Audit of Organic Acidurias from a Single Centre: Clinical and Metabolic Profile at Presentation with Long Term Outcome

Clinical and Genetic Spectrum of 50 Children with Inborn Errors of Metabolism from Central India

This is a single-center, retrospective analysis of children confirmed to have an inborn error of metabolism in the pediatric department of a teaching hospital in central India. Patients were categorized as acute encephalopathy, developmental delay/seizures, and neuroregression or organomegaly depending on their predominant phenotype. Of the 50 patients analyzed, the commonest group was lysosomal storage disorders in 13 (26%), followed by organic acidurias - 8 (16%), mitochondrial disorders - 5 (10%), urea cycle disorders, carbohydrate metabolism disorders, and amino acidopathies - 4 (8%) each, fatty acid oxidation defects and neurotransmitter deficiency disorders - 3 (6%) each, and miscellaneous (8%). Genetic variations were identified in 25 (50%). Acylcarnitine profiles and urine organic acids were diagnostic in 62.5% of children presenting as acute encephalopathy, exome sequencing in 55.5% of children with neuroregression, and specific enzyme assay in 83.3% of children with predominant organomegaly (83.3%). Children with developmental delay/seizures needed a wider range of tests.

Functional neurologic disorders in an adult with propionic acidemia: a case report

BACKGROUND

Inborn errors of metabolism are often characterized by various psychiatric syndromes. Previous studies tend to classify psychiatric manifestations into clinical entities. Among inborn errors of metabolism, propionic acidemia (PA) is a rare inherited organic aciduria that leads to neurologic disabilities. Several studies in children with PA demonstrated that psychiatric disorders are associated to neurological symptoms. To our knowledge, no psychopathological description in adult with propionic acidemia is available.

CASE PRESENTATION

We aimed to compare the case of a 53-year-old woman with PA, to the previous psychiatric descriptions in children with PA and in adults with other inborn errors of metabolism. Our patient presented a large variety of signs: functional neurologic disorders, borderline personality traits (emotional dyregulation, dissociative and alexithymic trends, obsessive-compulsive disorders), occurring in a context of neurodevelopmental disorder.

CONCLUSION

Clinical and paraclinical examinations are in favor of a mild mental retardation since childhood and disorders of behavior and personality without any definite psychiatric syndrome, as already described in other metabolic diseases (group 3). Nonetheless, further studies are needed to clarify the psychiatric alterations within adult patients with PA.

Clinical Spectrum of Inherited Disorders of Metabolism

OBJECTIVE

To study the clinical profile and outcome of children with Inborn errors of metabolism.

METHODS

Thirty one newly diagnosed children with Inborn errors of metabolism over a 1 y period were studied for their relevant clinical, biochemical, diagnosis, treatment and follow-up details.

RESULTS

Inborn errors of metabolism accounted for 2% of hospital admissions. Sixty five percent were born to parents of consanguineous marriage. Of the 31 children with Inborn errors of metabolism, 16 (51%) had lysosomal storage disorders, 8 (26%) had disorders of amino acid metabolism, 2 (6%) each had disorders of carbohydrate and bile acid metabolism, 1 (3%) each had disorders of fatty acid oxidation, mitochondrial and peroxisome metabolism. Acrodermatitis dysmetabolica, as a complication was observed in one child and the overall mortality rate in this series was 10%.

CONCLUSIONS

Lysosomal storage disorders constituted the majority of Inborn errors of metabolism in this series and amino acidopathies/organic acidemias were successfully treated with special formulas.