Presentation
Abstract The disorders of purine and pyrimidine metabolism are unusual in their variety of clinical presentations and in the mechanisms by which these presentations result from the fundamental mutations. [ncbi.nlm.nih.gov]
The presentation is most commonly monoarticular, typically in the metatarsophalangeal joint of the big toe. [clinicalgate.com]
These clinically-focused chapters include one or more vignettes that present simulated patient cases designed to highlight teaching points related to each chapter's content area. [books.google.de]
More severely affected patients present with neonatal seizures. Hypotonia, autistic features, and growth retardation may occur. [musculoskeletalkey.com]
For all other metabolites, the detection limit was precision The intraday variations for the various metabolites are presented in Table 3 . [clinchem.aaccjnls.org]
Entire Body System
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Hyperthermia
Patients with muscle adenylate deaminase deficiency also appear to be at higher risk for malignant hyperthermia. In general, no specific therapy exists. Ribose administration has resulted in varying responses. [musculoskeletalkey.com]
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Cyanotic Congenital Heart Disease
Increased production of uric acid is found in malignancy; Reye syndrome; Down syndrome; psoriasis; sickle cell anemia; cyanotic congenital heart disease; pancreatic enzyme replacement; glycogen storage disease types I, III, IV, and V; hereditary fructose [clinicalgate.com]
Ears
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Low Set Ears
AICA-RIBOSIDURIA (ATIC DEFICIENCY) In a female infant with profound mental retardation, dysmorphic features (prominent forehead, brachycephaly, wide mouth, low-set ears, prominent clitoris), and blindness, the following were identified: a massive excretion [obgynkey.com]
Psychiatrical
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Head Banging
The type of behavior is different from that seen in other intellectual disability syndromes involving self-injury; self-hitting and head banging are the most common initial presentations in other syndromes. [clinicalgate.com]
Neurologic
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Neonatal Seizures
More severely affected patients present with neonatal seizures. Hypotonia, autistic features, and growth retardation may occur. [musculoskeletalkey.com]
seizures, mild to profound mental retardation, and autistic features. [obgynkey.com]
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Motor Symptoms
HPRT levels are related to the extent of motor symptoms, to the presence or absence of self-injury, and possibly to the level of cognitive function. The majority of individuals with classic LND have low or undetectable levels of the HPRT enzyme. [clinicalgate.com]
Workup
EEG
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Hypsarrhythmia
Phosphoribosylpyrophosphate synthetase deficiency (311850) Phosphoribosylpyrophosphate synthetase PRPS1 (Xq22-q24) PRPS2 (Xp22.3-p22.2) Biochemical profile: Increased urinary orotate, hypouricemia Clinical features: Developmental disabilities, seizures with hypsarrhythmia [merckmanuals.com]
Serum
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Anisopoikilocytosis
Supportive care, enzyme replacement, bone marrow or stem cell transplantation, experimental gene therapy Increased adenosine deaminase (102730) Adenosine deaminase ADA Biochemical profile: Mild hyperuricemia Clinical features: Hemolytic anemia with anisopoikilocytosis [merckmanuals.com]
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Uric Acid Decreased
Primary gout, ordinarily occurring in middle-aged men, results from overproduction of uric acid, decreased renal excretion of uric acid, or both. [clinicalgate.com]
Treatment
No clear treatment Lesch-Nyhan syndrome (300322) Classic form Variant form Hypoxanthine-guanine phosphoribosyltransferase HPRT (Xq26-q27.2)* Biochemical profile: Hyperuricemia, hyperuricosuria Clinical features: Orange sandy crystals in diapers, growth [merckmanuals.com]
Secondary gout also may be seen during treatment with diuretics, low-dose salicylates, pyrazinamide, ethambutol, and niacin or during the treatment of malignant diseases. [musculoskeletalkey.com]
