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Zhi Y, Liu L, Wang H, Chen X, Lv Y, Cui X, Chang H, Wang Y, Cui S. Prenatal exome sequencing analysis in fetuses with central nervous system anomalies. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2023; 62:721-726. [PMID: 37204857 DOI: 10.1002/uog.26254] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 04/28/2023] [Accepted: 05/07/2023] [Indexed: 05/20/2023]
Abstract
OBJECTIVE To evaluate the utility of prenatal exome sequencing (pES) in fetuses with central nervous system (CNS) abnormalities. METHODS This was a retrospective cohort study of fetuses identified to have CNS abnormality on prenatal ultrasound and/or magnetic resonance imaging. All fetuses were first analyzed by chromosomal microarray analysis (CMA). Fetuses with a confirmed aneuploidy or causal pathogenic copy-number variant (CNV) on CMA did not undergo pES analysis and were excluded, while those with a negative CMA result were offered pES testing. RESULTS Of the 167 pregnancies included in the study, 42 (25.1%) were identified to have a pathogenic or likely pathogenic (P/LP) variant. The diagnostic rate was significantly higher in fetuses with a non-isolated CNS abnormality than in those with a single CNS abnormality (35.7% (20/56) vs 14.5% (8/55); P = 0.010). Moreover, when a fetus had three or more CNS abnormalities, the positive diagnostic rate increased to 42.9%. A total of 25/42 (59.5%) cases had de-novo mutations, while, in the remaining cases, mutations were inherited and carried a significant risk of recurrence. Families whose fetus carried a P/LP mutation were more likely to choose advanced pregnancy termination than those with a variant of uncertain significance, secondary/incidental finding or negative pES result (83.3% (25/30) vs 41.3% (38/92); P < 0.001). CONCLUSION pES improved the identification of genetic disorders in fetuses with CNS anomalies without a chromosomal abnormality or CNV identified on CMA, regardless of the number of CNS anomalies and presence of extracranial abnormality. We also demonstrated that pES findings can significantly impact parental decision-making. © 2023 International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- Y Zhi
- Prenatal Diagnosis Center, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - L Liu
- Prenatal Diagnosis Center, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - H Wang
- Prenatal Diagnosis Center, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - X Chen
- Prenatal Diagnosis Center, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Y Lv
- Prenatal Diagnosis Center, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - X Cui
- Prenatal Diagnosis Center, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - H Chang
- Scientific Research Office, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Y Wang
- Clinical Laboratory, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - S Cui
- Prenatal Diagnosis Center, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
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Guo Y, Jiang J, Xu Z. Chinese genetic variation database of inborn errors of metabolism: a systematic review of published variants in 13 genes. Orphanet J Rare Dis 2023; 18:148. [PMID: 37308883 DOI: 10.1186/s13023-023-02726-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 05/14/2023] [Indexed: 06/14/2023] Open
Abstract
BACKGROUND Population-specific variation database of inborn errors of metabolism (IEMs) is essential for precise genetic diagnosis and disease prevention. Here we presented a systematic review of clinically relevant variants of 13 IEMs genes reported among Chinese patients. METHODS A systematic search of the following electronic databases for 13 IEMs genes was conducted: PubMed-NCBI, China national knowledge infrastructure and Wanfang databases. Patient data was extracted from articles eligible for inclusion and recorded in Excel electronic form using a case-by-case approach. RESULTS A total of 218 articles, 93 published in English and 125 in Chinese, were retrieved. After variant annotation and deduplication, 575 unique patients (241 from articles published in Chinese) were included in the population-specific variation database. Patients identified by newborn screening and symptomatic presentation were 231 (40.17%) and 344 (59.83%), respectively. Biallelic variants were observed in 525/575 (91.3%). Among the 581 unique variants identified, 83 (14.28%) were described ≥ 3 times and 97 (16.69%) were not recorded in Clinvar or HGMD. Four variants were reclassified as benign and dozens of confusing variants deserved further research. CONCLUSION This review provides a unique resource of the well-characterized diseases and causative variants that have accumulated in Chinese population and is a preliminary attempt to build the Chinese genetic variation database of IEMs.
