DOCSLIB.ORG

Inborn Errors of Metabolism

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Inborn Errors of Metabolism Inborn Errors of Metabolism About Emory Genetics Laboratory (EGL) EGL specializes in genetic diagnostic testing, with 45 years of clinical experience and board-certified laboratory directors and genetic counselors reporting out cases. EGL offers a combined 1100 molecular genetics, biochemical genetics, and cytogenetics tests under one roof and custom testing for all medically relevant genes, for domestic and international clients. Equally important to improving patient care through quality genetic testing is the contribution EGL makes back to the scientific and medical communities. EGL is one of only a few clinical diagnostic laboratories to openly share data with the NCBI freely available public database ClinVar (>7000 variants on >500 genes) and is also the only laboratory with a free online database (EmVClass), featuring a variant classification search and report request interface, which facilitates rapid interactive curation and reporting of variants. Inborn Errors of Metabolism EGL offers biochemical and molecular testing for the diagnosis of more than 100 inborn errors of metabolism, including those associated with the disorders detected by the expanded newborn screening (NBS). Biochemical Testing Metabolic testing available includes: • Organic acid analysis • Acylcarnitine analysis • CoQ10, plasma • Amino acid analysis • Carnitine concentration • CoQ10, leukocyte • Orotic acid • Homocysteine • Methylmalonic acid Biochemical Panel Testing EGL offers a metabolic panel, which includes amino acid analysis, organic acid quantitative analysis, acylcarnitine analysis, and a carnitine concentration profile. The NBS follow-up metabolic panel includes those same tests and in addition, a homocysteine and methylmalonic acid test (if homocysteine levels are elevated). Molecular Testing EGL offers follow-up gene sequencing and deletion/duplication analysis to identify mutations, when a biochemical abnormality is detected. Molecular testing provides additional information to help interpret equivocal biochemical test results and also to determine risk for family members or the need for prenatal testing. Why Choose EGL? • Interlab panels, such as the rhabdomyolysis panel, incorporate biochemical testing and molecular common mutation testing for McArdle’s disease, AMPD1 deficiency, and MCAD deficiency Inborn Errors of Metabolism Disease Analyte Genes Sequencing Del/Dup Organic Aciduria 2-Methyl-3-Hydroxybutyryl-CoA Dehydrogenase Deficiency X HSD17B10 X X 3-Hydroxy-3-Methylglutaryl-CoA Lyase Deficiency X HMGCL X X 3-Methylcrotonyl-CoA Carboxylase (3-MCC) Deficiency X MCCC1 and MCCC2 X X FTCD Deficiency/FIGLU-Uria X FTCD X X Glutaric Aciduria, Type 1 X GCDH X X Isovaleric Acidemia (IVA) X IVD X X Malonyl-CoA Decarboxylase Deficiency X MLYCD X Methylmalonic Aciduria - CblA/CblB Deficiency X MMAA and MMAB X X Methylmalonic Aciduria - CblC Deficiency X MMACHC X X Methylmalonic Aciduria - Mutase Deficiency X MUT X X ETFA, ETFB and Multiple Acyl-CoA Dehydrogenase Deficiency X X X ETFDH Multiple CoA Carboxylase Deficiency X HLCS X X Propionic Acidemia X PCCA and PCCB X X Ketothiolase Deficiency X ACAT1 X X SOXCT SCOT Deficiency X OXCT1 X Fatty Acid Oxidation ACAD9 Deficiency X ACAD9 X X Carnitine Deficiency, Primary Carnitine Uptake X SLC22A5 X X Carnitine Palmitoyltransferase 1A Deficiency X CPT1A X X Carnitine Palmitoyltransferase II Deficiency X CPT2 X X Carnitine-Acylcarnitine Translocase Deficiency X SLC25A20 X X SCHAD, Hyperinsulinemic Hypoglycemia X HADH X X Isobutyryl-CoA Dehydrogenase Deficiency X ACAD8 X X Long-Chain 3-Hydroxy Acyl-CoA Dehydrogenase Deficiency X HADHA X X Medium-Chain Acyl-CoA Dehydrogenase Deficiency* X ACADM X X Trifunctional Protein Deficiency X HADHA and HADHB X X Very Long-Chain Acyl-CoA Dehydrogenase Deficiency X ACADVL X X Amino Acidopathy Argininosuccinate Lyase Deficiency X ASL X X Citrullinemia, Type 1 X ASS1 X X Homocystinuria X CBS X X BCKDHA,BCKDHB, Maple Syrup Urine Disease (MSUD)** X X X and DBT MSUD Type III (E3 Deficiency) X DLD X X OTC Deficiency X OTC X X Phenylketonuria (PKU)/Hyperphenylalaninemia X PAH X X Tyrosinemia, Type 1 X FAH X X Other G6PD Deficiency G6PD X X Biotinidase Deficiency** X BTD X X Congenital Hypothyroidism FOXE1 X X Congenital Hypothyroidism PAX8 X X X-Linked Adrenoleukodystrophy ABCD1 X X *Common mutation panel is available. **Enzyme analysis is available. For more information about EGL and the nearly 1100 tests we offer: EMAIL CALL WEB [email protected] 404-778-8499 www.geneticslab.emory.edu.
