琥珀酸半醛脱氢酶缺陷病

邓小鹿,尹飞,向秋莲,刘沉涛,彭镜

中国当代儿科杂志 ›› 2011, Vol. 13 ›› Issue (9) : 740-742.

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PDF(446 KB)
中国当代儿科杂志 ›› 2011, Vol. 13 ›› Issue (9) : 740-742.
疑难病研究

琥珀酸半醛脱氢酶缺陷病

  • 邓小鹿,尹飞,向秋莲,刘沉涛,彭镜
作者信息 +

Succinic semialdehyde dehydrogenase deficiency

  • DENG Xiao-Lu, YIN Fei, XIANG Qiu-Lian, LIU Chen-Tao, PENG Jing
Author information +
文章历史 +

摘要

琥珀酸半醛脱氢酶(SSADH)缺陷病是一种少见的常染色体隐性遗传病。本研究总结3例SSADH缺陷病患儿的临床资料并复习相关文献。3例患儿均为婴幼儿,主要表现为智力运动、语言发育落后,抽搐和肌张力低下。3例患儿脑电图均表现异常;2例脑MRI检查异常,表现为大脑脚对称性长T2高信号和基底节损害;3例尿液的气相色谱-质谱(GC-MS)分析均显示4-羟基丁酸增高,根据临床表现及尿液GC-MS分析确诊为SSADH缺陷病。对不明原因发育迟缓、智力运动障碍和癫癎的患儿应早期进行尿液有机酸分析,对明确诊断具有重要意义。

Abstract

Succinic semialdehyde dehydrogenase (SSADH) deficiency is a rare autosomal recessive disorder. This paper reports three cases of SSADH deficiency in infants. The infants developed the symptoms including developmental delay, intellectual disability, hypotonia, hyporeflexia and seizures. The electroencephalogram (EEG) showed background slowing and focal spike discharges in all of 3 patients. Head magnetic resonance imaging (MRI) demonstrated abnormalities in 2 patients, including basal ganglia damage and increased T2-weighted signal in bilateral cerebral peduncles. Urinary organic acid analysis with gas chromatography-mass spectrometry (GC-MS) revealed increased levels of 4-hydroxybutyrate (GHB) in 3 patients. SSADH deficiency was definitely diagnosed based on the clinical manifestations and the results of urinary organic acid analysis in the 3 children. It was concluded that early urine organic acid analysis is essential for children presenting with mental retardation, neuropsychiatric disturbance or epilepsy of unknown etiology.

关键词

琥珀酸半醛脱氢酶缺陷病 / 4-羟基丁酸 / 儿童

引用本文

导出引用
邓小鹿,尹飞,向秋莲,刘沉涛,彭镜. 琥珀酸半醛脱氢酶缺陷病[J]. 中国当代儿科杂志. 2011, 13(9): 740-742
DENG Xiao-Lu, YIN Fei, XIANG Qiu-Lian, LIU Chen-Tao, PENG Jing. Succinic semialdehyde dehydrogenase deficiency[J]. Chinese Journal of Contemporary Pediatrics. 2011, 13(9): 740-742
中图分类号: R596.1   

参考文献

[1]Jakobs C, Bojasch M, Monch E, Rating D, Siemes H, Hanefeld F. Urinary excretion of gamma-hydroxybutyric acid in a patient with neurological abnormalities. The probability of a new inborn error of metabolism[J]. Clin Chim Acta, 1981, 111(2-3):169-178.

[2]Pearl PL, Gibson KM, Cortez MA, Wu Y, Carter Snead O 3rd, Knerr I, et al. Succinic semialdehyde dehydrogenase deficiency: lessons from mice and men[J]. J Inherit Metab Dis, 2009, 32(3): 343-352.

[3]赵小朋,柳国胜,宋元宗.琥珀酸半醛脱氢酶缺陷病一例[J].中华儿科杂志,2003,41(9):719.

[4]崔湘君,袁宝强.4羟基丁酸尿症1例报道并文献复习[C]//第六届江浙沪儿科学术会议暨儿科学基础与临床研究进展学术班论文汇编.杭州:浙江省科学技术协会,2009.

[5]Trettel F, Malaspina P, Jodice C, Novelletto A, Slaughter CA, Caudle DL, et al. Human succinic semialdehyde dehydrogenase. Molecular cloning and chromosomal localization[J]. Adv Exp Med Biol, 1997, 414:253-260.

[6]Pearl PL, Gibson KM, Acosta MT, Vezina LG, Theodore WH, Rogawski MA, et al. Clinical spectrum of succinic semialdehyde dehydrogenase deficiency[J]. Neurology, 2003, 60(9): 1413-1417.

[7]Knerr I, Gibson KM, Murdoch G, Salomons GS, Jakobs C, Combs S, et al. Neuropathology in succinic semialdehyde dehydrogenase deficiency[J]. Pediatr Neurol, 2010, 42(4): 255-258.

[8]Pearl PL, Taylor JL, Trzcinski S, Sokohl A. The pediatric neurotransmitter disorders[J]. J Child Neurol, 2007, 22(5):606-616.

[9]Pearl PL,Capp PK, Novotny EJ, Gibson KM. Inherited disorders of neurotransmitters in children and adults[J]. Clin Biochem, 2005, 38(12):1051-1058.

[10]Rahbeeni Z, Ozand PT, Rashed M, Gascon GG, al Nasser M, al Odaib A, et al. 4-Hydroxybutyric aciduria[J]. Brain Dev, 1994,16(suppl):64-71.

[11]Lee WT, Weng WC, Peng SF, Tzen KY. Neuroimaging findings in children with paediatric neurotransmitter diseases[J]. J Inherit Metab Dis, 2009, 32(3):361-370.

[12]Pearl PL, Vezina LG, Saneto RP, McCarter R, Molloy-Wells E, Heffron A, et al. Cerebral MRI abnormalities associated with vigabatrin therapy[J]. Epilepsia, 2009, 50(2):184-194.

[13]Leuzzi V, Di Sabato ML, Deodato F, Rizzo C, Boenzi S, Carducci C, et al. Vigabatrin improves paroxysmal dystonia in succinic semialdehyde dehydrogenase deficiency[J]. Neurology, 2007, 68(16):1320-1321.

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