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Pyruvate dehydrogenase deficiency: molecular basis for intrafamilial heterogeneity.
[pyruvate dehydrogenase deficiency]
Two
half
-brothers
and
their
mother
had
symptomatic
pyruvate
dehydrogenase
complex
deficiency
.
The
infants
had
severe
congenital
lactic
acidosis
,
seizures
,
and
apneic
spells
and
died
at
the
ages
3
and
4
months
.
The
mother
was
less
symptomatic
with
mental
retardation
,
truncal
ataxia
,
and
dysarthria
.
The
residual
pyruvate
dehydrogenase
activities
in
cultured
skin
fibroblasts
from
the
2
infants
and
their
mother
were
7
,
15
,
and
10
%
of
control
values
.
Immunoblot
analysis
showed
negligible
amounts
of
E
1
alpha
and
E
1
beta
subunits
of
the
complex
.
Northern
blot
analysis
for
the
E
1
alpha
subunit
showed
normal
results
.
In
the
2
sons
,
complementary
DNA
sequence
analysis
revealed
a
cytosine
to
thymine
mutation
in
exon
4
,
resulting
in
a
change
of
arginine
127
to
tryptophan
in
the
E
1
alpha
subunit
.
Restriction
enzyme
analysis
of
the
polymerase
chain
reaction
product
representing
exon
4
of
the
E
1
alpha
gene
revealed
that
the
mother
was
a
heterozygotes
.
Complementary
DNA
restriction
analysis
and
methylation
analysis
of
the
X
chromosome
DXS
255
loci
revealed
skewed
activation
of
the
mutant
allele
,
consistent
with
the
deficient
pyruvate
dehydrogenase
activity
in
the
mother
's
fibroblasts
.
The
milder
maternal
phenotype
is
consistent
with
variable
X-
inactivation
patterns
in
different
organs
of
female
heterozygotes
.
Diseases
Validation
Diseases presenting
"maternal phenotype"
symptom
pyruvate dehydrogenase deficiency
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