晚期多重乙-CoA脱酶缺乏症 (MADD):一个具有复杂生化特征的病例报告
Romain Penicaud1, Jean-Baptiste Ferron2, Xavier Valette3
1Department of Clinical Biochemistry Caen University Hospital Caen France.
JIMD reports
|July 21, 2025
概括
基因检测诊断出晚发多重乙-CoA脱酶缺乏症 (MADD) 在一个患有严重精神和肌肉症状的妇女身上. 这种被生物化学测试遗漏的诊断导致了有效的维生素B2治疗.
科学领域:
- 生物化学 生物化学
- 遗传学 是一个遗传学.
- 神经学 神经学
- 代谢障碍 代谢障碍 代谢障碍
背景情况:
- 多重乙-CoA脱酶缺乏症 (MADD) 呈现出不同的临床表型,包括严重的新生儿和晚期发作的形式.
- 晚期发病的MADD通常涉及肌肉症状,如运动不耐受和软弱,通常与改变的甲蛋白样本.
- 不典型的MADD表现可以通过传统的生物化学查来挑战诊断.
研究的目的:
- 报告一个独特的成人发病MADD病例,最初呈现出严重的精神症状和营养不良.
- 突出整个外体序列 (WES) 的诊断实用性,当生物化学测试对MADD没有确定性时.
- 为了证明维生素B2补充剂在通过遗传分析诊断的MADD治疗中的有效性.
主要方法:
- 详细的临床病例介绍,一个33岁的女性患有逐渐增长的肌肉衰弱,疲劳,死和狂肌症.
- 综合的生物化学研究,包括乙卡尼丁的概况,尿道有机酸分析和体外β-氧化试验.
- 整体外基因组测序 (WES) 以确定疑似代谢障碍的遗传基础.
主要成果:
- 标准生物化学测试对MADD没有确定性,尽管患者的临床表现严重.
- 在ETFDH基因中,WES发现了两种新的致病变异,证实了MADD的诊断.
- 维生素B2补充剂导致肌肉软弱和其他症状的快速临床改善.
结论:
- 基因诊断,特别是WES,对于在生物化学标志物异常或缺失时识别MADD至关重要.
- ETFDH基因变异可能导致晚期发病的MADD,具有不寻常的初始精神病和严重的肌肉症状.
- 早期遗传诊断能够及时启动辅因子补充,显著改善MADD患者的治疗结果.
关键词:
乙卡尼丁的个人资料在β-氧化过程中.电子转移黄蛋白脱酶 (ETFDH) 的使用线粒体疾病是线粒体疾病.多重乙-CoA脱酶缺乏症 (MADD) 是一种疾病.拉布多米溶解 (rhabdomyolysis) 是一种治疗方法.更多相关视频
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