9 research outputs found

    Neurological and Vascular Manifestations of Ethylmalonic Encephalopathy

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    How to Cite This Article: Tavasoli AR, Rostami P, Ashrafi MR, Karimzadeh P. Neurological and Vascular Manifestations of Ethylmalonic Encephalopathy. Iran J Child Neurol. Spring 2017; 11(2):57-60. AbstractObjectiveEthylmalonic encephalopathy (EE) is a severe mitochondrial disease of early infancy clinically characterized by a combination of developmental delay, progressive pyramidal signs, and vascular lesions including petechial purpura, orthostatic acrocyanosis, and chronic hemorrhagic diarrhea. Biochemical hallmarks of the disease are persistently high level of lactate, and C4–C5-acylcarnitines in blood, markedly elevated urinary excretion of methylsuccinic and ethylmalonic (EMA) acids. Here we report two patients with EE as a 16-months-old male infant and a 2-yr-old boy referred to Pediatric Neurology Clinic in Children’s Medical Center, Tehran-Iran that in one patient genetic analysis revealed a homozygous mutation of the ETHE1 gene in favor of ethylmalonic acidemia. References 1. Tiranti V, D’Adamo P, Briem E, Ferrari G, Mineri R, Lamantea E. Ethylmalonic encephalopathy is caused by mutation in ETHE1, a gene encoding a mitochondrial matrix protein. Am J Hum Genet 2004; 74:239-252.2. Di Meo I, Fagiolari G, Prelle A, Viscomi C, Zeviani M, Tiranti V. Chronic exposure to sulfide causes accelerated degradation of cytochrome c oxidase in ethylmalonic encephalopathy. Antioxid Redox Signal 2011; 15:353– 362.3.Zafeiriou DI, Augoustides-Savvopoulou P, Haas D, Smet J, Triantafyllou, Vargiami E. Ethylmalonic encephalopathy: clinical and biochemical observations. Neuropediatrics 2007; 38:59-60.4. UluçYis, IpekPolat, PakizeKarakaya, MügeAyanoglu, AyseSemraHiz. Importance of acrocyanosis in delayed walking. J Pediatr Neurosci 2015; 10(1):80-81.5.Garcia-Silva MT, Ribes A, Campos Y, Garavaglia B, Arenas J Grosso S, Mostardini R, Farnetani MA, Molinelli. Syndrome of encephalopathy, petechiae, and ethylmalonic aciduria. Pediatr Neurol 1997; 17:165–170.6. Tiranti V, Briem E, Lamantea E, Mineri R, Papaleo E, De Gioia L, et al. ETHE1 mutations are specific to ethylmalonic encephalopathy. J Med Genet 2006; 43:340-346.7. Heberle Lada Cindro LC, Al Tawari Asma A AA, Ramadan Dina G DG, Ibrahim Jamila K JK. Ethylmalonic encephalopathy report of two cases. Brain & Development 2006; 28(5):329–331.8. Mineri R, Rimoldi M, Burlina AB. Identification of new mutations in the ETHE1 gene in a cohort of 14 patients presenting with ethylmalonic encephalopathy. J Med Genet 2008; 45:473-478.9. H.R. Yoon, S.H. Hahn, Y.M. Ahn, S.H. Jang, Y.J. Shin, E.H. Lee, K.H. Ryu, B.L. Eun, P.Rinaldo, S. Yamaguchi. Therapeutical trial in the first three Asian cases of ethylmalonic encephalopathy: response to riboflavin. J Inherit Metab Dis 2001; 24:870–873.10. Maja Di Rocco, Ubaldo Caruso, Egill Briem, Andrea Rossi, Anna E.M. Allegri, Davide Buzzi, Valeria Tiranti. A case of ethylmalonic encephalopathy with atypical clinical and biochemical presentation. Mol Gen Metab 2006; 89:395–397.11. Mohammed Owaidha Al-Ajmi, Satheesh Kalanthra Kutty. Ethylmalonic Aciduria Encephalopathy with Respiratory Failure and Nephrotic Syndrome Rare Presentation. Middle East J Fam Med 2005; 3(3).12. Laura Papetti, Giacomo Garone, Livia Schettini, Carla Giordano, Francesco Nicita, Paola Papoff, Massimo Zeviani, Vincenzo Leuzzi, Alberto Spalice. Severe early onset ethylmalonic encephalopathy with West syndrome. Metab Brain Dis 2015; Jul 21.13. Dweikat I, Naser E, Damsah N, Libdeh BA, Bakri I. Ethylmalonic encephalopathy associated with crescentic glomerulonephritis. Metab Brain Dis 2012; 27(4):613-6.14. Nowaczyk MJ, Blaser SI, Clarke JT. Central nervous system malformations in ethylmalonic encephalopathy. Am J Med Genet 1998; 75:292–6.15. Christodoulou J, Petrova-Benedict R, Robinson BH, Jay V, Clarke JTR. An unusual patient with the neonatal Marfan phenotype and mitochondrial complex I deficiency. Eur J Pediatr 1993; 152:428–432.16. Chen E, Jurecki ER, Rinaldo P, Keilman C, Packman S, Johnston K. Nephrotic syndrome and dysmorphic facial features in a new family of three affected siblings with ethylmalonic encephalopathy. Am J Hum Genet 1994; 55:A2000.17. Lehnert W, Ruitenbeek W. Ethylmalonic aciduria associated with progressive neurological disease and partial cytochrome c oxidase deficiency. J Inherit Metab Dis 1993; 16:557–559.18. Garavaglia B, Colamaria V, Carrara F, Tonin P, RimoldiM,Uziel G. Muscle cytochrome c oxidase deficiency in two Italian patients with ethylmalonic aciduria and peculiar clinical phenotype. J Inherit Metab Dis 1994; 17:301–303.19. Ozand PT, Rashed M, Millington DS, SakatiN,Hazzaa S, Rahbeeni Z, al OdaibA,Youssef N, Mazrou A,Gascon GG. Ethylmalonic aciduria: an organic acidemia with CNS involvement and vasculopathy. Brain Dev 1994; 16: 12–22.20. Burlina AB, Dionisi-Vici C, Bennett MJ, Gibson KM, Servidei S, Bertini E, Hale DE, Schmidt-Sommerfeld E, Sabetta G, Zachello F, Rinaldo P. A new syndrome with ethylmalonic aciduria and normal fatty acid oxidation in fibroblasts. J Pediatr 1994; 125:79–86. 

