ATYPICAL FEATURES OF THE HEPATIC FORM OF CARNITINE PALMITOYLTRANSFERASE DEFICIENCY IN A HUTTERITE FAMILY

被引:26
作者
HAWORTH, JC
DEMAUGRE, F
BOOTH, FA
DILLING, LA
MOROZ, SP
SESHIA, SS
SEARGEANT, LE
COATES, PM
机构
[1] UNIV MANITOBA, DEPT PEDIAT & CHILD HLTH, WINNIPEG R3T 2N2, MANITOBA, CANADA
[2] UNIV MANITOBA, DEPT BIOCHEM & MOLEC BIOL, WINNIPEG R3T 2N2, MANITOBA, CANADA
[3] FAC MED NECKER ENFANTS MALAD, PARIS, FRANCE
[4] CHILDRENS HOSP PHILADELPHIA, PHILADELPHIA, PA USA
关键词
D O I
10.1016/S0022-3476(05)81143-6
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
We describe hepatic carnitine palmitoyltransferase (CPT I) deficiency in three children (a brother and sister and their second cousin) from an extended inbred Hutterite kindred. The patients were first seen between 8 and 18 months of age with recurrent episodes of hypoketotic hypoglycemia accompanied by a decreased level of consciousness and hepatomegaly. One patient had two Reye syndrome-like episodes. Abnormal organic acids were rarely detected in urine. Serum total and free carnitine levels were elevated in all three patients. Fibroblast acyl-coenzyme A dehydrogenase activities were normal in all, but palmitic acid oxidation, performed in fibroblasts from one patient, was less than 10% of control values. Activity of CPT I in cultured skin fibroblasts from the three patients was 10% to 15% of control levels; CPT II activity was normal. Activity of CPT I and CPT II in muscle from one patient was normal. Atypical features in two of these patients were greatly elevated levels of liver enzymes and creatine kinase during acute episodes. The patients have recently been successfully treated with medium-chain triglycerides and avoidance of fasting. Early identification and treatment of this disorder may avert potentially fatal episodes of hypoglycemia.
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页码:553 / 557
页数:5
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