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Molecular genetic analysis of a female patient with pyruvate dehydrogenase deficiency: detection of a new mutation and differential expression of mutant gene product in cultured cells.
[pyruvate dehydrogenase deficiency]
A
new
18
bp
insertion
mutation
in
the
gene
for
the
alpha
subunit
of
pyruvate
dehydrogenase
(
E
1
alpha
)
was
found
in
a
female
patient
with
congenital
lactic
acidaemia
.
Cultured
skin
fibroblasts
and
Epstein-
Barr
virus-transformed
lymphoblastoid
cells
from
this
patient
showed
decreased
and
normal
pyruvate
dehydrogenase
complex
(
PDHC
)
activity
,
respectively
.
This
18
bp
insertion
was
a
de
novo
mutation
,
because
it
was
not
present
in
her
parents
.
Although
this
female
patient
was
heterozygous
for
the
normal
and
the
mutant
alleles
,
97
%
of
cultured
skin
fibroblasts
expressed
the
mutant
allele
,
while
100
%
of
cultured
lymphoblastoid
cells
,
94
%
of
peripheral
blood
lymphocytes
and
98
%
of
IL
-
2
-
activated
T
-
cells
expressed
the
normal
allele
.
These
results
suggest
that
in
this
patient
the
X
chromosome
containing
the
normal
allele
was
predominantly
inactivated
in
fibroblasts
and
the
X
chromosome
containing
the
mutant
allele
was
predominantly
inactivated
in
lymphocytes
.
The
diagnosis
of
E
1
alpha
deficiency
is
usually
established
by
measurement
of
PDHC
activity
and
the
level
of
immunoreactive
proteins
.
However
,
these
methods
are
not
sufficient
to
diagnose
the
disorder
in
female
patients
with
E
1
alpha
deficiency
due
to
differential
inactivation
of
the
X
chromosome
.
Therefore
,
it
is
necessary
to
develop
a
new
method
to
firmly
establish
the
diagnosis
of
E
1
alpha
deficiency
.
Diseases
Validation
Diseases presenting
"98%"
symptom
pyruvate dehydrogenase deficiency
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