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Affiliation(s)
- Yongchao Guo
- Shenzhen Uni-medica Technology Co., Ltd, Liuxian Culture Park, Nanshan District, 5180553, Shenzhen, China
| | - Jianhui Jiang
- Maternal and Child Health Hospital of Guangdong Province, No.13 Guangyuan West Road, Yuexiu District, 510010, Guangzhou, Guangdong Province, China
| | - Zhongyao Xu
- Shenzhen Uni-medica Technology Co., Ltd, Liuxian Culture Park, Nanshan District, 5180553, Shenzhen, China.
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Guo Z, Gong A, Liu S, Liang H. Two novel compound heterozygous variants of the GCDH gene in two Chinese families with glutaric acidaemia type I identified by high-throughput sequencing and a literature review. Mol Genet Genomics 2023; 298:603-614. [PMID: 36906724 DOI: 10.1007/s00438-023-02002-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 02/20/2023] [Indexed: 03/13/2023]
Abstract
Autosomal recessive glutaric acidaemia type I (GA-I) is a rare hereditary metabolic disease characterized by increased organic acids and neurologic symptoms. Although numerous variants in the GCDH gene have been identified to be connected with the pathogenesis of GA-I, the relationship between genotype and phenotype remains uncertain. In this study, we evaluated genetic data for two GA-I patients from Hubei, China, and we reviewed the previous research findings to clarify the genetic heterogeneity of GA-I and identify the potential causative variants. After we extracted genomic DNA from peripheral blood samples obtained from two unrelated Chinese families, we used target capture high-throughput sequencing combined with Sanger sequencing to determine likely pathogenic variants in the two probands. Electronic databases were also searched for the literature review. The genetic analysis revealed two compound heterozygous variants in the GCDH gene expected to lead to GA-I in the two probands (P1 and P2), with P1 carrying two known variants (c.892G > A/p. A298T and c.1244-2A > C/IVS10-2A > C) and P2 harbouring two novel variants (c.370G > T/p.G124W and c.473A > G/p.E158G). In the literature review, the most common alleles in low excretors (i.e., individuals with low excretion of GA) were R227P, V400M, M405V, and A298T, with variation in the severity of clinical phenotypes. Overall, we identified two novel GCDH gene candidate pathogenic variants in a Chinese patient, enriching the GCDH gene mutational spectrum and providing a solid foundation for the early diagnosis of GA-I patients with low excretion.
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Affiliation(s)
- Zihan Guo
- The Institute of Human Nutrition, College of Public Health, Qingdao University, Ning Xia Road 308, Qingdao, 266071, Shandong, China
| | - Anyue Gong
- Neonatal Screening Center, Maternal and Child Health Hospital of Xiangyang, Xiangyang, China
| | - Shiguo Liu
- Prenatal Diagnosis Center, The Affiliated Hospital of Qingdao University, Qingdao, China. .,Department of Medical Genetics, The Affiliated Hospital of Qingdao University, Jiangsu Road 16, Qingdao, 266000, China.
| | - Hui Liang
- The Institute of Human Nutrition, College of Public Health, Qingdao University, Ning Xia Road 308, Qingdao, 266071, Shandong, China.
