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Chandran P, Kc S, Mp J, Am S. SCOT Deficiency - A Fatal Metabolic Disorder Treated with Peritoneal Dialysis. Indian J Pediatr 2023; 90:528. [PMID: 36949368 DOI: 10.1007/s12098-023-04546-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Accepted: 03/01/2023] [Indexed: 03/24/2023]
Affiliation(s)
- Pooja Chandran
- Department of Pediatrics, Government Medical College, Kozhikode, Kerala, 673008, India.
| | - Sadik Kc
- Department of Pediatrics, Government Medical College, Kozhikode, Kerala, 673008, India
| | - Jayakrishnan Mp
- Department of Pediatrics, Government Medical College, Kozhikode, Kerala, 673008, India
| | - Shameem Am
- Department of Pediatrics, Government Medical College, Kozhikode, Kerala, 673008, India
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Dhammi N, Essakow J, Gallagher R, Gaw C. A case of severe acidosis in a 12-month-old: Succinyl-CoA:3-ketoacid -CoA transferase deficiency with OXCT1 gene mutations. SAGE Open Med Case Rep 2022; 10:2050313X221111274. [PMID: 35847427 PMCID: PMC9280792 DOI: 10.1177/2050313x221111274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 05/20/2022] [Indexed: 12/04/2022] Open
Abstract
Succinyl-CoA:3-ketoacid CoA transferase (SCOT) deficiency is a rare autosomal recessive disorder that results in severe ketoacidosis due to a defect in ketone utilization. We describe a case of a 12-month-old infant presenting with severe metabolic acidosis, ketosis, and hyperammonemia, a combination of symptoms suggestive of an inborn error of metabolism. Genetic testing found our patient had a homozygous variant in the OXCT1 gene, c.1543A>G (p.Met515Val). This was the first identified case of SCOT deficiency at our institution. We share our acute management strategies for initial stabilization in the intensive care unit, as well as our approach to preventing morning ketosis after discharge using uncooked cornstarch.
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Affiliation(s)
- Navjot Dhammi
- Department of Pediatrics, UCSF Benioff Children’s Hospital Oakland, Oakland, CA, USA
| | - Jenna Essakow
- Department of Pediatrics, UCSF Benioff Children’s Hospital Oakland, Oakland, CA, USA
| | - Renata Gallagher
- Department of Pediatrics, UCSF Benioff Children’s Hospital Oakland, Oakland, CA, USA
| | - Cynthia Gaw
- Department of Pediatrics, UCSF Benioff Children’s Hospital Oakland, Oakland, CA, USA
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Grünert SC, Foster W, Schumann A, Lund A, Pontes C, Roloff S, Weinhold N, Yue WW, AlAsmari A, Obaid OA, Faqeih EA, Stübbe L, Yamamoto R, Gemperle-Britschgi C, Walter M, Spiekerkoetter U, Mackinnon S, Sass JO. Succinyl-CoA:3-oxoacid coenzyme A transferase (SCOT) deficiency: A rare and potentially fatal metabolic disease. Biochimie 2021; 183:55-62. [PMID: 33596448 DOI: 10.1016/j.biochi.2021.02.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 02/03/2021] [Accepted: 02/03/2021] [Indexed: 12/23/2022]
Abstract
Succinyl-CoA:3-oxoacid coenzyme A transferase deficiency (SCOTD) is a rare autosomal recessive disorder of ketone body utilization caused by mutations in OXCT1. We performed a systematic literature search and evaluated clinical, biochemical and genetic data on 34 previously published and 10 novel patients with SCOTD. Structural mapping and in silico analysis of protein variants is also presented. All patients presented with severe ketoacidotic episodes. Age at first symptoms ranged from 36 h to 3 years (median 7 months). About 70% of patients manifested in the first year of life, approximately one quarter already within the neonatal period. Two patients died, while the remainder (95%) were alive at the time of the report. Almost all the surviving patients (92%) showed normal psychomotor development and no neurologic abnormalities. A total of 29 missense mutations are reported. Analysis of the published crystal structure of the human SCOT enzyme, paired with both sequence-based and structure-based methods to predict variant pathogenicity, provides insight into the biochemical consequences of the reported variants. Pathogenic variants cluster in SCOT protein regions that affect certain structures of the protein. The described pathogenic variants can be viewed in an interactive map of the SCOT protein at https://michelanglo.sgc.ox.ac.uk/r/oxct. This comprehensive data analysis provides a systematic overview of all cases of SCOTD published to date. Although SCOTD is a rather benign disorder with often favourable outcome, metabolic crises can be life-threatening or even fatal. As the diagnosis can only be made by enzyme studies or mutation analyses, SCOTD may be underdiagnosed.
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Affiliation(s)
- Sarah C Grünert
- Department of General Paediatrics, Adolescent Medicine and Neonatology, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany.
| | - William Foster
- Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Anke Schumann
- Department of General Paediatrics, Adolescent Medicine and Neonatology, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - Allan Lund
- Department of Paediatrics, Department of Clinical Genetics, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Christina Pontes
- Centre for Paediatrics and Adolescent Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - Sylvia Roloff
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Center for Chronically Sick Children, Berlin, Germany
| | - Natalie Weinhold
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Center for Chronically Sick Children, Berlin, Germany
| | - Wyatt W Yue
- Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Ali AlAsmari
- Children's Specialist Hospital, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Osama A Obaid
- Children's Specialist Hospital, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Eissa Ali Faqeih
- Children's Specialist Hospital, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Lisa Stübbe
- MVZ Dr. Eberhard & Partner Dortmund GbR (ÜBAG), Dortmund, Germany
| | - Raina Yamamoto
- MVZ Dr. Eberhard & Partner Dortmund GbR (ÜBAG), Dortmund, Germany
| | - Corinne Gemperle-Britschgi
- University Children's Hospital, Clinical Chemistry & Biochemistry and Children's Research Center, Zürich, Switzerland
| | - Melanie Walter
- Department of General Paediatrics, Adolescent Medicine and Neonatology, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - Ute Spiekerkoetter
- Department of General Paediatrics, Adolescent Medicine and Neonatology, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - Sabrina Mackinnon
- Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
| | - Jörn Oliver Sass
- Research Group Inborn Errors of Metabolism, Department of Natural Sciences & Institute for Functional Gene Analytics (IFGA), Bonn-Rhein-Sieg University of Applied Sciences, Rheinbach, Germany.
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