• 제목/요약/키워드: Metabolic disorder

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확장성 심근병증으로 발현된 프로피온산혈증 1례 (A Case of Propionic Acidemia Presenting with Dilated Cardiomyopathy)

  • 손지수;최윤하;서고훈;강민지;이범희
    • 대한유전성대사질환학회지
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    • 제21권1호
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    • pp.22-27
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    • 2021
  • 프로피온산혈증은 PCCA 및 PCCB 유전자의 돌연변이로 발생하며 대사산물의 축적으로 신생아기부터 근긴장 저하, 구토, 케톤산증, 고암모니아혈증, 경련 등이 나타나 사망에 이를 수 있고, 비교적 후기에 신경학적 증상과 함께 발현하는 경과를 보이기도 한다. 저자들은 특별한 과거력 없이 지내던 중 확장성 심근병증이 확인된 16세 남아에서 유전자 검사로 프로피온산혈증이 진단된 1례를 보고하는 바이다.

Glutaric Aciduria Type I 1례 (A Case of Glutaric Aciduria Type I with Macrocephaly)

  • 신우종;문여옥;윤혜란;동은실;안영민
    • Clinical and Experimental Pediatrics
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    • 제46권3호
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    • pp.295-301
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    • 2003
  • 출생 이후 머리둘레가 커지는 1개월 남아에게서 뇌초음파 검사상 지주막하 공간이 확장되어 있고 백질의 음영이 증가 되어 있었고 뇌 MRI 소견은 실비우스열의 확장과 양측 대뇌, 소뇌 피질과 백질이 T1 강조 영상에서 저신호 강도와 T2 강조영상에서 고신호 강도를 보였으며 경피생검으로 얻은 섬유아세포 배양에서 glutaryl-CoA 탈수소효소의 활성도가 전혀 없어 GA1을 확진하게 되었다. 대두증이 있는 신생아나 영아에서 전측두엽 위축의 신경방사선학적 징후가 있으면 우선적으로 GA1을 의심해 보아야 한다. 이후 특수분유인 Glutatex 분유의 수유와 카르니틴, 리보플라빈 보충요법을 시행하여 대사성 위기나 급성 뇌증의 위기 없이 양호한 발달을 하고 있는 환아를 경험하였기에 보고하는 바이다.

A compound heterozygous mutation in the FMO3 gene: the first pediatric case causes fish odor syndrome in Korea

  • Kim, Ji Hyun;Cho, Sung Min;Chae, Jong-Hee
    • Clinical and Experimental Pediatrics
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    • 제60권3호
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    • pp.94-97
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    • 2017
  • Trimethylaminuria (TMAuria), known as "fish odor syndrome," is a congenital metabolic disorder characterized by an odor resembling that of rotting fish. This odor is caused by the secretion of trimethylamine (TMA) in the breath, sweat, and body secretions and the excretion of TMA along with urine. TMAuria is an autosomal recessive disorder caused by mutations in flavin-containing monooxygenase 3 (FMO3). Most TMAuria cases are caused by missense mutations, but nonsense mutations have also been reported in these cases. Here, we describe the identification of a novel FMO3 gene mutation in a patient with TMAuria and her family. A 3-year-old girl presented with a strong corporal odor after ingesting fish. Genomic DNA sequence analysis revealed that she had compound heterozygous FMO3 mutations; One mutation was the missense mutation p.Val158Ile in exon 3, and the other was a novel nonsense mutation, p.Ser364X, in exon 7 of the FMO3 gene. Familial genetic analyses showed that the p.Val158Ile mutation was derived from the same allele in the father, and the p.Ser364X mutation was derived from the mother. This is the first description of the p.Ser364X mutation, and the first report of a Korean patient with TMAuria caused by novel compound heterozygous mutations.

근무력증과 왜소증을 동반한 Bartter syndrome 1례 (A Case of Bartter Syndrome with Muscle Weakness and Short Stature)

  • 김인성;강주형;신윤혜;이동국;김순남;배기수
    • Childhood Kidney Diseases
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    • 제6권2호
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    • pp.259-265
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    • 2002
  • 저자들은 본원 소아과에 입원한 9년 3개월된 남아에서 만성병색소견, 심한 근무력증, 왜소증, 저칼륨성 대사성 알칼리혈증 및 신석회증과 좌측 요관의 확장을 보이는 영아기 이후 발병한 Bartter 증후군 1례를 경험하였기에 치료반응 및 임상경과를 문헌 고찰과 함께 보고하는 바이다.

