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Published on: June 25, 2010
Ethylmalonic Encephalopathy in an Indian Boy
Sunita Bijarnia-Mahay1, Deepti Gupta, Yosuke Shigematsu
1Institute of Medical Genetics and Genomics and $Department of Molecular Genetics, Sir Ganga Ram Hospital, New Delhi, India; *Department of Health Science, University of Fukui, Japan; and #Department of Pediatrics, Shimane University School of Medicine, Izumo, Shimane, Japan. Correspondence to: Dr Sunita Bijarnia-Mahay, Senior Consultant and Associate Professor, GRIPMER, Institute of Medical Genetics and Genomics, Sir Ganga Ram Hospital, Rajinder Nagar, New Delhi 110 060, India. bijarnia@gmail.com.
Ethylmalonic encephalopathy (EE) is a rare metabolic disorder. Early recognition of its distinct clinical signs aids diagnosis in affected children.
Area of Science:
- Biochemistry
- Genetics
- Pediatric Neurology
Background:
- Ethylmalonic encephalopathy (EE) is a rare inherited metabolic disorder.
- Characterized by neurodevelopmental delay, petechiae, acrocyanosis, and chronic diarrhea.
Observation:
- A 4-year-old boy presented with developmental regression, chronic diarrhea, petechiae, and acrocyanosis.
- Brain MRI revealed T2W/FLAIR hyperintensities in the caudate and putamen.
- Abnormal acyl-carnitine profiles and urinary GC-MS metabolites indicated EE.
Findings:
- Genetic analysis identified ETHE1 gene mutations: c.488G>A and a novel c.375+5G>T.
- These mutations are associated with the observed clinical and radiological features of EE.
Implications:
- EE is a clinically recognizable disorder with characteristic symptoms.
- Prompt diagnosis through clinical evaluation and biochemical/genetic testing is crucial for management.
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