A Case Report of Mucopolysaccharidosis Type VI

Mucopolysaccharidosis type VI (MPS VI) is a lysosomal storage disorder and autosomal recessive caused by arylsulfatase B deficiency in the body and progressive accumulation of glycosaminoglycan in different organs. Considering that this disease has low prevalence in Iran and worldwide, we report a case of MPS VI diagnosis in this study.  A five-year-old boy was referred to Imam Khomeini Clinic in Esfarayen due to impaired growth and dyspnea. In the biography of this boy, there is the history of previous hospitalization due to dyspnea when he was three months, two years and three years old and was treated with antibiotics and salbutamol spray for three days each time. The pediatrician got suspicious of MPS because of the child's peculiar face. Blood tests were performed in terms of the levels of lysosomal enzymes and the urine sample was sent to the Metabolic Laboratory of Hamburg University Medical Center to study the glycosaminoglycan levels. After six months, the results of the tests indicated low levels of serum arylsulfatase B and the increase in chondroitin and urinary levels of dermatan sulfate. To investigate the presence of complications, echocardiography, electromyography, eye and ear examinations as well as radiography for chest, back, hip and hand were performed. Clinical and paraclinical findings confirmed the MPS VI disease and therefore, treatment with naglazyme enzyme was started for the patient. Based on the results of this case report, growth impairment, history of hospitalization due to respiratory problems and the patient’s peculiar face are key points for further investigation regarding MPS VI disease.