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Arginase deficiency with parotid gland swelling and hyperamylasemia: A case report
Noboru Kuyama1,2, Shigeru Nagaki1,3, Akie Miyamoto1
1Department of Pediatrics, Tokyo Women's Medical University, Tokyo, Japan.
Insights
Arginase deficiency, a rare genetic disorder, causes neurological issues and hyperammonemia crises. Early symptoms like parotid swelling can precede diagnosis, highlighting the need for awareness in neurological patient care.
Area of Science:
- Biochemistry
- Genetics
- Neurology
Background:
- Arginase deficiency is a rare autosomal recessive metabolic disorder.
- It leads to progressive neurological impairment and episodic hyperammonemia.
- Early diagnosis is often delayed due to non-specific symptoms.
Abstract:
Arginase deficiency is a progressive neurological disorder characterized by episodic hyperammonemia crises. Our patient had been diagnosed with cerebral palsy (spastic paraplegia) in childhood and received rehabilitation. She had suffered parotid swelling since the age of 5 years, prior to liver dysfunction becoming apparent, and then developed hyperamylasemia at 8 years of age. At age 25 years, she presented with hyperammonemia and elevations of aspartate aminotransferase and alanine aminotransferase. At age 27 years, she was diagnosed with arginase deficiency due to hyperargininemia and absent arginase activity in erythrocytes. Liver cirrhosis was also present. She was hospitalized several times for management of episodic hyperammonemia due to recurrent viral infections, an unbalanced diet, and poor compliance with medications.
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