Based on the experience concerning allopurinol and Amplivix treatment, a better effect of the latter on the neurological symptoms has been expected because Amplivix treatment did not result in accumulation of xanthine and hypoxanthine. [jstage.jst.go.jp]
Treatment of Gout: Consist of: (a) Palliative Treatment (b) Specific Treatment (a) Palliative treatment: Bed rest in acute stage. Diet—Purine free diet. Restricting alcohol consumption. • Anti-inflammatory Drugs 1. [7med-pdf.com]
The chapters on diagnosis and treatment are written from a practical "how to" perspective. Those on etiology are written with the clinician in mind. [books.google.de]
Prognosis
Prognosis The prognosis is uncertain in the severe form of the disease. Severe gout can lead to renal impairment, if not properly treated. The documents contained in this web site are presented for information purposes only. [orpha.net]
Etiology
Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.com]
The sections include Background and Diagnostic Assessment, Etiology, Treatment, and Other Care Delivery Services and Perspectives, with each chapter written by an internationally recognized expert in the field. [books.google.de]
The biochemical etiology of gout is unknown for most of those affected, and it is considered to be a polygenic trait. [clinicalgate.com]
Etiology The disease is due to overactivity of ribose-phosphate pyrophosphokinase 1 (PRS-I), an enzyme that catalyzes the synthesis of PRPP, a cofactor involved in the synthesis of purine and pyrimidine nucleotides. [orpha.net]
Epidemiology
Summary Epidemiology PRPP synthetase superactivity is a rare disorder with less than 30 families described in the literature to date. Clinical description PRPP synthetase superactivity affects mainly males. [orpha.net]
An epidemiological link between elevated serum UA level and cardiovascular risk has been recognized. Hyperuricemia in hypertensive subjects may represent an early indicator of hypertensive cardiorenal disease. [karger.com]
Epidemiology The incidence is 40 cases/100,000 live births in a Canadian study [ 1 ]. A much higher incidence of 1 in 784 live births has been reported from the West Midlands in the UK [ 2 ]. [patient.info]
Moderate alcohol consumption and breast cancer in women: from epidemiology to mechanisms and interventions. Alcohol Clin Exp Res. 2013;37(1):23-30. (PubMed) 122. Rohan TE, Jain MG, Howe GR, Miller AB. [lpi.oregonstate.edu]
[…] derivatives Ragged red diseases (ie, limb-girdle neuromuscular diseases with ragged red fibers seen on trichrome stain of frozen biopsied specimens) Defects of mitochondria, especially of the electron transport chain and of proteins coded by mitochondrial DNA Epidemiology [emedicine.medscape.com]
Pathophysiology
[…] with symptoms suspicious for disorders of purine and pyrimidine metabolism Monitoring patients with disorders of purine and pyrimidine metabolism Laboratory evaluation of primary and secondary hyperuricemias Clinical Information Discusses physiology, pathophysiology [mayomedicallaboratories.com]
As a result, we now know many genetic defects responsible for neurological disease, but frequently we do not know much about the resulting protein product and therefore the pathophysiologic basis for the disease. [6] Pathophysiology The human genome at [emedicine.medscape.com]
Prevention
0% Emergent - ED Care Needed - Preventable/Avoidable - 0% Emergent - ED Care Needed - Not Preventable/Avoidable - 0% Primary diagnosis of injury 0% Primary diagnosis of mental health problems 0% Primary diagnosis of substance abuse 0% Primary diagnosis [medicbind.com]
The patient may ask for restraints to prevent elbow movement; when the restraints are placed or replaced, the patient may appear relaxed and better humored. [clinicalgate.com]
To prevent stone formation, high fluid intake is recommended and urine alkalinized. [obgynkey.com]
Patiens with ADA or PNP deficiency can be treated with bone marrow transplantation which provides B and T cells with sufficient enzyme activities to prevent the accumulation of the toxic nucleosides and nucleotides. [home.kpn.nl]
Strict compliance is necessary to prevent neurological damage. Glycine - nonketotic hyperglycinaemia, or glycine encephalopathy: It is caused by deficiency of the glycine cleavage multi-enzyme system. [patient.info]