• 제목/요약/키워드: Inborn error of metabolism

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아이소발레린산혈증 신생아에서 발견된 새로운 돌연변이 (Neonatal Onset Isovaleric Acidemia with Novel Mutation)

  • 김영한;배은주;박형두;이홍진
    • 대한유전성대사질환학회지
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    • 제16권1호
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    • pp.42-46
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    • 2016
  • Isovaleric acidemia is autosomal-recessively inherited and an inborn error of metabolism caused by abnormal leucine metabolism due to the genetic defect of IVD (Isovaleryl-CoA dehydrogenase). IVD corresponds to mitochondrial matrix enzyme that acts on converting isovaleryl-CoA into 3-methylcrotonyl-CoA in the leucine catabolism. The IVD gene is located at Chromosome 15q14-q15, particularly between base pair 40,405,485 and base pair 40,435,948. It consists of 12 exons and has been reported to cause over 50 diseases so far. We conducted IVD gene test on the patient with acute isovaleric acidemia and confirmed a new type of mutation for the first time. As a result of analyzing the IVD gene sequence, we found out that c.129T>G(p.Asn43Lys) and c.1033A>G(p.Asn345Asp) mutations exist as heterozygosity at Exon 1 and Exon 10 respectively, novel mutation.

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Wilson's Disease 환자 1례의 증례 보고 (A Case of Wilson's Disease)

  • 이상관
    • 동의생리병리학회지
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    • 제16권5호
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    • pp.1066-1069
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    • 2002
  • Wilson's disease is a rare inborn error of metabolism inherited as a autosomal recessive trait. The disease has varied mode of manifestations. It is characterized by different neurologic disorder and hepatic disease. I experienced a case of Wilson's disease in 40 year old woman who was suffered from liver cirrhosis, severe anorexia, and classical neurologic symptoms such as tremour, dysarthria and ataxia. The symptoms was not relieved by D-penicillamine, Youngyanggaksan and Samchulgunbi-tang but anorexia was improved significantly by same medication.

Bilateral Pallidotomy for Dystonia with Glutaric Aciduria Type 1

  • Hwang, Hyung-Sik;Salles, Antonio De
    • Journal of Korean Neurosurgical Society
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    • 제38권5호
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    • pp.380-383
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    • 2005
  • Glutaric aciduria type 1 is an inborn error of lysine, hydroxylysine, and tryptophan metabolism caused by deficiency of glutaryl-coenzyme A dehydrogenase. The disease often appears in infancy with encephalopathy episode that results in acute basal ganglia and white matter degeneration. The majority of patients develop a dystonic-dyskinetic syndrome. This reports 6year-old boy who had been done previous gastrostomy due to swallowing difficulty underwent bilateral pallidotomy with intraoperative electromyography[EMG] monitoring for disabling dystonia. Intraoperative EMG was used to assess stimulation thresholds required for capsular responses and muscle tone. Surface EMG electrodes were placed on the face and cricopharyngeal muscles. Exact target were directly modified according to MRI-visualized anatomy. EMG response was consistently seen prior to visual observation of muscle activity. The surgery improved dystonic symptoms without swallowing difficulty.

Long-Term Clinical Course of a Korean Patient with Chronic Neuropathic (type III) Gaucher Disease

  • Lee, Jun Hwa
    • Journal of Interdisciplinary Genomics
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    • 제1권2호
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    • pp.15-18
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    • 2019
  • Gaucher disease (GD) is an autosomal recessive inborn error of metabolism resulting from a deficiency in ${\beta}$-glucocerebrosidase (GBA) activity that leads to the accumulation of glucocerebroside in macrophages in multiple organs, such as the bone marrow, liver, spleen, and brain. GD can be classified into three clinical types: type 1 (non-neuropathic form, OMIM #230800); type II (acute neuropathic form, OMIM #230900); and type III (chronic neuropathic form, OMIM #231000). Type III is the subacute form of neuropathic GD. The best available treatment for GD is long-term enzyme (imiglucerase) replacement therapy (ERT) performed every two weeks. This report describes the long-term clinical course of a patient with type III GD who was treated with ERT for 18 years.

