Heterogeneous phenotypes, genotypes, treatment and prevention of 1 003 patients with methylmalonic acidemia in the mainland of China

Objective: To analyz the current situation of the diagnosis, treatment and prevention of methylmalonic acidemia, the phenotypes, biochemical features and genotypes of the patients in the mainland of China, were investigated. Methods: Tottally 1 003 patients of methylmalonic acidemia from 26 province...

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Veröffentlicht in:Zhonghua er ke za zhi = Chinese journal of pediatrics. - 1960. - 56(2018), 6 vom: 02. Juni, Seite 414-420
1. Verfasser: Liu, Y (VerfasserIn)
Weitere Verfasser: Liu, Y P, Zhang, Y, Song, J Q, Zheng, H, Dong, H, Ma, Y Y, Wu, T F, Wang, Q, Li, X Y, Ding, Y, Li, D X, Jin, Y, Li, M Q, Wang, Z X, Yuan, Y, Li, H X, Qin, J, Yang, Y L
Format: Online-Aufsatz
Sprache:Chinese
Veröffentlicht: 2018
Zugriff auf das übergeordnete Werk:Zhonghua er ke za zhi = Chinese journal of pediatrics
Schlagworte:Journal Article Homocysteinemia Inherited metabolic disorders Methylmalonic acidemia Neonatal screening Prenatal diagnosis Carrier Proteins Methylmalonic Acid 8LL8S712J7 MMACHC protein, human mehr... EC 1.- Oxidoreductases Succinate-CoA Ligases EC 6.2.1.- SUCLA2 protein, human EC 6.2.1.5
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245 1 0 |a Heterogeneous phenotypes, genotypes, treatment and prevention of 1 003 patients with methylmalonic acidemia in the mainland of China 
264 1 |c 2018 
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500 |a Date Revised 10.12.2019 
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500 |a Citation Status MEDLINE 
520 |a Objective: To analyz the current situation of the diagnosis, treatment and prevention of methylmalonic acidemia, the phenotypes, biochemical features and genotypes of the patients in the mainland of China, were investigated. Methods: Tottally 1 003 patients of methylmalonic acidemia from 26 provinces and municipalities of the mainland of China were enrolled. The clinical data, biochemical features and gene mutations were studied. Blood aminoacids and acylcarnitines, urine organic acids, and plasma total homocysteine were determined for the biochemical diagnosis. Gene analyses were performed for the genetic study of 661 patients. The patients were treated with individual intervention and long-term follow up. Prenatal diagnoses were carried out for 165 fetuses of the families. Results: Among 1 003 patients (580 boys and 423 girls), 296 cases (29.5%) had isolated methylmalonic acidemia; 707 cases (70.5%) had combined homocysteinemia; 59 patients (5.9%) were detected by newborn screening; 944 patients (94.1%) had the onset at the ages from several minutes after birth to 25 years and diagnosed at 3 days to 25 years of age. The main clinical presentations were psychomotor retardation and metabolic crisis. Multi-organ damage, including hematological abnormalities, pulmonary hypertension, kidney damage, were found. MMACHC, MUT, MMAA, MMAB, HCFC1, SUCLG1, SUCLA2 mutations were found in 631 patients (96.6%) out of 661 patients who accepted gene analysis. MMACHC mutations were detected in 460 patients (94.7%) out of 486 cases of methylmalonic acidemia combined with homocysteinemia. MUT mutations were found in 158 (90.3%) out of 169 cases of isolated methylmalonic acidemia. The development of 59 patients detected by newborn screening were normal; 918 cases (97.2%) were diagnosed after onset accepted the treatment. Forty-five of them completely recovered with normal development. Twenty-six patients (2.7%) died; 873 (92.5%) patients had mild to severe psychomotor retardation. Methylmalonic acidemia were found in 35 out of 165 fetuses by metabolites assay of amniotic fluid and amniocytes gene analysis. Conclusion: Combined methylmalonic acidemia and homocysteinemia is the common type of methylmalonic acidemia in the mainland of China. CblC defect due to MMACHC mutations is the most common type of methylmalonic acidemia combined with homocysteinemia. MUT gene mutations are frequent in the patients with isolated methylmalonic acidemia. Newborn screening is key for the early diagnosis and the better outcome. Combined diagnosis of biochemical assays and gene analysis are reliable for the prenatal diagnosis of methylmalonic acidemia 
650 4 |a Journal Article 
650 4 |a Homocysteinemia 
650 4 |a Inherited metabolic disorders 
650 4 |a Methylmalonic acidemia 
650 4 |a Neonatal screening 
650 4 |a Prenatal diagnosis 
650 7 |a Carrier Proteins  |2 NLM 
650 7 |a Methylmalonic Acid  |2 NLM 
650 7 |a 8LL8S712J7  |2 NLM 
650 7 |a MMACHC protein, human  |2 NLM 
650 7 |a EC 1.-  |2 NLM 
650 7 |a Oxidoreductases  |2 NLM 
650 7 |a EC 1.-  |2 NLM 
650 7 |a Succinate-CoA Ligases  |2 NLM 
650 7 |a EC 6.2.1.-  |2 NLM 
650 7 |a SUCLA2 protein, human  |2 NLM 
650 7 |a EC 6.2.1.5  |2 NLM 
700 1 |a Liu, Y P  |e verfasserin  |4 aut 
700 1 |a Zhang, Y  |e verfasserin  |4 aut 
700 1 |a Song, J Q  |e verfasserin  |4 aut 
700 1 |a Zheng, H  |e verfasserin  |4 aut 
700 1 |a Dong, H  |e verfasserin  |4 aut 
700 1 |a Ma, Y Y  |e verfasserin  |4 aut 
700 1 |a Wu, T F  |e verfasserin  |4 aut 
700 1 |a Wang, Q  |e verfasserin  |4 aut 
700 1 |a Li, X Y  |e verfasserin  |4 aut 
700 1 |a Ding, Y  |e verfasserin  |4 aut 
700 1 |a Li, D X  |e verfasserin  |4 aut 
700 1 |a Jin, Y  |e verfasserin  |4 aut 
700 1 |a Li, M Q  |e verfasserin  |4 aut 
700 1 |a Wang, Z X  |e verfasserin  |4 aut 
700 1 |a Yuan, Y  |e verfasserin  |4 aut 
700 1 |a Li, H X  |e verfasserin  |4 aut 
700 1 |a Qin, J  |e verfasserin  |4 aut 
700 1 |a Yang, Y L  |e verfasserin  |4 aut 
773 0 8 |i Enthalten in  |t Zhonghua er ke za zhi = Chinese journal of pediatrics  |d 1960  |g 56(2018), 6 vom: 02. Juni, Seite 414-420  |w (DE-627)NLM136249191  |x 0578-1310  |7 nnns 
773 1 8 |g volume:56  |g year:2018  |g number:6  |g day:02  |g month:06  |g pages:414-420 
856 4 0 |u http://dx.doi.org/10.3760/cma.j.issn.0578-1310.2018.06.003  |3 Volltext 
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