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Mitochondrial DNA Depletion Syndrome 3 Type Hepatocerebral

DGUOK-Related Hepatocerebral Mitochondrial DNA Depletion Syndrome


Presentation

  • He has been the Editor in Chief, JAMA Neurology (1997- present) and a member of the Editorial Board of JAMA (1997-present).[books.google.com]
  • MTDPS3 presents in infancy with progressive liver failure, hypoglycemia, increased lactate in body fluids, and neurologic abnormalities including hypotonia, encephalopathy, and peripheral neuropathy.[cags.org.ae]
  • Metabolic acidosis, hyperbilirubinemia, hypoalbuminemia, and hypoglycemia are often present. Mitochondrial DNA depletion in the liver approaches 84-90%.[disorders.eyes.arizona.edu]
  • Affected patients usually present in infancy with hypotonia, lactic acidemia, encephalopathy, hepatopathy, or myopathy.[bcm.edu]
  • MDS is phenotypically heterogeneous, and can affect a specific organ or a combination of organs, with the main presentations described being either hepatocerebral (i.e. hepatic dysfunction, psychomotor delay), myopathic (i.e. hypotonia, muscle weakness[orpha.net]
Splenomegaly
  • High pressure in the portal venous system leads to shunting of blood through vessels that are poorly suited to carrying large blood volumes, resulting in collateral circulation and splenomegaly. NCPH patients show normal liver function.[genecards.org]
  • Biopsy shows micronodular cirrhosis; Cholestasis; Steatosis; Jaundice; Hepatocellular loss; Hepatocellular necrosis; Periportal fibrosis; Pseudoacinar formation; Electron microscopy shows increased and abnormal mitochondria; Hepatic failure; [Spleen]; Splenomegaly[genome.jp]
  • Within the approach for hepatopathy, portal hypertension without splenomegaly was identified.[elsevier.es]
Poor Feeding
  • Common features included poor feeding, vomiting, failure to thrive, hypothermia, metabolic acidosis, and hypoglycemia in the neonatal period.[genome.jp]
  • Without healthy functioning cells in all parts of the body, individuals with PDCD can experience poor muscle tone, neurological damage (brain cell injury, cognitive delays, and seizures), and other problems like poor feeding and lethargy (lack of interest[rarediseasesnetwork.org]
  • Glycogen Storage Disease, Type 4 often causes symptoms in infancy with poor feeding and growth (failure to thrive), an enlarged liver and spleen, enlarged heart, low muscle tone (hypotonia), and muscle wasting.[natera.com]
Hypothermia
  • Common features included poor feeding, vomiting, failure to thrive, hypothermia, metabolic acidosis, and hypoglycemia in the neonatal period.[genome.jp]
Gaucher Disease
  • disease, 608013 LSD Lysosomal Storage Disorder GDAP1 Charcot-Marie-Tooth disease, axonal, type 2K, 4A 607831, 214400 CMT Charcot-Marie-Tooth GFER Myopathy, mitochondrial progressive, with congenital cataract, hearing loss, and developmental delay 600924[lhsc.on.ca]
Muscle Hypotonia
  • Motor skills that had been learned may be lost, but generally the functioning of the brain and ability to think are not affected. [5] In MDDS associated with mutations in SUCLA2 or SUCLG1 that primarily affect the brain and muscle, hypotonia generally[mashpedia.com]
Disconjugate Eye Movement
  • Clinical Characteristics Ocular Features: Nystagmus, disconjugate eye movements, and "optic dysplasia" have been noted. Systemic Features: Infants feed poorly which is frequently associated with vomiting, failure to thrive, and growth delay.[disorders.eyes.arizona.edu]
  • Clinical Synopsis: INHERITANCE: Autosomal recessive GROWTH: [Other]; Poor growth; Failure to thrive HEAD AND NECK: [Head]; Microcephaly (less common); [Eyes]; Nystagmus; Disconjugate eye movements; Optic dysplasia ABDOMEN: [External features]; Ascites[genome.jp]
Hyperreflexia
  • Hyperreflexia may be present and some infants have seizures. Muscle tissue, however, has normal histology and respiratory chain activity. Genetics This disorder results from homozygous or compound heterozygous mutations in the DGUOK gene (2p13).[disorders.eyes.arizona.edu]
  • […] microscopy shows increased and abnormal mitochondria; Hepatic failure; [Spleen]; Splenomegaly; [Gastrointestinal]; Poor feeding; Vomiting SKIN, NAILS, HAIR: [Skin]; Jaundice NEUROLOGIC: [Central nervous system]; Encephalopathy; Nystagmus; Hypotonia; Hyperreflexia[genome.jp]
Neonate-Onset
  • The typical phenotype associated with mutations in DGUOK is neonatal onset of progressive liver disease and feeding difficulties, usually associated with hypotonia, nystagmus, and psychomotor retardation by the age of three months.[ijponline.biomedcentral.com]

