Presentation
Cardiac Presentation Some metabolic disorders can present predominantly with cardiac disease. [obgynkey.com]
Tyrosinemia type I may also manifest as a disease of proximal renal tubular dysfunction, which may be present with or without associated liver manifestations at the time of initial presentation. [clinicaladvisor.com]
Nephromegaly and nephrocalcinosis may be present on ultrasound examination. Hypertrophic cardiomyopathy and hyperinsulinism are seen in some infants. [clinicalgate.com]
Comorbid & Secondary Conditions Neurologic crises, which occur in untreated children, are variable in presentation. [medicalhomeportal.org]
Hypertyrosinemia is present in most untreated patients. The presence of elevated levels of succinylacetone in plasma or urine is diagnostic for this condition. [ommbid.mhmedical.com]
Entire Body System
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Pathologist
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Neurologic
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Stroke
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Funding and Disclosures Supported by a grant (NS 05096) from the National Institute of Neurological and Communicative Disorders and Stroke, by Project 928 from Maternal and Child Health Service, U.S. [nejm.org]
Neurological coma with focal signs, seizures, severe intracranial hypertension, strokes, or strokelike episodes. [obgynkey.com]
[…] adrenoleukodystrophy Rhizomelic chrondrodysplasia punctata X-linked adrenoleukodystrophy Zellweger syndrome Excludes: infantile Refsum disease (356.3) 277.87 Disorders of mitochondrial metabolism Kearns-Sayre syndrome Mitochondrial Encephalopathy, Lactic Acidosis and Stroke-like [theodora.com]
Leber's disease (H47.22) Leigh's encephalopathy (G31.82) Mitochondrial myopathy, NEC (G71.3) Reye's syndrome (G93.7) E88.40 Mitochondrial metabolism disorder, unspecified E88.41 MELAS syndrome Mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like [en.wikisource.org]
Treatment
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Corneal opacities associated with NTBC treatment. Am J Ophthalmol. 2002; 134 (2): 266-8[ PubMed ] [ijp.tums.pub]
Treatment: Nitrisinone (NTBC) inhibits pHPPD enzyme to make it like Type III hypertyrosinemia which is benign since there is no elevated succinylacetone accumulation Oculocutaneous Tyrosinemia (Type II) Lesion: error in transaminase pHPPD deficiency [quizlet.com]
[…] guidelines for the diagnosis or treatment of tyrosinemia type 1. [medicalhomeportal.org]
Prognosis
Hereditary tyrosinemia type I: a new clinical classification with difference in prognosis on dietary treatment. Hepatology. 1994; 20 (5): 1187-91[ PubMed ] 3. van Spronsen FJ, Smit GP, Wijburg FA, Thomasse Y, Visser G, Heymans HS. [ijp.tums.pub]
FAH gene testing (GTR) Prognosis If untreated, affected children typically die in childhood. [medicalhomeportal.org]
The earlier the presentation, the poorer is the prognosis. The 1 yr mortality, which is about 60% in infants who develop symptoms before 2 mo of age, decreases to 4% in infants who become symptomatic after 6 mo of age. [clinicalgate.com]
The prognosis for liver, renal, and neurologic complications from untreated tyrosinemia type I is very poor. [clinicaladvisor.com]
Etiology
acetaminophen toxicity and others), autoimmune etiologies, and a large number of inborn errors of metabolism (IEM). [clinicaladvisor.com]
[…] are attributed to sepsis • Carefully review all autopsy findings • Do not confuse a symptom (such as peripheral neuropathy, retinitis pigmentosa, cardiomyopathy, etc) or a syndrome (such as Reye syndrome, Leigh syndrome, sudden infant death, etc) with etiology [obgynkey.com]
Epidemiology
Roller In a collective prospective epidemiological study on 13,643 pregnanciesfrom 1963 to 1975, an attempt was made to explore all accessible factors ofpossible influence on the course of pregnancy and child development. Author(s): F.J. [nestlenutrition-institute.org]
There is no clearly established epidemiology. It has been associated with mental retardation, ataxia, and in asymptomatic patients by routine screening for elevated tyrosine. It may be associated with eye and skin findings if untreated. [clinicaladvisor.com]
Pathophysiology
[…] tyrosine Diagnosis of Tyr 1 Follow-up of patients with Tyr 1 Genetics Test Information Provides information that may help with selection of the correct genetic test or proper submission of the test request Clinical Information Discusses physiology, pathophysiology [mayomedicallaboratories.com]
Type III tyrosinemia can be diagnosed by detection of a mutation in HPD in cultured fibroblasts. [3] Pathophysiology of metabolic disorders of tyrosine, resulting in elevated levels of tyrosine in blood. [en.wikipedia.org]
Mild retardation and decreased psycholinguistic abilities have been noted in some studies. 179 Pathophysiology Type I This disorder, although not a primary disorder of tyrosine metabolism, is accompanied by increased concentrations of tyrosine and its [wvdhhr.org]
From a pathophysiological perspective, metabolic disorders from Category 2 can be divided into three diagnostically useful groups. Group 1 Disorders that cause intoxication. [obgynkey.com]
Prevention
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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]
Now, nitisinone can prevent or reverse many of the liver problems and decreases the risk of developing liver cancer. For most children, nitisinone will delay, and hopefully prevent, the need for liver transplant. [newbornscreening.info]
Hepatic transplantation cures the liver manifestations and prevents further neurologic crises. [ommbid.mhmedical.com]