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Molecular, Biochemical, and Clinical Characterization of Thirteen Patients with Glycogen Storage Disease 1a in Malaysia. Genet Res (Camb) 2022; 2022:5870092. [PMID: 36160031 PMCID: PMC9489408 DOI: 10.1155/2022/5870092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 08/11/2022] [Accepted: 08/13/2022] [Indexed: 02/06/2023] Open
Abstract
Background Glycogen storage disease type 1a (GSD1a) is a rare autosomal recessive metabolic disorder characterized by hypoglycaemia, growth retardation, lactic acidosis, hepatomegaly, hyperlipidemia, and nephromegaly. GSD1a is caused by a mutation in the G6PC gene encoding glucose-6-phosphatase (G6Pase); an enzyme that catalyses the hydrolysis of glucose-6-phosphate (G6P) to phosphate and glucose. Objective To elaborate on the clinical findings, biochemical data, molecular genetic analysis, and short-term prognosis of 13 GSD1a patients in Malaysia. Methods The information about 13 clinically classified GSD1a patients was retrospectively studied. The G6PC mutation analysis was performed by PCR-DNA sequencing. Results Patients were presented with hepatomegaly (92%), hypoglycaemia (38%), poor weight gain (23%), and short stature (15%). Mutation analysis revealed nine heterozygous mutations; eight previously reported mutations (c.155 A > T, c.209 G > A, c.226 A > T, c.248 G > A, c.648 G > T, c.706 T > A, c.1022 T > A, c.262delG) and a novel mutation (c.325 T > C). The most common mutation found in Malaysian patients was c.648 G > T in ten patients (77%) of mostly Malay ethnicity, followed by c.248 G > A in 4 patients of Chinese ethnicity (30%). A novel missense mutation (c.325 T > C) was predicted to be disease-causing by various in silico software. Conclusions The establishment of G6PC molecular genetic testing will enable the detection of presymptomatic patients, assisting in genetic counselling while avoiding the invasive methods of liver biopsy.
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Shaik M, Kamate M, T.P. KV, A.B. V. Molecular identification of glutaryl CoA dehydrogenase gene variations and clinical course in three glutaric aciduria type I patients. Meta Gene 2020. [DOI: 10.1016/j.mgene.2020.100804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Campos-Garcia FJ, Chacon-Camacho OF, Contreras-Capetillo S, Cruz-Aguilar M, Medina-Escobedo CE, Moreno-Graciano CM, Rodas A, Herrera-Perez LDA, Zenteno JC. Characterization of novel GCDH pathogenic variants causing glutaric aciduria type 1 in the southeast of Mexico. Mol Genet Metab Rep 2019; 21:100533. [PMID: 31788423 PMCID: PMC6879986 DOI: 10.1016/j.ymgmr.2019.100533] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 10/08/2019] [Accepted: 10/09/2019] [Indexed: 11/16/2022] Open
Abstract
Biallelic mutations of the GCDH gene result in Glutaric Aciduria type 1 (GA1; OMIM #231670), an uncommon autosomal recessive inborn error caused by the deficiency of glutaryl-CoA dehydrogenase (CCDH), a mitochondrial matrix protein involved in the degradation of l-lysine, L-hydroxylysine, and L-tryptophan. The enzymatic deficiency leads to the accumulation of neurotoxins causing macrocephaly at birth, hypotonia and dystonia due to bilateral striatal injury, that evolves with aging, if untreated, to fixed dystonia and akinetic-rigid parkinsonism. In this article, we describe the results of molecular studies of 5 unrelated patients with GA1 in Southern Mexico. Mutational analysis identified 2 novel likely pathogenic GCDH variants (p.Leu130Pro and p.Gly391Val), 1 pathogenic variant that is predicted to cause a premature stop codon (p.Leu370*), and 2 previously reported pathogenic variants (p.Arg294Trp and p.Arg294Gln). The recurrence of the p.Leu130Pro variant (60% of mutant alleles) suggested a possible founder mutation effect. Our results expand the mutational spectrum in GA1 patients and support the importance of early diagnosis through newborn screening that promotes early nutritional treatment and prevents metabolic crisis. TAKE HOME MESSAGE Glutaric Aciduria type 1 has a wide mutational spectrum; the p.Leu130Pro variant may be a founder mutation in Southeast Mexico.
