无症状的小儿S-adenosylhomocysteine酶缺乏症的表现
Patrícia Lipari Pinto1, Marjorie Dixon2, Sniya Sudhakar3
1Hereditary Metabolic Disease Reference Center, Metabolic Unit, Pediatric Department Santa Maria's Hospital-Lisbon North University Hospital Center, EPE, Pediatric University Clinic, Faculty of Medicine, University of Lisbon Lisbon Portugal.
作为一种代谢障碍的S-adenosylhomocysteine酸酶缺乏症,在儿童中可能呈现轻度. 饮食中氨酸的限制可能会逆转神经症状,这表明早期干预的可能性.
科学领域:
- 生物化学 生物化学
- 遗传学 是一个遗传学.
- 代谢障碍 代谢障碍 代谢障碍
背景情况:
- S-adenosylhomocysteine hydrolase (AHCY) 缺乏症是一种影响甲基化的遗传代谢障碍.
- 这种疾病的临床谱从严重到无症状,经常呈现出高超氨酸血.
研究的目的:
- 描述两例在巴基斯坦兄弟姐妹中出现轻度无症状的AHCY缺乏症的新病例.
- 调查这些患者的临床过程和对饮食干预的反应.
主要方法:
- 临床病例介绍和后续行动.
- 基因分析证实了AHCY基因中的一个同卵性误解变体 (c.146G>A,p.Arg49His).
- 在饮食干预之前和之后,对血中 metionin,S-adenosylhomocysteine和S-adenosylmethionine水平的生物化学分析.
主要成果:
- 两个兄弟姐妹都呈现无症状的轻度慢性肝衰竭和高水平的肌酸激酶.
- 经过12个月的 metionin 限制后,这位年长的兄弟姐妹显示出可逆的语言处理困难和白血病.
- 饮食中的氨酸限制降低了血中的氨酸,但没有显著改变S-adenosylhomocysteine或S-adenosylmethionine水平.
结论:
- 这项研究扩大了已知的轻度AHCY缺乏的范围,特别是在具有c.146G>A变异的南亚人群中.
- 这些发现表明这种轻度形式可能被低诊断,并突出了饮食管理在预防长期并发症方面的潜在益处.
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