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Published on: April 4, 2018
A Novel Variant in an Israeli Bedouin Family: The First Reported Cases of Carbonic Anhydrase VA (CA5A) Deficiency in
Nitzan Abelson1, Eyal Kristal2, Eli Hershkovitz3
1Pediatrics Department A, The Cheryl and Haim Saban Children's Hospital, Soroka University Medical Center, Ben-Gurion University, P.O. Box 151, Beer Sheva 84101, Israel.
Insights
Carbonic anhydrase VA (CA5A) deficiency is a rare metabolic disorder. Early diagnosis and treatment of this condition in infants are crucial for favorable developmental outcomes.
Area of Science:
- Biochemistry
- Genetics
- Pediatrics
Background:
- Carbonic anhydrase VA (CA5A) deficiency is an ultra-rare inherited metabolic disorder.
- It presents in infants and young children with severe symptoms including encephalopathy, hyperammonemia, lactic acidosis, ketonuria, and hypoglycemia.
Abstract:
Carbonic anhydrase VA (CA5A) deficiency (OMIM 615751) is an ultra-rare inborn error of metabolism, presenting in newborns, infants, and young children with a pentad of encephalopathy, hyperammonemia, lactic acidosis, ketonuria, and hypoglycemia. We present two cases: a case of a healthy Bedouin infant admitted with hyperammonemic encephalopathy that required urgent hemodialysis, and her younger sibling, who presented with a milder episode. Molecular analysis confirmed the diagnosis of CA5A deficiency due to a homozygous missense variant in the CA5A gene. Both patients had a favorable outcome with continued normal development. These were the first identified cases of CA5A deficiency in the Bedouin population, emphasizing the importance of a high index of suspicion, early genetic consultation and diagnosis, and prompt treatment at the earliest possible stage of a hyperammonemic crisis.
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