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Leigh syndrome: pyruvate dehydrogenase defect. A case with peripheral neuropathy.
[pyruvate dehydrogenase deficiency]
Pyruvate
dehydrogenase
deficiency
is
one
of
the
most
common
causes
of
encephalopathy
associated
with
lactic
acidosis
and
is
known
to
account
for
congenital
lactic
acidosis
,
recurrent
ataxia
,
and
infantile
Leigh
syndrome
.
Hitherto
,
however
,
peripheral
neuropathy
has
not
been
regarded
as
a
presenting
symptom
of
pyruvate
dehydrogenase
deficiency
.
Here
,
we
report
on
a
boy
who
presented
peripheral
neuropathy
with
severe
limb
hypotonia
,
absent
deep
-tendon
reflexes
,
and
reduced
motor
nerve
conduction
velocities
at
8
months
of
age
.
Persistent
hyperpyruvicemia
with
normal
lactate
/
pyruvate
molar
ratios
in
plasma
were
highly
suggestive
of
a
pyruvate
dehydrogenase
deficiency
,
and
the
determination
of
pyruvate
dehydrogenase
activity
in
circulating
lymphocytes
led
to
the
diagnosis
of
pyruvate
decarboxylase
(
PDH
-
E
1
)
deficiency
in
the
proband
.
Based
on
this
observation
,
we
suggest
that
pyruvate
dehydrogenase
deficiency
should
be
considered
in
the
diagnosis
of
peripheral
neuropathy
in
infancy
,
especially
when
associated
with
persistent
hyperpyruvicemia
,
normal
lactate
/
pyruvate
molar
ratios
in
plasma
,
and
recurrent
episodes
of
drowsiness
and
hypotonia
of
unknown
origin
.
Diseases
Validation
Diseases presenting
"encephalopathy"
symptom
adrenomyeloneuropathy
alexander disease
cadasil
child syndrome
congenital toxoplasmosis
dedifferentiated liposarcoma
hereditary cerebral hemorrhage with amyloidosis
homocystinuria without methylmalonic aciduria
legionellosis
locked-in syndrome
neonatal adrenoleukodystrophy
neuralgic amyotrophy
phenylketonuria
pyruvate dehydrogenase deficiency
scrub typhus
sneddon syndrome
systemic capillary leak syndrome
waldenström macroglobulinemia
werner syndrome
wolf-hirschhorn syndrome
zellweger syndrome
This symptom has already been validated