{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T05:30:48Z","timestamp":1790400648549,"version":"4.1.0"},"reference-count":18,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2021,1,23]],"date-time":"2021-01-23T00:00:00Z","timestamp":1611360000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000781","name":"European Research Council","doi-asserted-by":"publisher","award":["671055"],"award-info":[{"award-number":["671055"]}],"id":[{"id":"10.13039\/501100000781","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Nakalanga syndrome is a clinical manifestation of onchocerciasis-associated epilepsy characterized by stunting, delayed or absent secondary sexual development and skeletal deformities, and is often accompanied by epileptic seizures. The pathophysiology of Nakalanga syndrome is unknown. Here, we describe the post-mortem findings of a 17-year-old female who died with Nakalanga syndrome in northern Uganda. Macroscopic and histopathological examination of all major organs (liver, lungs, kidney and heart), including the brain and the pituitary gland, was performed. The suspected cause of death was malaria, and all major organs and pituitary gland appeared normal, except the lungs, which were edematous consistent with the malaria. Neuropathological changes include signs of neuro-inflammation (gliosis and activated microglia), which co-localized with tau-reactive neurofibrillary tangles and threads. The pathology was most abundant in the frontal cortex, thalamic and hypothalamic regions, and mesencephalon. The choroid plexus showed psammoma bodies. These findings indicate accelerated aging, probably due to repeated seizures. The neuropathological findings were similar to other persons who died with onchocerciasis-associated epilepsy. Examination of the pituitary gland did not reveal new information concerning the underlying pathophysiological mechanism of Nakalanga syndrome. Therefore, more post-mortem studies should be performed.<\/jats:p>","DOI":"10.3390\/pathogens10020116","type":"journal-article","created":{"date-parts":[[2021,1,25]],"date-time":"2021-01-25T09:59:40Z","timestamp":1611568780000},"page":"116","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Neuropathological Changes in Nakalanga Syndrome\u2014A Case Report"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3356-4032","authenticated-orcid":false,"given":"An","family":"Hotterbeekx","sequence":"first","affiliation":[{"name":"Global Health Institute, University of Antwerp, 2100 Antwerp, Belgium"},{"name":"Molecular Pathology Group, Laboratory of Cell Biology &amp; Histology, Faculty of Medicine and Health Sciences, University of Antwerp, 2100 Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3881-6692","authenticated-orcid":false,"given":"Martin","family":"Lammens","sequence":"additional","affiliation":[{"name":"Department of Pathology, Antwerp University Hospital, 2100 Antwerp, Belgium"},{"name":"Department of Neuropathology, Born-Bunge Institute, University of Antwerp, 2100 Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvester","family":"Onzivua","sequence":"additional","affiliation":[{"name":"Department of Pathology, Makerere University Medical School, Kampala P.O. Box 7072, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Lukande","sequence":"additional","affiliation":[{"name":"Department of Pathology, Makerere University Medical School, Kampala P.O. Box 7072, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francis","family":"Olwa","sequence":"additional","affiliation":[{"name":"Department of Diagnostics, Faculty of Health Sciences, Lira University, Lira P. O. Box 1035, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samir","family":"Kumar-Singh","sequence":"additional","affiliation":[{"name":"Molecular Pathology Group, Laboratory of Cell Biology &amp; Histology, Faculty of Medicine and Health Sciences, University of Antwerp, 2100 Antwerp, Belgium"},{"name":"Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, 2100 Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4296-8493","authenticated-orcid":false,"given":"Stijn","family":"Van Hees","sequence":"additional","affiliation":[{"name":"Global Health Institute, University of Antwerp, 2100 Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Idro","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Makerere University Medical School, Kampala P.O. Box 7072, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1919-1340","authenticated-orcid":false,"given":"Robert","family":"Colebunders","sequence":"additional","affiliation":[{"name":"Global Health Institute, University of Antwerp, 2100 Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,1,23]]},"reference":[{"key":"ref_1","first-page":"11","article-title":"El sindrome epileptico y sus relaciones con la Oncocercosis","volume":"1","author":"Sacre","year":"1938","journal-title":"Bol. Salubr. Hig."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"F\u00f6ger, K., Gora-Stahlberg, G., Sejvar, J., Ovuga, E., Jilek-Aall, L., Schmutzhard, E., Kaiser, C., and Winkler, A.S. (2017). Nakalanga Syndrome: Clinical Characteristics, Potential Causes, and Its Relationship with Recently Described Nodding Syndrome. PLoS Negl. Trop. 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