    Methylmalonic acidemia with emergency hypertension

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    Pericentric Inversion of Chromosome 9 in an Infant With Ambiguous Genitalia

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    Pericentric inversion of Chromosome 9 is one of the most common chromosomal abnormalities, which could be associated with various manifestations in some cases. Herein, a patient is presented with ambiguous genitalia that karyotyping revealed pericentric inversion of Chromosome 9 (p12,q13). Pericentric inversion of Chromosome 9 could be considered in the list of differential diagnosis of those with ambiguous genitalia, while chromosomal karyotype and culture could be recommended in children with ambiguous genitalia

    Hypothalamic Hamartoma in An Unusual Case with Delayed Puberty

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    Hypothalamic hamartoma (HH) is a rare intracranial lesion that usually presents with classic triad of central precocious puberty, gelastic epilepsy, and developmental delay. Herein, a 14-year old boy is presented in whom the diagnosis of HH was made by magnetic resonance imaging. While he did not have any complain of precocious puberty, he surprisingly suffered from delay in puberty. The definite diagnosis of HH can only be made by appropriate imaging, in a case with atypical feature of delay in puberty and in the absence of gelastic epilepsy. To our best knowledge, this is the first case of HH who is presented with delay in puberty as of first manifestation

    Lung Transplantation as a way to Escape Pneumonia in Patients with COVID-19: Lessons from ARDS and Influenza

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    In this era, the novel Coronavirus, referred to as Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), a life-threatening virus with a high mortality rate (4.2%) and with no absolute treatment as of yet, may ultimately result in acute respiratory distress syndrome (ARDS). ARDS is one of the fatal complications, highlighted by pulmonary infiltration and severe hypoxemia. This condition can be developed from primary lung inflammation caused by various viruses, particularly influenza viruses, some of the most common human pathogens. Due to this issue, many studies explored several approaches for ARDS treatment. Lung transplantation has been claimed as an efficient cure for severe ARDS and Influenza, which can also be offered for treating critical lung complications of SARS-CoV-2. Thereupon, to the best of our knowledge for the first time, we aimed to review all available data about capability of lung transplantation for the treatment of critically ill patients with ARDS, Influenza, and SARS-CoV-2

    Inborn errors of metabolism underlying primary immunodeficiencies

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