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Published on: January 22, 2017
Succinate Dehydrogenase Deficiency: A Treatable Neurometabolic Disorder
Parvaneh Karimzadeh1,2, Mohammad Keramatipour3, Arezou Karamzade4
1Pediatric Neurology Research Center, Research Institute for Children's Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Insights
Succinate dehydrogenase (SDH) deficiency, a rare neurometabolic disorder, can cause developmental delays and brain issues. Early diagnosis and mitochondrial cocktail treatment led to significant improvement in a young patient.
Area of Science:
- Neurology
- Metabolic Disorders
- Genetics
Background:
- Succinate dehydrogenase (SDH) deficiency is a rare autosomal recessive neurometabolic disorder.
- It presents with neurological deficits, developmental delay, exercise intolerance, and cardiomyopathy.
Observation:
- A 25-month-old boy experienced developmental regression post-influenza vaccination.
- MRI revealed white matter changes, and MRS showed a succinate peak.
- Elevated urinary succinic acid and whole exome sequencing confirmed SDH deficiency.
Findings:
- Confirmed SDH deficiency in a pediatric patient presenting with developmental regression and neurological abnormalities.
- Diagnostic findings included characteristic MRI/MRS signals and elevated succinic acid levels.
Implications:
- SDH deficiency is a treatable neurometabolic disorder that requires consideration in developmental disorders with white matter abnormalities.
- Early diagnosis and intervention, such as mitochondrial cocktail therapy, are crucial for improving patient outcomes.
Abstract:
Succinate dehydrogenase (SDH) deficiency is a rare autosomal recessive neurometabolic disorder that causes brain insult, neurodevelopmental delay, exercise intolerance, and cardiomyopathy. A 25-month-old boy was referred to our neurometabolic center due to developmental regression after injecting the influenza vaccine when he was 10 months old. Magnetic resonance imaging (MRI) showed high signal changes in the brain white matter, and magnetic resonance spectroscopy (MRS) detected a high succinate peak at 2.4 parts per million (ppm). The evaluation of urine organic acids showed a significant elevated succinic acid and whole exome sequencing, confirming SDH. Treatment with a mitochondrial cocktail was initiated, and remarkable improvement was observed. SDH deficiency as a treatable neurometabolic disorder should be considered in any patients with developmental disorders, accompanied by hyperintensity in white matter (as similar to leukodystrophia). Further evaluation is recommended since outcomes depend on early diagnosis and treatment.
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