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Clinical and genetic spectrum of pyruvate dehydrogenase deficiency: dihydrolipoamide acetyltransferase (E2) deficiency.
[pyruvate dehydrogenase deficiency]
Pyruvate
dehydrogenase
deficiency
is
a
major
cause
of
primary
lactic
acidosis
and
neurological
dysfunction
in
infancy
and
early
childhood
.
Most
cases
are
caused
by
mutations
in
the
X-
linked
gene
for
the
E
1
alpha
subunit
of
the
complex
.
Mutations
in
DLAT
,
the
gene
encoding
dihydrolipoamide
acetyltransferase
,
the
E
2
core
component
of
the
complex
,
have
not
been
described
previously
.
We
report
two
unrelated
patients
with
pyruvate
dehydrogenase
deficiency
caused
by
defects
in
the
E
2
subunit
.
Both
patients
are
less
severely
affected
than
typical
patients
with
E
1
alpha
mutations
and
both
have
survived
well
into
childhood
.
Episodic
dystonia
was
the
major
neurological
manifestation
,
with
other
more
common
features
of
pyruvate
dehydrogenase
deficiency
,
such
as
hypotonia
and
ataxia
,
being
less
prominent
.
The
patients
had
neuroradiological
evidence
of
discrete
lesions
restricted
to
the
globus
pallidus
,
and
both
are
homozygous
for
different
mutations
in
the
DLAT
gene
.
The
clinical
presentation
and
neuroradiological
findings
are
not
typical
of
pyruvate
dehydrogenase
deficiency
and
extend
the
clinical
and
mutational
spectrum
of
this
condition
.
Diseases
Validation
Diseases presenting
"defects in the e2 subunit"
symptom
pyruvate dehydrogenase deficiency
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