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탠덤매스에의한 체액 중 Globotriaocylceramide(Gb-3)의 측정을 이용한 한국인 고 위험도군에서의 파브리병 스크리닝 (Status of High Risk Group Fabry Disease Screening in Korea by Measuring Globotriacocylceramide in Body Fluid using Electrospray-MS/MS)

  • 윤혜란
    • 약학회지
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    • 제55권1호
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    • pp.56-63
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    • 2011
  • Fabry disease (FD) is an X-linked inborn error of glycoshpingolipid metabolism resulting from mutation in the enzyme ${\alpha}$-galactosidase A gene. The disease is an X-linked lipid storage disorder and the lack of ${\alpha}$-Gal A causes an intracellular accumulation of glycosphingolipids, mainly globotriaosylceramide (Gb-3). Measurement of Gb-3 in plasma has clinical importance for monitoring after enzyme replacement therapy for confirmed FD patients. Using electrospray ionization MS/MS we had developed, a simple, rapid, and highly sensitive analytical method for Gb-3 in plasma was used for the purpose of screening FD among high risk groups in Korean population. To date, no comprehensive results for FD screening have been performed and reported in Korea. We screened 1,100 outpatients from 13 hospitals (including clinics) to assess the incidence of FD among patients in high risk groups. For patients with borderline level amount of Gb-3, we repeated Gb-3 or performing complementary or confirmative assay with ${\alpha}$-Gal A activity and DNA mutaion analysis for confirmation diagnosis. Of 1,100 we diagnosed 3 FD with 2 classical type and 1 carrier (0.27%).

1H-Nuclear Magnetic Resonance-Based Plasma Metabolic Profiling of Dairy Cows with Fatty Liver

  • Xu, Chuang;Sun, Ling-wei;Xia, Cheng;Zhang, Hong-you;Zheng, Jia-san;Wang, Jun-song
    • Asian-Australasian Journal of Animal Sciences
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    • 제29권2호
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    • pp.219-229
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    • 2016
  • Fatty liver is a common metabolic disorder of dairy cows during the transition period. Historically, the diagnosis of fatty liver has involved liver biopsy, biochemical or histological examination of liver specimens, and ultrasonographic imaging of the liver. However, more convenient and noninvasive methods would be beneficial for the diagnosis of fatty liver in dairy cows. The plasma metabolic profiles of dairy cows with fatty liver and normal (control) cows were investigated to identify new biomarkers using $^1H$ nuclear magnetic resonance. Compared with the control group, the primary differences in the fatty liver group included increases in ${\beta}$-hydroxybutyric acid, acetone, glycine, valine, trimethylamine-N-oxide, citrulline, and isobutyrate, and decreases in alanine, asparagine, glucose, ${\gamma}$-aminobutyric acid glycerol, and creatinine. This analysis revealed a global profile of endogenous metabolites, which may present potential biomarkers for the diagnosis of fatty liver in dairy cows.

무증상 신생아에서 진단된 경쇄 acyl-CoA 탈수소효소 결핍증 1례 (Short-chain Acyl-CoA Dehydrogenase Deficiency in an Asymptomatic Neonate)

  • 이연희;김진섭;허림;조성윤;진동규
    • 대한유전성대사질환학회지
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    • 제15권2호
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    • pp.93-97
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    • 2015
  • 경쇄 acyl-CoA 탈수소효소 결핍증(short chain acyl-CoA dehydrogenase deficiency, SCAD)은 미토콘드리아에서 일어나는 지방산 대사과정에서 베타-산화지방산의 산화에 장애를 일으키는 질환으로 임상증상으로는 저혈당, 근육긴장저하, 진행성 근육약화, 발달지연, 발작 등이 다양하게 나타날 수 있다. 저자들은 신생아 선별검사에서 지방산 대사의 질환의 양성 검사결과를 갖는 무증상 환아에서 추가적인 소변 유기산 분석 검사를 시행하였으며, 유전자 분석검사를 통해 질환을 진단하였다. 이후 환아의 임상적 증상 발현 유무를 관찰하였으며 조기 진단과 질환 악화요인에 대한 설명 및 교육을 통해 4년이 지난 현재까지 나이에 적합한 발달과 성장의 임상경과를 확인하였기에 문헌 고찰과 함께 보고하는 바이다.

저나트륨혈증성 탈수증으로 진단된 소아 부신백질이영양증 1례 (A Case of Adrenoleukodystrophy Diagnosed as Hyponatremic Dehydration)

  • 이상헌;김형진;권영세;김순기;이지은
    • 대한유전성대사질환학회지
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    • 제14권1호
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    • pp.66-70
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    • 2014
  • X-linked adrenoleukodystrophy (ALD) is a uncommon metabolic disorder which derived by peroxismal ${\beta}$-oxidation and elevation of serum very long chain fatty acid (VLCFA). VLCFA is mainly accumulated in the myelin of the central nervous system and adrenal cortex, by which the expressed symptoms of this disease are mainly neurologic and endocrinologic (such as adrenal insufficiency). The mutations in the ABCD1 gene causes X-linked ALD, nevertheless its phenotypes and genotypes are poorly coordinated. We report the case of a 12-year-old boy with X-linked ALD who developed vomiting, fatigue and poor oral intake. Severe dehydration and hyponatremia were found in initial physical examination and laboratory test, but his motor/sensory nerve function and mental status were completely normal. We diagnosed ALD with diffuse high-intensity signal in both parietotemporal cerebellar white matter in brain MRI and elevated serum VLCFA. Later, we confirmed a novel c.1635-1G>A (IVS6-1G>A) mutations of the ABCD1 gene. With the discrepancy between its phenotypes and genotypes, various phenotypes could be seen in X-ALD patient. Careful examination and further studies for these patients will be needed.

