%0 Case Reports
%T Prenatal molecular diagnosis of pyruvate dehydrogenase complex deficiency enables rapid initiation of ketogenic diet.
%A Bowen AB
%A Rapalino O
%A Jaimes C
%A Ratai EM
%A Zhong Y
%A Thiele EA
%A Kritzer A
%A Ganetzky RD
%A Gold NB
%A Walker MA
%J Am J Med Genet A
%V 0
%N 0
%D 2024 Jul 26
%M 39058293
%F 2.578
%R 10.1002/ajmg.a.63825
%X Pyruvate dehydrogenase complex deficiency (PDCD) is a mitochondrial disorder of carbohydrate oxidation characterized by lactic acidosis and central nervous system involvement. Knowledge of the affected metabolic pathways and clinical observations suggest that early initiation of the ketogenic diet may ameliorate the metabolic and neurologic course of the disease. We present a case in which first trimester ultrasound identified structural brain abnormalities prompting a prenatal molecular diagnosis of PDCD. Ketogenic diet, thiamine, and N-acetylcysteine were initiated in the perinatal period with good response, including sustained developmental progress. This case highlights the importance of a robust neurometabolic differential diagnosis for prenatally diagnosed structural anomalies and the use of prenatal molecular testing to facilitate rapid, genetically tailored intervention.