以周围神经病为主要表现的成人cbc1型甲基丙戊二酸血症一例
A Case of Adult cbc1 Type Methylmalonic Acidemia with Peripheral Neuropathy as the Main Manifestation
摘要: 甲基丙二酸血症(methylmalonic acidemia, MMA)是一种罕见的常染色体隐性遗传病,其中cblC型MMA最为常见,是因MMACHC基因突变造成编码cblC蛋白缺陷所致。MMA最常见于少儿期,成人发病罕见。鉴于该病临床表现异质性较高且特异性差,在实际临床工作中易出现误诊和漏诊。现报告1例以周围神经病变起病的成人cblC型MMA并做文献复习,为临床上诊断和治疗该疾病提供参考。
Abstract: Methylmalonic acidemia (MMA) is a rare autosomal recessive genetic disease, among which cblC type MMA is common, caused by the deficiency of cblC protein encoded by MMACHC gene mutation. MMA is the most common in children and rarely occurs in adults. Given the high heterogeneity and poor specificity of the clinical manifestations of this disease, it is easy to be misdiagnosed and misdiagnosed in practical clinical work. A case of adult cblC MMA with peripheral neuropathy onset is reported and the literature is reviewed to provide reference for clinical diagnosis and treatment of this disease.
文章引用:张濛文, 孙妍萍. 以周围神经病为主要表现的成人cbc1型甲基丙戊二酸血症一例[J]. 临床医学进展, 2024, 14(5): 1303-1311. https://doi.org/10.12677/acm.2024.1451554

参考文献

[1] Chen, T., Gao, Y., Zhang, S., Wang, Y., Sui, C. and Yang, L. (2023) Methylmalonic Acidemia: Neurodevelopment and Neuroimaging. Frontiers in Neuroscience, 17, Article 1110942. [Google Scholar] [CrossRef] [PubMed]
[2] Han, L.S., Huang, Z., Han, F., Ye, J., Qiu, W.J., Zhang, H.W., Wang, Y., Gong, Z.W. and Gu, X.F. (2015) Clinical Features and MUT Gene Mutation Spectrum in Chinese Patients with Isolated Methylmalonic Acidemia: Identification of Ten Novel Allelic Variants. World Journal of Pediatrics, 11, 358-365. [Google Scholar] [CrossRef] [PubMed]
[3] Thompson, G.N., Christodoulou, J. and Danks, D.M. (1989) Metabolic Stroke in Methylmalonic Acidemia. The Journal of Pediatrics, 115, 499-500. [Google Scholar] [CrossRef
[4] Zhou, X., Cui, Y. and Han, J. (2018) Methylmalonic Acidemia: Current Status and Research Priorities. Intractable & Rare Diseases Research, 7, 73-78. [Google Scholar] [CrossRef] [PubMed]
[5] Fischer, S., Huemer, M., Baumgartner, M., Deodato, F., Ballhausen, D., Boneh, A., Burlina, A.B., Cerone, R., Garcia, P., Gökçay, G., Grünewald, S., Häberle, J., Jaeken, J., Ketteridge, D., Lindner, M., Mandel, H., Martinelli, D., Martins, E.G., Schwab, K.O., Gruenert, S.C., Schwahn, B.C., Sztriha, L., Tomaske, M., Trefz, F., Vilarinho, L., Rosenblatt, D.S., Fowler, B. and Dionisi-Vici, C. (2014) Clinical Presentation and Outcome in a Series of 88 Patients with the cblC Defect. Journal of Inherited Metabolic Disease, 37, 831-840. [Google Scholar] [CrossRef] [PubMed]
[6] Wang, X., Sun, W., Yang, Y., Jia, J. and Li, C. (2012) A Clinical and Gene Analysis of Late-Onset Combined Methylmalonic Aciduria and Homocystinuria, cblC Type, in China. Journal of the Neurological Sciences, 318, 155-159. [Google Scholar] [CrossRef] [PubMed]
[7] Forny, P., Schnellmann, A.S., Buerer, C., Lutz, S., Fowler, B., Froese, D.S. and Baumgartner, M.R. (2016) Molecular Genetic Characterization of 151 Mut-Type Methylmalonic Aciduria Patients and Identification of 41 Novel Mutations in MUT. Human Mutation, 37, 745-754. [Google Scholar] [CrossRef] [PubMed]
[8] de Keyzer, Y., Valayannopoulos, V., Benoist, J.F., Batteux, F., Lacaille, F., Hubert, L., Chrétien, D., Chadefeaux-Vekemans, B., Niaudet, P., Touati, G., Munnich, A. and de Lonlay, P. (2009) Multiple OXPHOS Deficiency in the Liver, Kidney, Heart, and Skeletal Muscle of Patients with Methylmalonic Aciduria and Propionic Aciduria. Pediatric Research, 66, 91-95. [Google Scholar] [CrossRef
[9] Worgan, L.C., Niles, K., Tirone, J.C., Hofmann, A., Verner, A., Sammak, A., Kucic, T., Lepage, P. and Rosenblatt, D.S. (2006) Spectrum of Mutations in Mut Methylmalonic Acidemia and Identification of a Common Hispanic Mutation and Haplotype. Human Mutation, 27, 31-43. [Google Scholar] [CrossRef] [PubMed]
[10] Zhang, Y., Song, J.Q., Liu, P., Yan, R., Dong, J.H., Yang, Y.L., Wang, L.F., Jiang, Y.W., Zhang, Y.H., Qin, J. and Wu, X.R. (2007) Clinical Studies on Fifty-Seven Chinese Patients with Combined Methylmalonic Aciduria and Homocysteinemia. Zhonghua Er Ke Za Zhi, 45, 513-517.