Isovaleric Acidemia 3례 (3 Case of Isovaleric Acidemia)

  • 이동환;전경수;안영민
    • 대한유전성대사질환학회지
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    • 제2권1호
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    • pp.7-11
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    • 2002
  • 저자들은 잘 교정되지 않는 대사성 산혈증을 주소로 내원한 3세된 남아와 원인 모르는 기면과 구토로 5차례 입원했던 과거력을 가진 8세된 남아 형제가 유기산 분석에서 isovalerylglycine의 현저한 증가를 보여 만성 간헐형의 isovaleric acidemia로 진단된 예와 탄뎀질량분석검사에서 isovaleric acidemia로 진단되어 조기치료하고 있는 예를 경험하였기에 보고하는 바이다.

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신생아 울음의 의사소통 의도와 관련된 음향학적 특성 (Acoustic and Physiologic Characteristics of Newborn Infants' Communication Intent via Crying)

  • 장효령;고도흥
    • 말소리와 음성과학
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    • 제5권3호
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    • pp.55-60
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    • 2013
  • The purpose of this study was to investigate the acoustic characteristics of crying infants according to the communication intents such as hunger and pain in terms of acoustic differences in the fundamental frequency ($F_0$), jitter, shimmer, noise-to-harmonic ratio(NHR), habitual pitch, and intensity. The subjects were 20 healthy, normal infants, less than seven days old, from the city of Seoul and were born after 38 to 42 weeks(full term) of pregnancy. The sound of crying was recorded for three minutes. The crying due to pain was induced by means of the inborn metabolism error test, whereas the crying due to hunger was verified by means of the rooting reflex by waiting for the designated eating time. The results were as follows: (1) the fundamental frequency, noise-to-harmonic ratio(NHR), and intensity of the infants' crying due to pain was higher than that by hunger, showing a significant difference between the mean values. (2) the infants' crying due to hunger and that by pain did not have a significant difference in the mean jitter and shimmer values but both of them were largely outside of the normal threshold values(jitter by 1.04% and shimmer by 3.81%). This study was significant in the sense that it showed the acoustic characteristics of infants' crying from hunger and pain were very different from each other according to the communication intents in terms of the six acoustic parameters.

유전성 대사질환의 임상증상과 진단 (Diagnosis of Inherited Metabolic Disorders Based on Their Diverse Clinical Features and laboratory Tests)

  • 유한욱
    • 대한유전성대사질환학회지
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    • 제13권1호
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    • pp.1-19
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    • 2013
  • Inherited metabolic disorders are individually rare but as a whole, they are nor rare. Since Archibald Garrod introduced a concept of "inborn error of metabolism" or "chemical individuality", more than 600 diseases are currently known, affecting approximately one in 500 newborns cumulatively. They frequently manifest with acute, life-threatening crisis that requires immediate specific intervention or they present with insidious diverse symptoms and signs involving multiple visceral organs or tissues as well as central nervous system, hampering a correct diagnosis. In addition, many pediatricians are not familiar with all diagnostic and therapeutic strategies for diverse inherited metabolic disorders. However, the prognosis of affected children are heavily dependent on rapid and effective treatment. In this lecture, practical guidelines for the specific diagnosis based on diverse clinical features of inherited metabolic disorders will be described. Many sophisticated laboratory tests are available for the confirmatory diagnosis of each disease, which is challenging to general pediatricians with respect to knowledge about biochemical metabolite assay test, enzymatic test and DNA diagnostic tests. Sample collections, indications, methods and interpretation of results in varying laboratory tests will be listed as well.

