Mesh : Amino Acid Metabolism, Inborn Errors / diagnosis diet therapy genetics Brain / pathology Carnitine / administration & dosage Cephalometry Child, Preschool Chromosome Aberrations DNA Mutational Analysis Diagnosis, Differential Diet, Protein-Restricted Exons / genetics Genes, Recessive Glutarates / urine Glutaryl-CoA Dehydrogenase / deficiency Guideline Adherence Humans Infant Infant, Newborn Lysine / administration & dosage Magnetic Resonance Imaging Male Neonatal Screening Prognosis Tryptophan / administration & dosage

来  源:   DOI:10.1055/s-0029-1239525   PDF(Sci-hub)

Abstract:
We report on a 4.5-year-old patient diagnosed with Glutaric aciduria type I (GAI), an autosomal recessive inborn error of lysine, hydroxylysine and tryptophan metabolism. Enzymatic assay in cultivated skin fibroblasts revealed complete absence of glutaryl-CoA dehydrogenase activity. All 11 Exons of the GCDH-Gen were sequenced and homozygosity for a yet undescribed mutation was identified. The patient was treated following the recently published guidelines for GA-I. Following this treatment regimen, the child developed normally without any manifest clinical crises. Our patient provides evidence that early commencement and strict adherence to treatment improves clinical outcome even in patients with complete absence of enzyme activity.
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