Load more

Recommended publications
  • Downloaded from GEO
    bioRxiv preprint doi: https://doi.org/10.1101/2020.08.17.252007; this version posted November 3, 2020. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity. It is made available under aCC-BY 4.0 International license. Oxylipin metabolism is controlled by mitochondrial b-oxidation during bacterial inflammation. Mariya Misheva1, Konstantinos Kotzamanis1*, Luke C Davies1*, Victoria J Tyrrell1, Patricia R S Rodrigues1, Gloria A Benavides2, Christine Hinz1, Robert C Murphy3, Paul Kennedy4, Philip R Taylor1,5, Marcela Rosas1, Simon A Jones1, Sumukh Deshpande1, Robert Andrews1, Magdalena A Czubala1, Mark Gurney1, Maceler Aldrovandi1, Sven W Meckelmann1, Peter Ghazal1, Victor Darley-Usmar2, Daniel White1, and Valerie B O’Donnell1 1Systems Immunity Research Institute and Division of Infection and Immunity, and School of Medicine, Cardiff University, UK, 2Department of Pathology, University of Alabama at Birmingham, Birmingham, AL 35294, USA, 3Department of Pharmacology, University of Colorado Denver, Aurora, CO 80045, USA, 4Cayman Chemical 1180 E Ellsworth Rd, Ann Arbor, MI 48108, United States, 5UK Dementia Research Institute at Cardiff, Cardiff University, UK Address correspondence: Valerie O’Donnell, [email protected] or Daniel White, [email protected], Systems Immunity Research Institute, Cardiff University *Both authors contributed equally to the study 1 bioRxiv preprint doi: https://doi.org/10.1101/2020.08.17.252007; this version posted November 3, 2020. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity.
    [Show full text]
  • Counsyl Foresight™ Carrier Screen Disease List
    COUNSYL FORESIGHT™ CARRIER SCREEN DISEASE LIST The Counsyl Foresight Carrier Screen focuses on serious, clinically-actionable, and prevalent conditions to ensure you are providing meaningful information to your patients. 11-Beta-Hydroxylase- Bardet-Biedl Syndrome, Congenital Disorder of Galactokinase Deficiency Deficient Congenital Adrenal BBS1-Related (BBS1) Glycosylation, Type Ic (ALG6) (GALK1) Hyperplasia (CYP11B1) Bardet-Biedl Syndrome, Congenital Finnish Nephrosis Galactosemia (GALT ) 21-Hydroxylase-Deficient BBS10-Related (BBS10) (NPHS1) Gamma-Sarcoglycanopathy Congenital Adrenal Bardet-Biedl Syndrome, Costeff Optic Atrophy (SGCG) Hyperplasia (CYP21A2)* BBS12-Related (BBS12) Syndrome (OPA3) Gaucher Disease (GBA)* 6-Pyruvoyl-Tetrahydropterin Bardet-Biedl Syndrome, Cystic Fibrosis GJB2-Related DFNB1 Synthase Deficiency (PTS) BBS2-Related (BBS2) (CFTR) Nonsyndromic Hearing Loss ABCC8-Related Beta-Sarcoglycanopathy and Deafness (including two Cystinosis (CTNS) Hyperinsulinism (ABCC8) (including Limb-Girdle GJB6 deletions) (GJB2) Muscular Dystrophy, Type 2E) D-Bifunctional Protein Adenosine Deaminase GLB1-Related Disorders (SGCB) Deficiency (HSD17B4) Deficiency (ADA) (GLB1) Biotinidase Deficiency (BTD) Delta-Sarcoglycanopathy Adrenoleukodystrophy: GLDC-Related Glycine (SGCD) X-Linked (ABCD1) Bloom Syndrome (BLM) Encephalopathy (GLDC) Alpha Thalassemia (HBA1/ Calpainopathy (CAPN3) Dysferlinopathy (DYSF) Glutaric Acidemia, Type 1 HBA2)* Canavan Disease Dystrophinopathies (including (GCDH) (ASPA) Alpha-Mannosidosis Duchenne/Becker Muscular
    [Show full text]
  • Child Neurology: Hereditary Spastic Paraplegia in Children S.T
    RESIDENT & FELLOW SECTION Child Neurology: Section Editor Hereditary spastic paraplegia in children Mitchell S.V. Elkind, MD, MS S.T. de Bot, MD Because the medical literature on hereditary spastic clinical feature is progressive lower limb spasticity B.P.C. van de paraplegia (HSP) is dominated by descriptions of secondary to pyramidal tract dysfunction. HSP is Warrenburg, MD, adult case series, there is less emphasis on the genetic classified as pure if neurologic signs are limited to the PhD evaluation in suspected pediatric cases of HSP. The lower limbs (although urinary urgency and mild im- H.P.H. Kremer, differential diagnosis of progressive spastic paraplegia pairment of vibration perception in the distal lower MD, PhD strongly depends on the age at onset, as well as the ac- extremities may occur). In contrast, complicated M.A.A.P. Willemsen, companying clinical features, possible abnormalities on forms of HSP display additional neurologic and MRI abnormalities such as ataxia, more significant periph- MD, PhD