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Treatment of cobalamin C (cblC) deficiency during pregnancy.
[homocystinuria without methylmalonic aciduria]
To
report
the
successful
pregnancy
of
a
woman
with
methylmalonic
acidemia
and
hyperhomocysteinemia
,
cblC
type
[
cobalamin
C
(
cblC
)
deficiency
]
(
MIM
277400
)
.
Retrospective
chart
review
.
A
24
-
year
-old
woman
presented
at
14
weeks
gestation
with
nausea
,
self-
restricted
protein
diet
,
and
weight
loss
.
She
had
a
past
history
of
asymptomatic
methylmalonic
acidemia
but
had
been
lost
to
follow-up
since
the
age
of
15
years
.
Biochemical
evaluation
revealed
combined
methylmalonic
acidemia
and
hyperhomocysteinemia
.
Complementation
analysis
confirmed
cblC
deficiency
.
One
copy
of
the
most
common
mutations
in
the
MMACHC
gene
,
c
.
271
dupA
,
was
identified
.
The
women
was
treated
from
15
weeks
of
gestation
with
a
low
protein
diet
(
64
g
/
day
)
(
1
.
1
g
/
kg
of
weight
/
day
)
,
L-
carnitine
(
1
g
per
os
3
times
daily
to
3
g
per
os
3
times
daily
in
the
third
trimester
)
,
aspirin
(
salicylic
acid
)
80
mg
per
day
,
folic
acid
5
mg
per
day
,
and
hydroxocobalamin
1
mg
intramuscular
every
week
to
two
times
per
week
in
the
third
trimester
.
The
pregnancy
was
uneventful
and
the
delivery
at
term
.
The
newborn
was
healthy
at
delivery
and
at
follow-up
.
We
report
on
the
successful
outcome
of
pregnancy
in
a
treated
woman
with
cblC
disease
.
The
pregnancy
was
uneventful
for
both
fetus
and
mother
with
the
delivery
of
a
term
healthy
boy
.
There
is
a
need
for
an
international
registry
on
the
management
and
outcomes
of
pregnancy
in
women
with
inborn
errors
of
metabolism
.
Diseases
Validation
Diseases presenting
"combined methylmalonic acidemia and hyperhomocysteinemia. complementation analysis"
symptom
homocystinuria without methylmalonic aciduria
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