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탠덤매스에의한 체액 중 Globotriaocylceramide(Gb-3)의 측정을 이용한 한국인 고 위험도군에서의 파브리병 스크리닝 (Status of High Risk Group Fabry Disease Screening in Korea by Measuring Globotriacocylceramide in Body Fluid using Electrospray-MS/MS)

  • 윤혜란
    • 약학회지
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    • 제55권1호
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    • pp.56-63
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    • 2011
  • Fabry disease (FD) is an X-linked inborn error of glycoshpingolipid metabolism resulting from mutation in the enzyme ${\alpha}$-galactosidase A gene. The disease is an X-linked lipid storage disorder and the lack of ${\alpha}$-Gal A causes an intracellular accumulation of glycosphingolipids, mainly globotriaosylceramide (Gb-3). Measurement of Gb-3 in plasma has clinical importance for monitoring after enzyme replacement therapy for confirmed FD patients. Using electrospray ionization MS/MS we had developed, a simple, rapid, and highly sensitive analytical method for Gb-3 in plasma was used for the purpose of screening FD among high risk groups in Korean population. To date, no comprehensive results for FD screening have been performed and reported in Korea. We screened 1,100 outpatients from 13 hospitals (including clinics) to assess the incidence of FD among patients in high risk groups. For patients with borderline level amount of Gb-3, we repeated Gb-3 or performing complementary or confirmative assay with ${\alpha}$-Gal A activity and DNA mutaion analysis for confirmation diagnosis. Of 1,100 we diagnosed 3 FD with 2 classical type and 1 carrier (0.27%).

유전성 대사질환의 임상증상과 진단 (Diagnosis of inherited metabolic disorders based on their diverse clinical features and laboratory tests)

  • 유한욱
    • Clinical and Experimental Pediatrics
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    • 제49권11호
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    • pp.1140-1151
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    • 2006
  • Inherited metabolic disorders are individually rare but as a whole, they are nor rare. Since Archibald Garrod introduced a concept of "inborn error of metabolism" or "chemical individuality", more than 500 diseases are currently known, affecting approximately one in 500 newborns cumulatively. They frequently manifest with acute, life-threatening crisis that require immediate specific intervention or they present with insidious diverse symptoms and signs involving multiple visceral organs or tissues as well as central nervous system, hampering a correct diagnosis. In addition, many pediatricians are not familiar with all diagnostic and therapeutic strategies for diverse inherited metabolic disorders. However, the prognosis of affected children are heavily dependent on rapid and effective treatment. In this lecture, practical guidelines for the specific diagnosis based on diverse clinical features of inherited metabolic disorders will be described. Many sophisticated laboratory tests are available for confirmatory diagnosis of each disease, which challenge to general pediatricians with respect to knowledge about biochemical metabolite assay test, enzymatic test and DNA diagnostic tests. Sample collections, indications, methods and interpretation of results in varying laboratory tests will be listed as well.

Sequential magnetic resonance spectroscopic changes in a patient with nonketotic hyperglycinemia

  • Shin, Ji-Hun;Ahn, So-Yoon;Shin, Jeong-Hee;Sung, Se-In;Jung, Ji-Mi;Kim, Jin-Kyu;Kim, Eun-Sun;Park, Hyung-Doo;Kim, Ji-Hye;Chang, Yun-Sil;Park, Won-Soon
    • Clinical and Experimental Pediatrics
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    • 제55권8호
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    • pp.301-305
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    • 2012
  • Nonketotic hyperglycinemia (NKH) is a rare inborn error of amino acid metabolism. A defect in the glycine cleavage enzyme system results in highly elevated concentrations of glycine in the plasma, urine, cerebrospinal fluid, and brain, resulting in glycine-induced encephalopathy and neuropathy. The prevalence of NKH in Korea is very low, and no reports of surviving patients are available, given the scarcity and poor prognosis of this disease. In the current study, we present a patient with NKH diagnosed on the basis of clinical features, biochemical profiles, and genetic analysis. Magnetic resonance spectroscopy (MRS) allowed the measurement of absolute glycine concentrations in different parts of the brain that showed a significantly increased glycine peak, consolidating the diagnosis of NKH. In additional, serial MRS follow-up showed changes in the glycine/creatinine ratios in different parts of the brain. In conclusion, MRS is an effective, noninvasive diagnostic tool for NKH that can be used to distinguish this disease from other glycine metabolism disorders. It may also be useful for monitoring NKH treatment.