[11] Carrillo-Carrasco, N., Chandler, R.J. and Venditti, C.P. (2012) Combined Methylmalonic Acidemia and Homocystinuria, cblC Type. I. Clinical Presentations, Diagnosis and Management. Journal of Inherited Metabolic Disease, 35, 91-102. [Google Scholar] [CrossRef] [PubMed]
[12] Forny, P., Hörster, F., Ballhausen, D., Chakrapani, A., Chapman, K.A., Dionisi-Vici, C., Dixon, M., Grünert, S.C., Grunewald, S., Haliloglu, G., Hochuli, M., Honzik, T., Karall, D., Martinelli, D., Molema, F., Sass, J.O., Scholl-Bürgi, S., Tal, G., Williams, M., Huemer, M. and Baumgartner, M.R. (2021) Guidelines for the Diagnosis and Management of Methylmalonic Acidaemia and Propionic Acidaemia: First Revision. Journal of Inherited Metabolic Disease, 44, 566-592. [Google Scholar] [CrossRef] [PubMed]
[13] Hörster, F., Baumgartner, M.R., Viardot, C., Suormala, T., Burgard, P., Fowler, B., Hoffmann, G.F., Garbade, S.F., Kölker, S. and Baumgartner, E.R. (2007) Long-Term Outcome in Methylmalonic Acidurias Is Influenced by the Underlying Defect (mut0, mut-, cblA, cblB). Pediatric Research, 62, 225-230. [Google Scholar] [CrossRef
[14] Zwickler, T., Lindner, M., Aydin, H.I., Baumgartner, M.R., Bodamer, O.A., Burlina, A.B., Das, A.M., DeKlerk, J.B., Gökcay, G., Grünewald, S., Guffon, N., Maier, E.M., Morava, E., Geb, S., Schwahn, B., Walter, J.H., Wendel, U., Wijburg, F.A., Müller, E., Kölker, S., Hörster, F. (2008) Diagnostic Work-Up and Management of Patients with Isolated Methylmalonic Acidurias in European Metabolic Centres. Journal of Inherited Metabolic Disease, 31, 361-367. [Google Scholar] [CrossRef] [PubMed]
[15] Ktena, Y.P., Paul, S.M., Hauser, N.S., Sloan, J.L., Gropman, A., Manoli, I. and Venditti, C.P. (2015) Delineating the Spectrum of Impairments, Disabilities, and Rehabilitation Needs in Methylmalonic Acidemia (MMA). American Journal of Medical Genetics Part A, 167, 2075-2084. [Google Scholar] [CrossRef] [PubMed]
[16] Nizon, M., Ottolenghi, C., Valayannopoulos, V., Arnoux, J.B., Barbier, V., Habarou, F., Desguerre, I., Boddaert, N., Bonnefont, J.P., Acquaviva, C., Benoist, J.F., Rabier, D., Touati ,G. and de Lonlay, P. (2013) Long-Term Neurological Outcome of a Cohort of 80 Patients with Classical Organic Acidurias. Orphanet Journal of Rare Diseases, 8, Article No. 148. [Google Scholar] [CrossRef] [PubMed]
[17] Cosson, M.A., Benoist, J.F., Touati, G., Déchaux, M., Royer, N., Grandin, L., Jais, J.P., Boddaert, N., Barbier, V., Desguerre, I., Campeau, P.M., Rabier, D., Valayannopoulos, V., Niaudet, P. and de Lonlay, P. (2009) Long-Term Outcome in Methylmalonic Aciduria: A Series of 30 French Patients. Molecular Genetics and Metabolism, 97, 172-178. [Google Scholar] [CrossRef] [PubMed]
[18] Kruszka, P.S., Manoli, I., Sloan, J.L., Kopp, J.B. and Venditti, C.P. (2013) Renal Growth in Isolated Methylmalonic Acidemia. Genetics in Medicine, 15, 990-996. [Google Scholar] [CrossRef] [PubMed]