TAILIEUCHUNG - báo cáo khoa học: " Female heterozygotes for the hypomorphic R40H mutation can have ornithine transcarbamylase deficiency and present in early adolescence: a case report and review of the literature"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Female heterozygotes for the hypomorphic R40H mutation can have ornithine transcarbamylase deficiency and present in early adolescence: a case report and review of the literature | Pinner et al. Journal of Medical Case Reports 2010 4 361 http content 4 1 361 jAg JOURNALOF medical ÌỤr case REPORTS CASE REPORT Open Access Female heterozygotes for the hypomorphic R40H mutation can have ornithine transcarbamylase deficiency and present in early adolescence a case report and review of the literature Jason R Pinner1 Mary-Louise Freckmann2 Edwin P Kirk2 Makoto Yoshino3 Abstract Introduction Ornithine transcarbamylase deficiency is the most common hereditary urea cycle defect. It is inherited in an X-linked manner and classically presents in neonates with encephalopathy and hyperammonemia in males. Females and males with hypomorphic mutations present later sometimes in adulthood with episodes that are frequently fatal. Case presentation A 13-year-old Caucasian girl presented with progressive encephalopathy hyperammonemic coma and lactic acidosis. She had a history of intermittent regular episodes of nausea and vomiting from seven years of age previously diagnosed as abdominal migraines. At presentation she was hyperammonemic ammonia 477 pmol L with no other biochemical indicators of hepatic dysfunction or damage and had grossly elevated urinary orotate orotate creatinine ratio pmol mmol creatinine reference range 500 pmol mmol creatinine highly suggestive of ornithine transcarbamylase deficiency. She was treated with intravenous sodium benzoate and arginine and made a rapid full recovery. She was discharged on a protein-restricted diet. She has not required ongoing treatment with arginine and baseline ammonia and serum amino acid concentrations are within normal ranges. She has had one further episode of hyperammonemia associated with intercurrent infection after one year of follow up. An R40H A mutation was identified in the ornithine transcarbamylase gene OTC in our patient confirming the first symptomatic female shown heterozygous for the R40H mutation. A review of the literature and correspondence with .

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