MRI, and family history. In order to develop a rational eral neuropathy, mental retardation, or a thin corpus diagnostic strategy for pediatric HSP cases, we per- callosum. HSP may be inherited as an autosomal formed a literature search focusing on presenting signs Address correspondence and dominant, autosomal recessive, or X-linked disease. reprint requests to Dr. S.T. de and symptoms, age at onset, and genotype. We present Over 40 loci and nearly 20 genes have already been Bot, Radboud University a case of a young boy with a REEP1 (SPG31) mutation. Nijmegen Medical Centre, identified.1 Autosomal dominant transmission is ob- Department of Neurology, PO served in 70% to 80% of all cases and typically re- Box 9101, 6500 HB, Nijmegen, CASE REPORT A 4-year-old boy presented with 2 the Netherlands progressive walking difficulties from the time he sults in pure HSP.
    [Show full text]
  • Inborn Errors of Metabolism Test Requisition
    LABORATORY OF GENETICS AND GENOMICS Mailing Address: For local courier service and/or inquiries, please contact 513-636-4474 • Fax: 513-636-4373 3333 Burnet Avenue, Room R1042 www.cincinnatichildrens.org/moleculargenetics • Email: [email protected] Cincinnati, OH 45229 INBORN ERRORS OF METABOLISM TEST REQUISITION All Information Must Be Completed Before Sample Can Be Processed PATIENT INFORMATION ETHNIC/RACIAL BACKGROUND (Choose All) Patient Name: ___________________ , ___________________ , ________ European American (White) African-American (Black) Last First MI Native American or Alaskan Asian-American Address: ____________________________________________________ Pacific Islander Ashkenazi Jewish ancestry ____________________________________________________ Latino-Hispanic _____________________________________________ Home Phone: ________________________________________________ (specify country/region of origin) MR# __________________ Date of Birth ________ / ________ / _______ Other ____________________________________________________ (specify country/region of origin) Gender: Male Female BILLING INFORMATION (Choose ONE method of payment) o REFERRING INSTITUTION o COMMERCIAL INSURANCE* Insurance can only be billed if requested at the time of service. Institution: ____________________________________________________ Policy Holder Name: _____________________________________________ Address: _____________________________________________________ Gender: ________________ Date of Birth ________ / ________ / _______
    [Show full text]
  • TITLE: Biotinidase Deficiency PRESENTER: Anna Scott Slide 1
    TITLE: Biotinidase Deficiency PRESENTER: Anna Scott Slide 1: Hello, my name is Anna Scott. I am a biochemical genetics laboratory director at Seattle Children’s Hospital. Welcome to this Pearl of Laboratory Medicine on “Biotinidase Deficiency.” Slide 2: Lecture Overview For today’s Pearl, I will start with background information about biotinidase including its role in metabolism and clinical features. Then we will discuss different clinical assays that can detect and diagnose the enzyme deficiency. Finally, I will touch on biotinidase as it relates to newborn screening. Slide 3: Background Biotinidase deficiency is an inborn error of metabolism, specifically affecting biotin metabolism. Biotin is also known as vitamin B7. Most free biotin is absorbed through the gut from food. This vitamin is an essential cofactor for four carboxylase enzymes. Biotin metabolism primarily consists of two steps- 1) loading the free biotin into an apocarboxylase to form the active form of the enzyme, called holocarboylases and 2) recycling biocytin back to lysine and free biotin after protein degradation. The enzyme responsible for loading free biotin into new enzymes is holocarboxylase synthetase. Loss of function of this enzyme can cause clinical features similar to biotinidase deficiency, typically with an earlier age of onset and greater severity. Biotinidase deficiency results in failure to recycle biocytin back to free biotin for re-incorporation into a new apoenzyme. Slide 4: Clinical Symptoms and Therapy © 2016 Clinical Chemistry Pearls of Laboratory Medicine Title Classical clinical symptoms associated with biotinidase deficiency include: alopecia, eczema, hearing and/or vision loss, and acidosis. During acute illness, hyperammonemia, seizures, and coma can also manifest.
