Presentation
Intermediate have the maple syrup odor to their urine and may also present with developmental delay and feeding problems in infancy. Oftentimes they are diagnosed with MSUD between 5 months and 7 years old, presenting with intellectual disability. [thinkgenetic.com]
METHODS This article presents the results of biochemical and molecular analyses and metabolic response to treatment procedures in a 10-week old boy presenting with vomiting, progressive OBJECTIVE To investigate the values of tandem mass spectrometry [herbal-organic.com]
The clinical presentation is very similar to that of intermediate maple syrup urine disease, with the exception of early-onset lactic acidosis. [emedicine.medscape.com]
May present with feeding problems, poor growth and developmental delay during infancy, or may present much later in life with learning difficulties. Usually diagnosed between ages 5 months and 7 years. [patient.info]
Overview Maple syrup urine disease is an inborn error of branched-chain ketoacid metabolism that presents classically with metabolic distress in newborns, although milder presentations exist. [medlink.com]
Entire Body System
- Weight Loss
Some of the initial symptoms of classic MSUD include irregular sleep patterns, lethargy, irritability, weight loss, poor appetite, and a distinctive maple sugar odor in earwax, sweat, and urine (which gives the disorder its name). [medicaldaily.com]
Within several days, the infant will show poor feeding, vomiting, and irritability, followed by lack of energy, weight loss, seizures, a tense arched posture, muscle tone which alternates between stiff and limp, and swelling of the brain. [counsyl.com]
These signs include: Poor appetite Trouble sucking during feeding Weight loss High pitched cry Urine that smells sweet like maple syrup or burnt sugar Sleeping longer or more often Tiredness Irritability Vomiting Developmental delays Many of these signs [babysfirsttest.org]
Some symptoms of inherited metabolic disorders include: Lethargy Poor appetite Abdominal pain Vomiting Weight loss Jaundice Failure to gain weight or grow Developmental delay Seizures Coma Abnormal odor of urine, breath, sweat, or saliva The symptoms [webmd.com]
Respiratoric
- Aspiration
Where there exists a high risk for aspiration or other contraindication to enteral feeding, the patient can be given a specialized parenteral MSUD amino acid solution available through specific pharmacies. 3. Correct metabolic abnormalities a. [newenglandconsortium.org]
Gastrointestinal
- Muscle Rigidity
rigidity) and hypotonia (muscle limpness) high-pitched cry Signs of intermediate and thiamine-response MSUD include: seizures neurological deficiencies developmental delays feeding problems poor growth a distinctive maple sugar odor in earwax, sweat, [healthline.com]
Neurologic
- Reduced Consciousness
METHODS One hundred and fifty-eight childhood A 9-year-old boy presented with a 2-day history of vomiting, ataxia and reduced consciousness. [herbal-organic.com]
- Stroke
[…] nerve damage ; the child usually lives only until age 4 or 5) Gaucher disease (bone pain, enlarged liver, and low platelet counts, often mild, in children or adults) Fabry disease (pain in the extremities in childhood, with kidney and heart disease and strokes [webmd.com]
Workup
A new metabolic workup was ordered, showing similar results. [pediatrics.aappublications.org]
Only samples with both increased total leucine and increased alloisoleucine would lead to further metabolic workup. This approach appears promising for further reducing false-positive rates. [clinchem.aaccjnls.org]
Biochemical workup MSUD in a newborn may be suspected due to the presence of illness and/or an abnormal neonatal screening test result. [dovepress.com]
Treatment
Without treatment, coma and central respiratory failure occur by days 7 to 10. [orpha.net]
Treatment of PKU and MSUD, is based on the restriction of the involved amino acids. Diet must begin very early in life in order to prevent neurological sequelae. [herbal-organic.com]
ACER-001 was granted orphan drug designation as a potential treatment for MSUD in 2014. [acertx.com]
Treatment: Treatment involves dietary restriction of the amino acids leucine, isoleucine, and valine. This treatment must begin very early to prevent brain damage. [medigoo.com]
Prognosis
Prognosis Prognosis is good for those who are diagnosed early, treated promptly and who follow a strict lifelong diet. The documents contained in this web site are presented for information purposes only. [orpha.net]
