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Adenine phosphoribosyltransferase deficiency.
Guillaume Bollée1, Jérôme Harambat, Albert Bensman
1Association pour l'Utilisation du Rein Artificiel and Inserm U970, Paris, France. gbollee@gmail.com
Complete adenine phosphoribosyltransferase (APRT) deficiency causes 2,8-dihydroxyadenine (DHA) stones, leading to kidney damage. Early diagnosis and treatment are vital to prevent irreversible renal function loss in this rare inherited metabolic disorder.
Area of Science:
- Biochemistry
- Genetics
- Nephrology
Background:
- Adenine phosphoribosyltransferase (APRT) deficiency is a rare inherited metabolic disorder.
- It causes hyperexcretion of 2,8-dihydroxyadenine (DHA), a compound with low solubility.
- DHA precipitation leads to urinary crystals, stones, and potential kidney damage (DHA nephropathy).
Purpose of the Study:
- To review the genetic and metabolic basis of stone formation and renal disease in APRT deficiency.
- To summarize current diagnostic approaches for APRT deficiency.
- To outline management strategies for APRT deficiency.
Main Methods:
- Literature review of genetic and metabolic mechanisms.
- Analysis of diagnostic tools including stone analysis, crystalluria, and enzyme activity assays.
- Synthesis of information on clinical presentation and treatment.
Main Results:
- APRT deficiency leads to DHA nephrolithiasis and nephropathy.
- Diagnosis is facilitated by specific tests when APRT deficiency is suspected.
- Varied presentation and age of onset can pose diagnostic challenges.
Conclusions:
- Early recognition and treatment of APRT deficiency are critical for preserving renal function.
- Understanding the metabolic pathways is key to managing the condition.
- Prompt intervention can prevent irreversible kidney damage.
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