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Affiliation(s)
- Felix-Julian Campos-Garcia
- Research Department, Instituto Mexicano del Seguro Social “Ignacio García Tellez”, Mérida, Yucatán, Mexico
| | - Oscar F. Chacon-Camacho
- Department of Genetics, Institute of Ophthalmology “Conde de Valenciana”, Mexico City, Mexico
- Carrera de Médico Cirujano, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla, Mexico
| | | | - Marisa Cruz-Aguilar
- Department of Genetics, Institute of Ophthalmology “Conde de Valenciana”, Mexico City, Mexico
| | | | | | - Agustín Rodas
- Department of Genetics, Institute of Ophthalmology “Conde de Valenciana”, Mexico City, Mexico
| | | | - Juan C. Zenteno
- Department of Genetics, Institute of Ophthalmology “Conde de Valenciana”, Mexico City, Mexico
- Department of Biochemistry, Faculty of Medicine, UNAM, Mexico City, Mexico
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Zayed H, El Khayat H, Tomoum H, Khalifa O, Siddiq E, Mohammad SA, Gamal R, Shi Z, Mosailhy A, Zaki OK. Clinical, biochemical, neuroradiological and molecular characterization of Egyptian patients with glutaric acidemia type 1. Metab Brain Dis 2019; 34:1231-1241. [PMID: 31062211 PMCID: PMC6617250 DOI: 10.1007/s11011-019-00422-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 04/21/2019] [Indexed: 12/02/2022]
Abstract
Glutaric acidemia type 1 (GA1) is an inherited metabolic autosomal recessive disorder that is caused by a deficiency in glutaryl-CoA dehydrogenase (GCDH). Untreated patients suffer primarily from severe striatal damage. More than 250 variants in the GCDH gene have been reported with a variable frequency among different ethnic groups. In this study, we aimed to characterize 89 Egyptian patients with GA1 and identify the variants in the 41 patients who were available for genotyping. All of our patients demonstrated clinical, neuroradiological, and biochemical characteristics that are consistent with a diagnosis of GA1. All patients presented with variable degrees of developmental delay ranging from mild to severe. Most of the 89 patients presented with acute onset type (71.9%), followed by insidious (19%) and asymptomatic (9%). A delay in diagnosis was inversely associated with macrocephaly. The prevalence rate ratio (PR) for macrocephaly that was associated with each 6-month delay was 0.95 (95%CI 0.91-0.99). However, high body weight was associated with a higher likelihood of having macrocephaly (PR 1.16, 95%CI 1.06-1.26 per 1 SD increment of Z score weight). However, body weight was inversely associated with the morbidity score. Consanguinity level was 64% among our patient's cohort and was positively associated with the C5DC level (β (95%CI) 1.06 (0.12-1.99)). Forty-one patients were available for genotyping and were sequenced for the GCDH gene. We identified a total of 25 variants, of which the following six novel variants were identified: three missense variants, c.320G > T (p.Gly107Val), c.481C > T (p.Arg161Trp) and c.572 T > G (p.Met191Arg); two deletions, c.78delG (p.Ala27Argfs34) and c.1035delG (p.Gly346Alafs*11); and one indel, c.272_331del (p.Val91_Lys111delinsGlu). All of the novel variants were absent in the 300 normal chromosomes. The most common variant, c.*165A > G, was detected in 42 alleles, and the most commonly detected missense variant, c.1204C > T (p.Arg402Trp), was identified in 29 mutated alleles in 15/41 (34.2%) of patients. Our findings suggest that GA1 is not uncommon organic acidemia disease in Egypt; therefore, there is a need for supporting neonatal screening programs in Egypt.
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MESH Headings
- Amino Acid Metabolism, Inborn Errors/diagnosis
- Amino Acid Metabolism, Inborn Errors/diagnostic imaging
- Amino Acid Metabolism, Inborn Errors/genetics
- Amino Acid Metabolism, Inborn Errors/metabolism
- Body Weight/physiology
- Brain/diagnostic imaging
- Brain Diseases, Metabolic/diagnosis
- Brain Diseases, Metabolic/diagnostic imaging
- Brain Diseases, Metabolic/genetics
- Brain Diseases, Metabolic/metabolism
- Child
- Child, Preschool
- Egypt
- Female
- Genotype
- Glutaryl-CoA Dehydrogenase/deficiency
- Glutaryl-CoA Dehydrogenase/genetics
- Glutaryl-CoA Dehydrogenase/metabolism
- Humans
- Magnetic Resonance Imaging
- Male
- Mutation, Missense
- Severity of Illness Index
- Symptom Assessment
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Affiliation(s)
- Hatem Zayed
- Department of Biomedical Sciences, College of Health Sciences, Qatar University, Doha, Qatar.