Pathway Analysis of Metabolic Syndrome Using a Genome-Wide Association Study of Korea Associated Resource (KARE) Cohorts

  • Shim, Unjin;Kim, Han-Na;Sung, Yeon-Ah;Kim, Hyung-Lae
    • Genomics & Informatics
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    • 제12권4호
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    • pp.195-202
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    • 2014
  • Metabolic syndrome (MetS) is a complex disorder related to insulin resistance, obesity, and inflammation. Genetic and environmental factors also contribute to the development of MetS, and through genome-wide association studies (GWASs), important susceptibility loci have been identified. However, GWASs focus more on individual single-nucleotide polymorphisms (SNPs), explaining only a small portion of genetic heritability. To overcome this limitation, pathway analyses are being applied to GWAS datasets. The aim of this study is to elucidate the biological pathways involved in the pathogenesis of MetS through pathway analysis. Cohort data from the Korea Associated Resource (KARE) was used for analysis, which include 8,842 individuals (age, $52.2{\pm}8.9years$ ; body mass index, $24.6{\pm}3.2kg/m^2$). A total of 312,121 autosomal SNPs were obtained after quality control. Pathway analysis was conducted using Meta-analysis Gene-Set Enrichment of Variant Associations (MAGENTA) to discover the biological pathways associated with MetS. In the discovery phase, SNPs from chromosome 12, including rs11066280, rs2074356, and rs12229654, were associated with MetS (p < $5{\times}10^{-6}$), and rs11066280 satisfied the Bonferroni-corrected cutoff (unadjusted p < $1.38{\times}10^{-7}$, Bonferroni-adjusted p < 0.05). Through pathway analysis, biological pathways, including electron carrier activity, signaling by platelet-derived growth factor (PDGF), the mitogen-activated protein kinase kinase kinase cascade, PDGF binding, peroxisome proliferator-activated receptor (PPAR) signaling, and DNA repair, were associated with MetS. Through pathway analysis of MetS, pathways related with PDGF, mitogen-activated protein kinase, and PPAR signaling, as well as nucleic acid binding, protein secretion, and DNA repair, were identified. Further studies will be needed to clarify the genetic pathogenesis leading to MetS.

Genome-Wide Association Study of Metabolic Syndrome in Koreans

  • Jeong, Seok Won;Chung, Myungguen;Park, Soo-Jung;Cho, Seong Beom;Hong, Kyung-Won
    • Genomics & Informatics
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    • 제12권4호
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    • pp.187-194
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    • 2014
  • Metabolic syndrome (METS) is a disorder of energy utilization and storage and increases the risk of developing cardiovascular disease and diabetes. To identify the genetic risk factors of METS, we carried out a genome-wide association study (GWAS) for 2,657 cases and 5,917 controls in Korean populations. As a result, we could identify 2 single nucleotide polymorphisms (SNPs) with genome-wide significance level p-values (< $5{\times}10^{-8}$), 8 SNPs with genome-wide suggestive p-values ($5{\times}10^{-8}{\leq}$ p < $1{\times}10^{-5}$), and 2 SNPs of more functional variants with borderline p-values ($5{\times}10^{-5}{\leq}$ p < $1{\times}10^{-4}$). On the other hand, the multiple correction criteria of conventional GWASs exclude false-positive loci, but simultaneously, they discard many true-positive loci. To reconsider the discarded true-positive loci, we attempted to include the functional variants (nonsynonymous SNPs [nsSNPs] and expression quantitative trait loci [eQTL]) among the top 5,000 SNPs based on the proportion of phenotypic variance explained by genotypic variance. In total, 159 eQTLs and 18 nsSNPs were presented in the top 5,000 SNPs. Although they should be replicated in other independent populations, 6 eQTLs and 2 nsSNP loci were located in the molecular pathways of LPL, APOA5, and CHRM2, which were the significant or suggestive loci in the METS GWAS. Conclusively, our approach using the conventional GWAS, reconsidering functional variants and pathway-based interpretation, suggests a useful method to understand the GWAS results of complex traits and can be expanded in other genomewide association studies.