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Understanding and Managing Infantile PHGDH Deficiency: A Case Report
Mayank Nilay1, Rani Manisha1, Dharmendra Kumar Singh2
1Department of Medical Genetics, Post Graduate Institute of Child Health, Noida, Uttar Pradesh, India.
Insights
Phosphoglycerate dehydrogenase deficiency, a rare neurometabolic disorder, can be treated with serine and glycine. Early diagnosis and treatment in children with microcephaly and seizures can improve developmental outcomes.
Area of Science:
- Neurology
- Metabolic Disorders
- Genetics
Background:
- Phosphoglycerate dehydrogenase deficiency is a rare neurometabolic condition.
- It presents with severe neurological symptoms like microcephaly, developmental delay, and seizures.
- These symptoms can be mistaken for cerebral palsy.
Purpose of the Study:
- To report a case of phosphoglycerate dehydrogenase deficiency in a young child.
- To highlight the importance of considering treatable neurometabolic disorders in patients with cerebral palsy-like symptoms.
- To demonstrate the efficacy of serine and glycine supplementation.
Main Methods:
- Clinical case presentation of a 2.5-year-old boy.
- Genetic testing to identify a pathogenic variant in the PHGDH gene.
- Biochemical analysis of serine levels and monitoring treatment response.
Main Results:
- A homozygous variant c.1129G>A in the PHGDH gene was identified.
- The patient presented with microcephaly, speech delay, seizures, and hyperactivity.
- Treatment with oral serine and glycine led to seizure control and developmental catch-up.
Conclusions:
- Phosphoglycerate dehydrogenase deficiency is a treatable cause of severe neurological impairment.
- Early diagnosis through genetic and biochemical testing is crucial.
- Prompt treatment with serine and glycine can significantly improve patient outcomes, averting misdiagnosis as cerebral palsy.
Abstract:
Phosphoglycerate dehydrogenase deficiency is a rare neurometabolic disorder with clinical features of congenital microcephaly, psychomotor retardation, intractable seizures, and spasticity. We report a 2.5-year-old boy presenting with speech delay, seizures, microcephaly, and hyperactive behavior. Genetic testing detected a likely pathogenic homozygous variant c.1129G>A in the PHGDH gene. Parents were carrier for the detected variant. Biochemical analysis showed low serine and treatment with oral serine and glycine resulted in seizure control, followed by catchup of developmental milestones. This case illustrates the need for evaluating underlying neurometabolic causes, particularly treatable entities, in clinical presentations similar to cerebral palsy.
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