    [Show full text]
  • Biotinidase Deficiency (Biot) Family Fact Sheet
    BIOTINIDASE DEFICIENCY (BIOT) FAMILY FACT SHEET What is a positive newborn screen? What problems can biotinidase deficiency Newborn screening is done on tiny samples of blood cause? taken from your baby’s heel 24 to 36 hours after birth. The blood is tested for rare, hidden disorders that may Biotinidase deficiency is different for each child. Some affect your baby’s health and development. The children have a mild, partial biotinidase deficiency with newborn screen suggests your baby might have a few health problems, while other children may have disorder called biotinidase deficiency. complete biotinidase deficiency with serious complications. A positive newborn screen does not mean your If biotinidase deficiency is not treated, a child might baby has biotinidase deficiency, but it does mean develop: your baby needs more testing to know for sure. • Muscle weakness • Hearing loss You will be notified by your primary care provider or • Vision (eye) problems the newborn screening program to arrange for • Hair loss additional testing. • Skin rashes What is biotinidase deficiency? • Seizures • Developmental delay Biotinidase deficiency affects an enzyme needed to It is very important to follow the doctor’s instructions free biotin (one of the B vitamins) from the food we for testing and treatment. eat, so it can be used for energy and growth. What is the treatment for biotinidase A person with biotinidase deficiency doesn’t have deficiency? enough enzyme to free biotin from foods so it can be used by the body. Biotinidase deficiency can be treated. Treatment is life- long and includes: Biotinidase deficiency is a genetic disorder that is • Daily biotin vitamin pill(s) or liquid.
    [Show full text]
  • Biotinidase Deficiency
    orphananesthesia Anaesthesia recommendations for patients suffering from Biotinidase deficiency Disease name: Biotinidase deficiency ICD 10: E53.8 Synonyms: Late-Onset Biotin-aesponsive Multiple Carboxylase Deficiency, Late-Onset Multiple Carboxylase Deficiency Disease summary: Biotinidase deficiency (BD), biotin metabolism disorder, was first described in 1982 [1]. It is inherited as an autosomal recessive trait. The incidence of BD in the world is approximately 1/60.000 newborns [1]. Clinical manifestations include neurological abnormalities (seizures, ataxia, hypotonia, developmental delay, hearing loss and vision problems like optic atrophy), dermatological abnormalities (seborrheic dermatitis, alopecia, skin rash, conjunctivitis, candidiasis, hair loss), neuromuscular abnormalities (motor limb weakness, spastic paresis, myelopathy), metabolic abnormalities (ketolactic acidosis, organic aciduria, hyperammonemia) [1-6]. Besides, respiratory problems (apnoea, dyspnoea, tachyponea, laryngeal stridor) and immune deficiency findings (prolonged or recurrent viral/fungal infections) are associated with BD [1,3,4]. Hypotonia and seizures are the most common clinical features [4,7]. Medicine in progress Perhaps new knowledge Every patient is unique Perhaps the diagnostic is wrong Find more information on the disease, its centres of reference and patient organisations on Orphanet: www.orpha.net 1 Disease summary Treatment with 5-10 mg of oral biotin per day results rapidly in clinical and biochemical improvement. However, once vision problems, hearing loss, and developmental delay occur, these problems are usually irreversible even if the child is on biotin therapy [4]. Moreover, BD can lead to coma and death when the child if not treated [8]. In some children, especially after puberty, biotin dose is increased from 10 mg per day to 20 mg per day.
