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Updated: Jun 7, 2025

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Child Neurology: Five-Year Update on Siblings With Riboflavin Transporter Deficiency: Stable Visual and Neurologic

Marisa A O'Brien1, Susan M Culican1, Marwan S Shinawi1

  • 1From the Department of Ophthalmology and Visual Sciences (M.A.O.), Division of Genetics and Genomic Medicine (M.S.S.), and Division of Pediatric and Developmental Neurology (C.M.Z.), Washington University School of Medicine, St. Louis, MO; Graduate Medical Education Office (S.M.C.) and Department of Ophthalmology and Visual Neurosciences (S.M.C.), University of Minnesota Medical School, Minneapolis.

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|November 15, 2024
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Summary

Riboflavin transporter deficiency (RTD) is a rare genetic disorder. Early treatment with riboflavin and coenzyme Q10 shows sustained visual and neurological improvements in affected siblings.

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Area of Science:

  • Genetics
  • Neurology
  • Rare Diseases

Background:

  • Riboflavin transporter deficiency (RTD), also known as Brown-Vialetto-Van Laere syndrome, results from pathogenic variants in SLC52A1, SLC52A2, or SLC52A3 genes.
  • RTD affects approximately 1 in 1,000,000 individuals, with distinct clinical manifestations across types 1, 2, and 3.
  • Type 2 RTD presents with muscle weakness, vision loss, hearing impairment, and sensory ataxia.

Purpose of the Study:

  • To provide a long-term update on the visual and neurological status of siblings with RTD type 2.
  • To assess the sustained efficacy of oral riboflavin and coenzyme Q10 supplementation over 7.5 years.

Main Methods:

  • Longitudinal follow-up of two siblings diagnosed with RTD type 2.
  • Continued treatment with oral riboflavin and coenzyme Q10 supplementation.
  • Assessment of visual and neurological outcomes over a 5-year period post-initial report.

Main Results:

  • The siblings demonstrated sustained visual and neurological improvements 7.5 years after initiating riboflavin treatment.
  • The treatment regimen proved effective in managing the symptoms associated with RTD type 2 in the long term.
  • No significant adverse effects were reported during the extended treatment period.

Conclusions:

  • Oral riboflavin and coenzyme Q10 supplementation is a viable and effective long-term treatment for RTD type 2.
  • Early intervention and sustained treatment can lead to significant and lasting recovery of visual and neurological functions in RTD patients.
  • Further research into the long-term effects and optimal dosing of riboflavin therapy for RTD is warranted.