous cytoplasmic bodies were detected in the brain cortex. In Krabbe's disease the myelinated regions of the spinal cord showed scattered storage (globoid) cells, sometimes closely related to blood vessels, which contained isolated or stranded tubular or spicular inclusions. In GM1-gangliosidosis type 1 neurons of the brain stem showed lamellar inclusions structured as zebra bodies, and splenic histiocytes exhibited numerous almost clear cytoplasmic vacuoles. In fetal metachromatic leukodystrophy the CNS including myelinated regions was essentially free of morphologic lipid storage effects. However, many kidney tubules cells contained great numbers of irregular or roughly parallel stacks of membranes. These inclusions may be equivalent to "tuffstone" bodies. In one fetus the bodies were restricted to tubular cells bearing microvilli. Fluorescent microscopy of arcus of the kidney tubule showed excess amounts of metachromatic material. Less of this material was demonstrable in the envelope layer of hepatic Glisson triangles. In the fetus with Niemann-Pick disease type C large neurons of the basal ganglia and the spinal cord were filled with membranous inclusions that were similar to myelin-shaped bodies rather than to solid membraneous bodies. The 19-weeks-old fetus with enzymically proven Gaucher disease was free of ultrastructural lipid storage effects. Most but not all of the morphological findings in the fetuses with neurolipidoses were in accordance with published results.