    [Show full text]
  • Newborn Screening FACT SHEET
    Newborn Screening FACT SHEET What is newborn screening? Blood spot screening checks babies for: Arginemia Newborn screening is a set of tests that check babies Argininosuccinate acidemia for serious, rare disorders. Most of these disorders Beta ketothiolase deficiency cannot be seen at birth but can be treated or helped Biopterin cofactor defects (2 types) if found early. The three tests include blood spot, Biotinidase deficiency hearing, and pulse oximetry screening. Carnitine acylcarnitine translocase deficiency Carnitine palmitoyltransferase deficiency (2 types) Carnitine uptake defect Citrullinemia (2 types) Blood spot screening checks for over Congenital adrenal hyperplasia 50 rare but treatable disorders. Early Congenital hypothyroidism Cystic fibrosis detection can help prevent serious health Dienoyl-CoA reductase deficiency problems, disability, and even death. Galactokinase deficiency The box on the right lists the disorders Galactoepimerase deficiency screened for in Minnesota. Galactosemia Glutaric acidemia (2 types) Hearing screening checks for hearing Hemoglobinopathy variants loss in the range where speech is heard. Homocystinuria Hypermethioninemia Identifying hearing loss early helps babies Hyperphenylalaninemia stay on track with speech, language, and Isobutyryl-CoA dehydrogenase deficiency communication skills. Isovaleric acidemia Long-chain hydroxyacyl-CoA dehydrogenase deficiency Pulse oximetry screening checks for a set Malonic acidemia of serious, life-threatening heart defects Maple syrup urine disease known as
    [Show full text]
  • Newborn Screening: Because You Touch the Future Everyday
    Newborn Screening: Because you touch the future everyday January 2007 Purpose of Newborn Screening • Program to screen for congenital and heritable disorders • These disorders may cause severe mental retardation, illness, or death if not treated early in life • If treated, infants may live relatively normal lives • Results in savings in medical costs over time If Untreated, Disorders • Can result in: – Growth problems – Developmental delays – Behavioral/emotional problems – Deafness or blindness – Retardation – Seizures – Coma, sometimes leading to death NBS Screening • Identification is a multi-step process – Blood specimens from infants are analyzed by the laboratory – If a result is abnormal, laboratory staff notifies case management staff – Case management provides follow-up to assist linking families with appropriate providers to • Confirm the test results and • Ensure the infant has the disorder prior to treatment • Ensure the infant receives appropriate treatment Results from Lab • Normal Screen Results • Abnormal results – Results are sent to – Results are reported to submitter when all test Case Management as are final soon as available for that disorder Abnormal Results for each disorder • High Panic Codes – are reported to RN in NBS Case Management – RN will notify MD ASAP. If MD unavailable RN will notify mother • Low Panic Codes – Health Tech will notify MD or facility – Mother notified by letter Abnormal Specimen • Case Management will send: – Lab results for that disorder – ACT sheet specific to that disorder – FACT sheet for families – List of Metabolic Specialists Newborn Screening ACT Sheet [Absent/Reduced biotinidase activity] Biotinidase Deficiency Differential Diagnosis: Biotinidase deficiency; see C5-OH for non-biotinidase associated conditions. Metabolic Description: Biotinidase deficiency results from defective activity of the biotinidase enzyme.
    [Show full text]
  • Free PDF Download
    European Review for Medical and Pharmacological Sciences 2019; 23: 1710-1721 Next-generation sequencing identifies a homozygous mutation in ACADVL associated with pediatric familial dilated cardiomyopathy S.J. CARLUS1, I.S. ALMUZAINI2, M. KARTHIKEYAN3, L. LOGANATHAN3, G.S. AL-HARBI1, A.M. ABDALLAH4, K.M. AL-HARBI1 1Pediatrics Department, Cardiogenetics Unit, College of Medicine, Taibah University, Al-Madinah, Kingdom of Saudi Arabia 2Department of Pediatric Cardiology, Al-Madinah Maternity and Children Hospital (MMCH), Al-Madinah, Kingdom of Saudi Arabia 3Department of Bioinformatics, Alagappa University, Karaikudi, Tamil Nadu, India 4West Midlands Regional Genetics Laboratory, Birmingham Women’s NHS Foundation Trust, Birmingham, United Kingdom Abstract. – OBJECTIVE: Pediatric familial di- Key Words lated cardiomyopathy (DCM) is a rare and se- Pediatric familial dilated cardiomyopathy, Targeted vere heart disease. The genetics of familial DCM gene sequencing, ACADVL, Saudi Arabia, Consanguinity, are complex and include over 100 known dis- Molecular docking, Molecular dynamics. ease-causing genes, but many causative genes are unknown. We aimed to identify the causative gene for DCM in a consanguineous Saudi Ara- bian family with affected family members and a history of sudden death. Introduction PATIENTS AND METHODS: Affected (two chil- dren) and unaffected (one sibling and the mother) Dilated cardiomyopathy (DCM) is a heart family members were screened by next-gener- ation sequencing (NGS) for 181 candidate DCM disease characterized by ventricular dilation and genes and underwent metabolic screening. Fif- impaired myocardial contractility. DCM affects ty-seven clinically annotated controls and 46 DCM 1 in 2500 of the general population and is one of cases were then tested for the identified mutation.
