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Cerebral palsy and pyruvate dehydrogenase deficiency: identification of two new mutations in the E1alpha gene.
[pyruvate dehydrogenase deficiency]
Pyruvate
dehydrogenase
(
PDH
)
complex
deficiency
,
a
common
cause
of
congenital
lactic
acidosis
,
is
mostly
due
to
mutations
in
the
X-
linked
gene
coding
for
the
E
1
alpha
subunit
of
the
complex
.
We
have
studied
two
unrelated
girls
presenting
a
static
encephalopathy
with
spastic
quadriplegia
,
microcephaly
and
seizures
and
in
one
girl
,
hypocalcaemia
,
a
new
finding
in
PDH
complex
deficiency
.
PDH
deficiency
was
diagnosed
in
adolescence
and
both
girls
had
low
PDH
complex
activity
in
muscle
but
normal
amounts
of
all
subunits
on
Western
blotting
,
and
a
normal
lactate
/
pyruvate
ratio
in
blood
and
CSF
.
Mutation
analysis
of
the
E
1
alpha
gene
at
the
cDNA
or
DNA
level
revealed
an
arginine
to
histidine
substitution
at
amino
acid
position
288
(
R
288
H
)
in
the
girl
with
hypocalcaemia
and
a
12
bp
insertion
,
predicting
a
four
amino
acid
duplication
at
the
c-terminal
end
of
the
protein
in
the
second
girl
.
They
both
carried
a
normal
and
a
mutated
E
1
alpha
gene
and
X-
inactivation
studies
showed
skewed
patterns
.
Mutation
identification
in
pyruvate
dehydrogenase
complex
deficiency
remains
important
especially
for
the
determination
of
the
recurrence
risk
and
for
reliable
genetic
counselling
in
couples
with
an
affected
child
.
Diseases
Validation
Diseases presenting
"duplication at the c-terminal end of the protein in the second girl"
symptom
pyruvate dehydrogenase deficiency
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