A novel compound heterozygous mutation in the arginase-1 gene identified in a Chinese patient with argininemia: A case report

INTRODUCTION

Arginineemia, also known as arginase deficiency, is a rare autosomal recessive metabolic disease. The diagnosis sometimes may be delayed due to atypical clinical manifestations. Confirmation of arginineemia depends on genetic testing.

PATIENT CONCERNS

We reported a Chinese male child presenting with hyperargininemia and progressive spastic diplegia, who has a novel compound heterozygous mutation in the arginase-1 (ARG1) gene (c.263-266delAGAA, p.K88Rfs45;c.674T>C,p.L216P), respectively, coming from his mother and father.

DIAGNOSIS

The patient was diagnosed with argininemia with a novel compound homozygous mutation of the ARG1 gene at the age of 12 years.

INTERVENTIONS

The patient had a low-protein diet (0.8 g/kg/day). Baclofen, eperisone hydrochloride, botulinum toxin, and rehabilitation training were used to improve his spastic diplegia symptoms for 3 months.

OUTCOMES

The patient's blood arginine was still high after 3 months' low-protein diet. His spastic diplegia symptoms had not aggravated after 3 months' treatment.

CONCLUSIONS

Argininemia should be considered in a patient with slowly progressive neurologic manifestations, especially spastic diplegia. This case also suggests that tandem mass spectrometry should be used as an effective tool in the validity of neonatal screening for early diagnosis.

The assessment of nephrotoxic effect of organophosphorous pesticides based on the determination of the activity of some selected enzymes in urine

Pesticides and their metabolites are excreted mainly by the kidneys. The effect of these compounds on the kidney parenchyma was evaluated on the basis of determinations of the activity of the following enzymes: alkaline phosphate, N-acetylglucosaminidase, lactate dehydrogenase, alanine aminotransferase, aspartate aminotransferase and arginase in urine of workers employed at the department producing organophosphorous pesticides (32 males and 53 females) as well as those employed at the production of chlorfenvinphos (35 males). The activity of most of the estimated enzymes was significantly higher as compared to control groups. The dynamic of changes of enzyme activity was traced in the workers employed at the department producing chlorfenvinphos over their first 18 months of employment.