    [Show full text]
  • Ab118182 – Fatty Acid Oxidation Human In-Cell ELISA
    ab118182 – Fatty Acid Oxidation Human In-Cell ELISA Kit (ACADVL, ACADM, HADHA) Instructions for Use For measuring in high throughput very long chain specific acyl-CoA dehydrogenase, medium-chain specific acyl-CoA dehydrogenase and long-chain 3-hydroxyl-CoA dehydrogenase This product is for research use only and is not intended for diagnostic use. 1 Table of Contents 1. Introduction 3 2. Assay Summary 6 3. Kit Contents 7 4. Storage and Handling 7 5. Additional Materials Required 8 6. Preparation of Reagents 8 7. Sample Preparation 9 8. Assay Procedure 11 9. Data Analysis 14 10. Assay Performance and Specificity 14 11. Frequently Asked Questions 18 12. Troubleshooting 21 2 1. Introduction Principle: ab118182 uses quantitative immunocytochemistry to measure protein levels or post-translational modifications in cultured cells. Cells are fixed in a microplate and targets of interest are detected with highly specific, well-characterized monoclonal antibodies, and levels are quantified with IRDye®-labeled Secondary Antibodies. IR imaging and quantitation is performed using a LI- COR® Odyssey® or Aerius® system. Background: The Fatty acid B-oxidation (FAO) pathway is a key metabolic pathway that plays an important role in energy homeostasis particularly in organs such as the liver, heart and skeletal muscle. Oxidation of fatty acids occurs inside the mitochondria where acyl-CoA esters (activated fatty acids) of various lengths are shortened into units of acetyl-CoA each time a cycle is fully completed. Each unit of acetyl-CoA is then oxidized by the mitochondria into CO 2 and H 2O via the citric acid cycle and the mitochondria respiratory chain.
    [Show full text]
  • Genotypic and Phenotypic Correlations of Biotinidase Deficiency in The
    Hsu et al. Orphanet Journal of Rare Diseases (2019) 14:6 https://doi.org/10.1186/s13023-018-0992-2 LETTER TO THE EDITOR Open Access Genotypic and phenotypic correlations of biotinidase deficiency in the Chinese population Rai-Hseng Hsu1,2,3, Yin-Hsiu Chien1,2, Wuh-Liang Hwu1,2, I-Fan Chang2, Hui-Chen Ho4, Shi-Ping Chou2, Tzu-Ming Huang1 and Ni-Chung Lee1,2* Abstract Biotinidase deficiency is an autosomal recessive disorder that affects the endogenous recycling and release of biotin from dietary protein. This disease was thought to be rare in East Asia. In this report, we delineate the phenotype of biotinidase deficiency in our cohort. The genotypes and phenotypes of patients diagnosed with biotinidase deficiency from a medical center were reviewed. The clinical manifestations, laboratory findings, and molecular test results were retrospectively analyzed. A total of 6 patients were evaluated. Three patients (50%) were diagnosed because of a clinical illness, and the other three (50%) were identified by newborn screening. In all patients, the molecular results confirmed the BTD mutation. The three patients with clinical manifestations had an onset of seizure at the age of 2 to 3 months. Two patients had respiratory problems (one with apnea under bilevel positive airway pressure (BiPAP) therapy at night, and the other with laryngomalacia). Hearing loss and eye problems were found in one patient. Interestingly, cutaneous manifestations including skin eczema, alopecia, and recurrent fungal infection were less commonly seen compared to cases in the literature. None of the patients identified by the newborn screening program developed symptoms. Our findings highlight differences in the genotype and phenotype compared with those in Western countries.
    [Show full text]