Diagnosis - Maple syrup urine disease Prognosis - Maple syrup urine disease This disease can be life threatening if untreated. Even with dietary treatment, stressful situations and illness can still cause high levels of certain amino acids. [checkorphan.org]
[…] exhibit high diffusion signal MR spectroscopy: single-voxel proton MR spectroscopy may show the presence of branched-chain amino acids and branched-chain alpha-keto acids resonating at 0.9-1.0 ppm, especially during a metabolic crisis 1,2 Treatment and prognosis [radiopaedia.org]
What is the prognosis? With treatment before any crises occur, lifetime adherence to the diet, and prompt treatment of illnesses, prognosis is good, and normal development and IQ are expected. [medicalhomeportal.org]
Etiology
Etiology MSUD is due to mutations in genes encoding 3 of the 4 subunits of the branched chain 2-ketoacid dehydrogenase (BCKAD) complex. [orpha.net]
This article presents the results of biochemical and molecular analyses and metabolic response to treatment procedures in a 10-week old boy presenting with vomiting, progressive OBJECTIVE To investigate the values of tandem mass spectrometry (MS/MS) in etiologic [herbal-organic.com]
Oltarzewski-M; Lenartowska-I Evaluation of the usefulness for neonatal mass screening in light of 35 years personal experience Med-Wieku-Rozwoj. 1999 Oct-Dec; 3(4): 529-59 Lebo-RV; Shapiro-LR; Fenerci-EY; Hoover-JM; Chuang-JL; Chuang-DT; Kronn-DF Rare etiology [malattierare.regione.veneto.it]
Epidemiology
Summary Epidemiology Birth prevalence of MSUD is estimated at around 1/150,000. Classic MSUD may account for 50-75% of cases. [orpha.net]
Molecular genetic testing of all three genes is available. [ 2 ] Epidemiology [ 1 ] Worldwide, MSUD occurs in about 1 case per 185,000 live births. [patient.info]
Amino acid deficiency can be detected through fetal growth, making it essential to monitor development closely. [6] Epidemiology [ edit ] Maple syrup urine disease (MSUD) is a rare, inherited metabolic disorder. [en.wikipedia.org]
GENES EPIDEMIOLOGY Maple syrup urine disease occurs in about 1 per 180,000 live births and affects both males and females. [flipper.diff.org]
Pathophysiology
Useful For Suggests clinical disorders or settings where the test may be helpful Follow-up of patients with maple syrup urine disease Monitoring of dietary compliance for patients with maple syrup urine disease Clinical Information Discusses physiology, pathophysiology [mayomedicallaboratories.com]
Clinical observations and the review of the literature regarding WE and MSUD pathophysiology prompted us to hypothesize a pathogenic link between these two disorders. [link.springer.com]
Pathophysiology Catabolic stress such as normal perinatal catabolism or an acute illness (e.g. infection, injury, surgery, febrile illness) produces endogenous protein breakdown leading to increase in the BCAA and related branched chain ketoacids. [newenglandconsortium.org]
Pathophysiology of brain disease in MSDU Figure Leucine and aKIC cause a complex neurochemical syndrome that disturbs brain protein accretion, neurotransmitter synthesis, cell volume regulation, neuron growth, and myelin synthesis. [flipper.diff.org]
Pathophysiology of MSUD MSUD is a metabolic disorder caused by decreased function of the BCKAD enzyme complex. [dovepress.com]
Prevention
XENical in the prevention of diabetes in obese subjects (XENDOS) study: a randomized study of orlistat as an adjunct to lifestyle changes for the prevention of type 2 diabetes in obese patients. Diabetes Care 2004: 27(1):155-161. [books.google.es]
• Novel therapies investigated include hepatocyte transplantation, drugs to counter oxidative stress, norleucine, and phenylbutyrate to prevent the inactivation of the dehydrogenase complex. [medlink.com]
Identifying the presence of MSUD at birth is critical to preventing long-term damage. [healthline.com]
Instead, the newborn’s urine is analyzed for levels of branched-chain alpha-hydroxyacids and alpha-ketoacids. [6] Prevention [ edit ] There are no methods for preventing the manifestation of the pathology of MSUD in infants with two defective copies of [en.wikipedia.org]
Prompt treatment is needed to prevent intellectual disabilities and serious medical problems. Most children need to eat a very low-protein diet and drink a special medical formula. [newbornscreening.info]