给予大剂量核黄素治疗1例5岁GAII男童

N. Mirhosseini, S. Taghiyar, M. Saatchi, Zeynab Eshaghiyeh
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摘要

背景:在儿科人群中,先天性代谢错误可引起许多发病率和死亡率。戊二酸尿症II (GAII)或多酰基辅酶a脱氢酶缺乏症(MADD)是一种超罕见(即<1:50 000)线粒体脂肪酸氧化(FAO)和氨基酸代谢紊乱。它以常染色体隐性遗传的方式遗传。先天性缺乏电子转移黄蛋白和ETF脱氢酶基因会导致一种疾病,这种疾病结合了脂肪酸氧化受损和几种氨基酸氧化受损的特征。新生儿筛查(NBS)使用串联质谱(MS/MS)允许检测新生儿戊二酸血症- II型。病例介绍:我们报告了一名5岁男孩,他患有下肢肌肉无力和无法行走(肌病),低血糖引起的癫痫发作(由于长时间禁食),肝肿大和横纹肌溶解,经大剂量核黄素治疗,随访良好。结论:轻症早期诊断,大剂量核黄素治疗可获得较好的预后。
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A Five-Year-Old Boy with GAII Administered with High-Dose Riboflavin: A Case Report
Background: Inborn errors of metabolism can cause a number of morbidities and mortality in pediatric population. Glutaric aciduria II (GAII) or multiple acyl-CoA dehydrogenase deficiency (MADD) is an ultra-rare (i.e. <1:50 000) disorder of mitochondrial fatty acid oxidation (FAO) and amino acid metabolism. It is inherited in an autosomal recessive manner. Congenital deficiency of electron transfer flavoproteins and ETF dehydrogenase genes cause an illness that combines the features of impaired fatty acid oxidation and impaired oxidation of several aminoacides. Newborn screening (NBS) using tandem mass spectrometry (MS/MS) permits detection of neonates with glutaricaciduria-Type II. Case Presentation: We reported a five-year-old boy with muscle weakness of lower limb and inability to walk (myopathy), seizure due to hypoglycemia (as a result of prolonged fasting), hepatomegaly and rhabdomyolysis that treated with high dose riboflavin and he is well in follow up. Conclusion: Early diagnosis of mild cases and treatment with high dose riboflavin may have better prognosis.
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