Workup

  • His weight was 6 kg and height was 60 cm (both His metabolic workup, including screening for Galactosemia, Tyrosinemia type 1, amino acids, organic acids and fatty acid oxidation defects, was normal. Plasma lactate was elevated on several occasions.[indianpediatrics.net]

Treatment

  • Treatment Treatment Options: There is no effective treatment. Liver transplantation in one infant was unsuccessful.[disorders.eyes.arizona.edu]
  • CLOSE Medical Disclaimer The medical information on this site is provided as an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes.[diseaseinfosearch.org]
  • Lifelong treatment with biotin supplementation can prevent the symptoms from occurring. With early diagnosis and treatment with biotin, people with Holocarboxylase Synthetase Deficiency can live healthy lives.[natera.com]
  • It is not in any way intended to be used as a substitute for professional medical advice, diagnosis, treatment or care. Our staff consists of biologists and biochemists that are not trained to give medical advice .[uniprot.org]
  • Treatment: As with all mitochondrial diseases, there is no cure for complex I deficiency. A variety of treatments, which may or may not be effective, include: riboflavin, thiamine, biotin, CoQ10, and carnitine.[rarediseasesnetwork.org]

Prognosis

  • Al-Hussaini et al. (2014) commented that liver failure associated to mutations in the MPV17 and DGUOK genes is associated with poor prognosis.[cags.org.ae]
  • The prognosis for Leigh syndrome is poor. Depending on the defect, individuals typically live a few years.[rarediseasesnetwork.org]
  • This expands thespectrum of DGUOK mutations, but also identifies MDS as adisorder that might be secondarily associated with cystathio-ninuria.Becausemolecular diagnosismayaffect prognosis andtreatment, this information may have future importance forMDS[docslide.net]
  • Accurate diagnosis can guide pediatricians for appropriate management and prognosis of the disease.[indianpediatrics.net]
  • Dev Disabil Res Rev 16:219–229 PubMed CrossRef Google Scholar Wilcken B (2010) Fatty acid oxidation disorders: outcome and long-term prognosis.[link.springer.com]

Etiology

  • The first two succumbed to a liver failure of unknown etiology, while the third died after having been diagnosed as having hepatocerebral MDS. The third kindred had one affected baby.[cags.org.ae]
  • Liver transplant was not performed in view of mitochondrial etiology and neurological involvement (as evident on neuroimaging).[indianpediatrics.net]
  • Regarding the etiology of liver failure, bile canalicular and structural anomalies were unlikely because absent acholic or hypocholic stools, or choluria.[elsevier.es]
  • Table 1 summarizes the main clinical manifestations and molecular etiologies associated with these different forms.[ijponline.biomedcentral.com]

Epidemiology

  • Relevant External Links for DGUOK Genetic Association Database (GAD) DGUOK Human Genome Epidemiology (HuGE) Navigator DGUOK Atlas of Genetics and Cytogenetics in Oncology and Haematology: DGUOK No data available for Genatlas for DGUOK Gene Kinetic properties[genecards.org]
  • Am J Hum Genet 75:97–105 PubMedCentral PubMed CrossRef Google Scholar Schaefer AM, Taylor RW, Turnbull DM, Chinnery PF (2004) The epidemiology of mitochondrial disorders – past, present and future.[link.springer.com]
  • PubMed Central View Article PubMed Google Scholar Schaefer AM, Taylor RW, Turnbull DM, Chinnery PF: The epidemiology of mitochondrial disorders- past, present and future. Biochim Biophys Acta. 2004, 1659 (Suppl 2–3): 115-120.[ijponline.biomedcentral.com]
Sex distribution
Age distribution

Prevention

  • This DNA vaccine has the potential to be a safe and effective therapy to prevent Alzheimer disease. He described Machado-Joseph disease (MJD), an autosomal dominant ataxia, with William Nyhan, M.D. Ph.D, in 1976, for the first time.[books.google.com]
  • . : Mitochondrial DNA depletion can be prevented by dGMP and dAMP supplementation in a resting culture of deoxyguanosine kinase-deficient fibroblasts. Hum. Molec. Genet. 12: 1839-1845, 2003. PubMed ID : 12874104 Tadiboyina, V.[humpath.com]
  • . - San Carlos, CA, USA TAT : 3-4 weeks price : 690.00 MPV17-Related Hepatocerebral Form of Mitochondrial DNA Depletion Syndrome via the MPV17 gene method(s): Del/Dup (CNV) PreventionGenetics (Prevention Genetics), Clinical DNA Testing and DNA Banking[genetests.org]
  • Genetic counseling is an important clinical tool for preventing new cases, especially for couples with an affected first child: the risk of having an affected child in further pregnancies is 25%.Management and treatmentIOSCA patients are often managed[malacards.org]

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