Mevalonate kinase deficiency: Evidence for a phenotypic continuum
A Simon1, H P H Kremer, R A Wevers
1Departments of General Internal Medicine, Section of DNA Diagnostics, Laboratory for Pediatrics and Neurology, University Medical Center St. Radboud, Nijmegen, the Netherlands. a.simon@aig.umcn.nl
Mevalonate kinase deficiency causes mevalonic aciduria and hyper-immunoglobulin D syndrome. A review found adult patients with overlapping symptoms, suggesting a disease spectrum.
Area of Science:
- Biochemistry
- Genetics
- Immunology
Background:
- Mevalonic aciduria and hyper-immunoglobulin D syndrome stem from mevalonate kinase deficiency.
- These conditions present with distinct symptoms: psychomotor retardation and ataxia in mevalonic aciduria, versus recurrent fevers without neurological issues in hyper-IgD syndrome.
Observation:
- A systematic review identified five adult patients exhibiting phenotypic overlap between mevalonic aciduria and hyper-IgD syndrome.
- These cases suggest a continuous spectrum of disease rather than distinct entities.
Findings:
- Mevalonate kinase deficiency manifests across a spectrum in adults.
- Phenotypic overlap challenges traditional diagnostic separation of these two related disorders.
Implications:
- Mevalonate kinase deficiency should be considered in adult patients presenting with neurological symptoms, even in the absence of periodic fever attacks.
- This broadens the diagnostic considerations for adult-onset neurological and inflammatory conditions.
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