Hermansky-Pudlak syndrome with special reference to lysosomal dysfunction. A case report and review of the literature.

In addition to the triad in the Hermansky-Pudlak syndrome (tyrosine-positive oculocutaneous albinism, mild bleeding tendency with a normal platelet-count and widespread accumulation of ceroid-like pigment in various organs), we document severe pulmonary fibrosis, pseudomelanosis coli and deeply pigmented renal cortex. In the liver, innumerable number of pigment-laden Kupffer cells and macrophages in the Glisson capsule were seen. Interestingly, many intralysosomal accumulations of the pigment within the hepatocytes were found by electron microscopy, suggesting that these configurations possibly resulted from a dysfunction of the lysosome itself, especially with regard to loss of digestive and secretory activity. The triad and other complications may also be resultants of a lysosomal dysfunction.