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Metabolic neuropathies and myopathies.
[adrenomyeloneuropathy]
Inborn
errors
of
metabolism
may
impact
on
muscle
and
peripheral
nerve
.
Abnormalities
involve
mitochondria
and
other
subcellular
organelles
such
as
peroxisomes
and
lysosomes
related
to
the
turnover
and
recycling
of
cellular
compartments
.
Treatable
causes
are
β-oxidation
defects
producing
progressive
neuropathy
;
pyruvate
dehydrogenase
deficiency
,
porphyria
,
or
vitamin
B
12
deficiency
causing
recurrent
episodes
of
neuropathy
or
acute
motor
deficit
mimicking
Guillain-
Barré
syndrome
.
On
the
other
hand
,
lysosomal
(
mucopolysaccharidosis
,
Gaucher
and
Fabry
diseases
)
,
mitochondriopathic
(
mitochondrial
or
nuclear
mutations
or
mDNA
depletion
)
,
peroxisomal
(
adrenomyeloneuropathy
,
Refsum
disease
,
sterol
carrier
protein-
2
deficiency
,
cerebrotendinous
xanthomatosis
,
α-methylacyl
racemase
deficiency
)
diseases
are
multisystemic
disorders
involving
also
the
heart
,
liver
,
brain
,
retina
,
and
kidney
.
Pathophysiology
of
most
metabolic
myopathies
is
related
to
the
impairment
of
energy
production
or
to
abnormal
production
of
reactive
oxygen
species
(
ROS
)
.
Main
symptoms
are
exercise
intolerance
with
myalgias
,
cramps
and
recurrent
myoglobinuria
or
limb
weakness
associated
with
elevation
of
serum
creatine
kinase
.
Carnitine
palmitoyl
transferase
deficiency
,
followed
by
acid
maltase
deficiency
,
and
lipin
deficiency
,
are
the
most
common
cause
of
isolated
rhabdomyolysis
.
Metabolic
myopathies
are
frequently
associated
to
extra
-neuromuscular
disorders
particularly
involving
the
heart
,
liver
,
brain
,
retina
,
skin
,
and
kidney
.
Diseases
Validation
Diseases presenting
"carnitine palmitoyl transferase deficiency"
symptom
adrenomyeloneuropathy
pyruvate dehydrogenase deficiency
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