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Biochemical and molecular analysis of an X-linked case of Leigh syndrome associated with thiamin-responsive pyruvate dehydrogenase deficiency.
[pyruvate dehydrogenase deficiency]
We
report
molecular
analysis
of
thiamin-responsive
pyruvate
dehydrogenase
complex
(
PDHC
)
deficiency
in
a
patient
with
an
X-
linked
form
of
Leigh
syndrome
.
PDHC
activity
in
cultured
lymphoblastoid
cells
of
this
patient
and
his
asymptomatic
mother
were
normal
in
the
presence
of
a
high
thiamin
pyrophosphate
(
TPP
)
concentration
(
0
.
4
mmol
/
L
)
.
However
,
in
the
presence
of
a
low
concentration
(
1
x
10
(
-
4
)
mmol
/
L
)
of
TPP
,
the
activity
was
significantly
decreased
,
indicating
that
PDHC
deficiency
in
this
patient
was
due
to
decreased
affinity
of
PDHC
for
TPP
.
The
patient
's
older
brother
also
was
diagnosed
as
PDHC
deficiency
with
Leigh
syndrome
,
suggesting
that
PDHC
deficiency
in
these
two
brothers
was
not
a
de
novo
mutation
.
Sequencing
of
the
X-
linked
PDHC
E
1
alpha
subunit
revealed
a
C--
>
G
point
mutation
at
nucleotide
787
,
resulting
in
a
substitution
of
glycine
for
arginine
263
.
Restriction
enzyme
analysis
of
the
E
1
alpha
gene
revealed
that
the
mother
was
a
heterozygote
,
indicating
that
thiamin-responsive
PDHC
deficiency
associated
with
Leigh
syndrome
due
to
this
mutation
is
transmitted
by
X-
linked
inheritance
.
Diseases
Validation
Diseases presenting
"low concentration"
symptom
hereditary cerebral hemorrhage with amyloidosis
homocystinuria without methylmalonic aciduria
pyruvate dehydrogenase deficiency
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