Author(s):
Sousa, Carmen 
Date: 2013
Persistent ID: http://hdl.handle.net/10400.18/1757
Origin: Repositório Científico do Instituto Nacional de Saúde
Subject(s): Carnitine Palmitoytransferase II; Doenças Genéticas
Document details
Biochemical and molecular heterogeneity in carnitine palmitoyltransferase ii de...
Description
Introduction: Carnitine palmitoytransferase II (CPTII) deficiency is a recessively inherited disorder of lipid metabolism. CPT II deficiency has several clinical presentations: the adult form is characterized by episodes of rhabdomyolysis, usually triggered by extensive exercice, cold, fever or prolonged fasting and the infantile-type CPT II hepatocardiomuscular form presents as severe attacks of hypoketotic, hypoglycemia, occasionally associated with cardiac damage. Molecular analysis of CPT II gene allows not only confirmation of classical forms, with typical biochemical abnormalities, but is also key for the diagnosis of less severe forms.The authors will present biochemical and molecular findings of eight CPT II, patients. Material and methods: Acylcarnitine profiles, on dried blood spots, were done as previously reported (Vilarinho et al) Molecular analysis of CPT II gene was done by direct sequencing as reported elsewhere (Finocchiaro et al.). From the eight patients, three were detected through newborn screening and five with clinical symptoms. Results: More pronounced abnormalities in the acylcarnitine profiles are associated with neonatal forms of the disease, while the patients with late onset forms present smother alterations or completely normal profiles. This biochemical heterogeneity correlates well with genetics data. The molecular analysis revealed the presence of ten different mutations, which seven were never reported. Discussion: Our results support that newborn screening can efficiently detect infantile CPT II deficiency but is less effective in detecting adult forms, were biochemical abnormalities may only be present during acute episodes. In these cases accurate clinical characterization alongside with molecular analysis are the key for diagnosis. Bibliography: J.P. Bonnefont, F. et al (2004) Mol. Aspects Med. 25 495–520. Rashed MS, et al.(1995) Diagnosis of inborn errors of metabolism from blood spots by acylcarnitines and amino acids profiling using automated electrospray tandem mass spectrometry. Pediatr Res.38:324–331 Finocchiaro, G. et al (1991). cDNA cloning, sequence analysis, and chomosomal localization of the gene for human carnitinepalmitoyltransferase. Proc. Natl. Acad. Sci. USA 88, 661–665. K. Gempel1 et al. (2002).Screening for Carnitine Palmitoyltransferase II Deficiency by Tandem Mass Spectrometry Anichini A.et al(2011) Genotype-phenotype correlations in a large series of patients with muscle type CPT II deficiency Vilarinho et al. (2009) Four Years of Expanded Newborn Screening in Portugal with MS/MS
Introduction: Carnitine palmitoytransferase II (CPTII) deficiency is a recessively inherited disorder of lipid metabolism. CPT II deficiency has several clinical presentations: the adult form is characterized by episodes of rhabdomyolysis, usually triggered by extensive exercice, cold, fever or prolonged fasting and the infantile-type CPT II hepatocardiomuscular form presents as severe attacks of hypoketotic, hypoglycemia, occasionally associated with cardiac damage. Molecular analysis of CPT II gene allows not only confirmation of classical forms, with typical biochemical abnormalities, but is also key for the diagnosis of less severe forms.The authors will present biochemical and molecular findings of eight CPT II, patients. Material and methods: Acylcarnitine profiles, on dried blood spots, were done as previously reported (Vilarinho et al) Molecular analysis of CPT II gene was done by direct sequencing as reported elsewhere (Finocchiaro et al.). From the eight patients, three were detected through newborn screening and five with clinical symptoms. Results: More pronounced abnormalities in the acylcarnitine profiles are associated with neonatal forms of the disease, while the patients with late onset forms present smother alterations or completely normal profiles. This biochemical heterogeneity correlates well with genetics data. The molecular analysis revealed the presence of ten different mutations, which seven were never reported. Discussion: Our results support that newborn screening can efficiently detect infantile CPT II deficiency but is less effective in detecting adult forms, were biochemical abnormalities may only be present during acute episodes. In these cases accurate clinical characterization alongside with molecular analysis are the key for diagnosis. Bibliography: J.P. Bonnefont, F. et al (2004) Mol. Aspects Med. 25 495–520. Rashed MS, et al.(1995) Diagnosis of inborn errors of metabolism from blood spots by acylcarnitines and amino acids profiling using automated electrospray tandem mass spectrometry. Pediatr Res.38:324–331 Finocchiaro, G. et al (1991). cDNA cloning, sequence analysis, and chomosomal localization of the gene for human carnitinepalmitoyltransferase. Proc. Natl. Acad. Sci. USA 88, 661–665. K. Gempel1 et al. (2002).Screening for Carnitine Palmitoyltransferase II Deficiency by Tandem Mass Spectrometry Anichini A.et al(2011) Genotype-phenotype correlations in a large series of patients with muscle type CPT II deficiency Vilarinho et al. (2009) Four Years of Expanded Newborn Screening in Portugal with MS/MS
Document Type
Conference Object
Language English
Language English
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