| | - Hamed El Khayat
- Medical Genetics Unit, Pediatric Department, Faculty of Medicine, Ain Shams Pediatrics Hospital, Ain-Shams University, Cairo, 11665, Egypt
| | - Hoda Tomoum
- Medical Genetics Unit, Pediatric Department, Faculty of Medicine, Ain Shams Pediatrics Hospital, Ain-Shams University, Cairo, 11665, Egypt
| | - Ola Khalifa
- Medical Genetics Unit, Pediatric Department, Faculty of Medicine, Ain Shams Pediatrics Hospital, Ain-Shams University, Cairo, 11665, Egypt
| | - Ehab Siddiq
- Medical Genetics Unit, Pediatric Department, Faculty of Medicine, Ain Shams Pediatrics Hospital, Ain-Shams University, Cairo, 11665, Egypt
| | - Shaimaa A Mohammad
- Medical Genetics Unit, Pediatric Department, Faculty of Medicine, Ain Shams Pediatrics Hospital, Ain-Shams University, Cairo, 11665, Egypt
| | - Radwa Gamal
- Medical Genetics Unit, Pediatric Department, Faculty of Medicine, Ain Shams Pediatrics Hospital, Ain-Shams University, Cairo, 11665, Egypt
| | - Zumin Shi
- Department of Biomedical Sciences, College of Health Sciences, Qatar University, Doha, Qatar
| | - Ahmed Mosailhy
- Medical Genetics Unit, Pediatric Department, Faculty of Medicine, Ain Shams Pediatrics Hospital, Ain-Shams University, Cairo, 11665, Egypt
| | - Osama K Zaki
- Medical Genetics Unit, Pediatric Department, Faculty of Medicine, Ain Shams Pediatrics Hospital, Ain-Shams University, Cairo, 11665, Egypt.
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Leong HY, Abdul Azize NA, Chew HB, Keng WT, Thong MK, Mohd Khalid MKN, Hung LC, Mohamed Zainudin N, Ramlee A, Md Haniffa MA, Yakob Y, Ngu LH. Clinical, biochemical and genetic profiles of patients with mucopolysaccharidosis type IVA (Morquio A syndrome) in Malaysia: the first national natural history cohort study. Orphanet J Rare Dis 2019; 14:143. [PMID: 31200731 PMCID: PMC6570902 DOI: 10.1186/s13023-019-1105-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Accepted: 05/26/2019] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Mucopolysaccharidosis IVA (MPS IVA) is an autosomal recessive lysosomal storage disease due to N-acetylgalactosamine-6-sulfatase (GALNS) deficiency. It results in accumulation of the glycosaminoglycans, keratan sulfate and chondroitin-6-sulfate, leading to skeletal and other systemic impairments. Data on MPS IVA in Asian populations are scarce. METHODS This is a multicentre descriptive case series of 21 patients comprising all MPS IVA patients in Malaysia. Mutational analysis was performed by PCR and Sanger sequencing of the GALNS gene in 17 patients. RESULTS The patients (15 females and 6 males) had a mean age (± SD) of 15.5 (± 8.1) years. Mean age at symptom onset was 2.6 (± 2.1) years and at confirmed diagnosis was 6.9 (± 4.5) years. The study cohort included patients from all the main ethnic groups in Malaysia - 57% Malay, 29% Chinese and 14% Indian. Common presenting symptoms included pectus carinatum (57%) and genu valgum (43%). Eight patients (38%) had undergone surgery, most commonly knee surgeries (29%) and cervical spine decompression (24%). Patients had limited endurance with lower mean walking distances with increasing age. GALNS gene analysis identified 18 distinct mutations comprising 13 missense, three nonsense, one small deletion and one splice site mutation. Of these, eight were novel mutations (Tyr133Ser, Glu158Valfs*12, Gly168*, Gly168Val, Trp184*, Leu271Pro, Glu320Lys, Leu508Pro). Mutations in exons 1, 5 and 9 accounted for 51% of the mutant alleles identified. CONCLUSIONS All the MPS IVA patients in this study had clinical impairments. A better understanding of the natural history and the clinical and genetic spectrum of MPS IVA in this population may assist early diagnosis, improve management and permit timely genetic counselling and prenatal diagnosis.
