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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
"c"
symptom
adrenomyeloneuropathy
alexander disease
cadasil
coats disease
cohen syndrome
dedifferentiated liposarcoma
epidermolysis bullosa simplex
erythropoietic protoporphyria
familial hypocalciuric hypercalcemia
gm1 gangliosidosis
homocystinuria without methylmalonic aciduria
junctional epidermolysis bullosa
kallmann syndrome
oligodontia
papillon-lefèvre syndrome
phenylketonuria
pyruvate dehydrogenase deficiency
von hippel-lindau disease
x-linked adrenoleukodystrophy
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