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Affiliation(s)
- Huey Yin Leong
- Genetics Department, Hospital Kuala Lumpur, Ministry of Health Malaysia, Jalan Pahang, 50586 Kuala Lumpur, Malaysia
| | - Nor Azimah Abdul Azize
- Unit of Molecular Diagnostics & Protein, Institute for Medical Research, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Hui Bein Chew
- Genetics Department, Hospital Kuala Lumpur, Ministry of Health Malaysia, Jalan Pahang, 50586 Kuala Lumpur, Malaysia
| | - Wee Teik Keng
- Genetics Department, Hospital Kuala Lumpur, Ministry of Health Malaysia, Jalan Pahang, 50586 Kuala Lumpur, Malaysia
| | - Meow Keong Thong
- Department of Paediatrics, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - Mohd Khairul Nizam Mohd Khalid
- Unit of Molecular Diagnostics & Protein, Institute for Medical Research, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Liang Choo Hung
- Paediatric Department, Hospital Kuala Lumpur, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Norzila Mohamed Zainudin
- Paediatric Department, Hospital Kuala Lumpur, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Azura Ramlee
- Ophthalmology Department, Hospital Selayang, Ministry of Health Malaysia, Selayang, Malaysia
| | - Muzhirah Aisha Md Haniffa
- Genetics Department, Hospital Kuala Lumpur, Ministry of Health Malaysia, Jalan Pahang, 50586 Kuala Lumpur, Malaysia
| | - Yusnita Yakob
- Unit of Molecular Diagnostics & Protein, Institute for Medical Research, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Lock Hock Ngu
- Genetics Department, Hospital Kuala Lumpur, Ministry of Health Malaysia, Jalan Pahang, 50586 Kuala Lumpur, Malaysia
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Zhang X, Luo Q. Clinical and laboratory analysis of late-onset glutaric aciduria type I (GA-I) in Uighur: A report of two cases. Exp Ther Med 2016; 13:560-566. [PMID: 28352331 PMCID: PMC5348702 DOI: 10.3892/etm.2016.4007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Accepted: 10/05/2016] [Indexed: 11/06/2022] Open
Abstract
The aim of the present study was to investigate the clinical, biochemical and genetic mutation characteristics of two cases of late-onset glutaric aciduria type I (GA-I) in Uighur. The clinical data and glutaryl-CoA dehydrogenase (GCDH) genetic test results of two cases of late-onset GA-I in Uighur were collected and analyzed, and reviewed with relevant literature. One patient with late-onset GA-I primarily exhibited clinical intermittent headache, while the other patient was asymptomatic. The urinary organic acid analysis detected a large number of glutaric acid and 3-hydroxy glutaric acid, 3-hydroxy-propionic acid. One patient exhibited white matter degeneration in cranial magnetic resonance imaging (MRI) and the other patient showed no abnormality. The two patients both exhibited c. 1204C >T, p.R402W, heterozygous mutation, and c. 532G >A, p.G178R, heterozygous mutation. Besides central nervous system infectious diseases, patients with clinical headache, cranial MRI-suggested bilateral temporal lobe arachnoid cyst and abnormal signals in the basal ganglia should be highly suspected as late-onset GA-I. Early diagnosis and correct treatment are key to improve its prognosis.
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Affiliation(s)
- Xiaoying Zhang
- Department of Pediatrics, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang 830054, P.R. China
| | - Qiong Luo
- Department of Pediatrics, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang 830054, P.R. China
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