1. A newborn with severe liver failure, cardiomyopathy and transaldolase deficiency.
- Author
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Verhoeven NM, Wallot M, Huck JH, Dirsch O, Ballauf A, Neudorf U, Salomons GS, van der Knaap MS, Voit T, and Jakobs C
- Subjects
- Cardiomyopathies diagnosis, Cardiomyopathies metabolism, Fatal Outcome, Female, Humans, Infant, Newborn, Infant, Newborn, Diseases diagnosis, Infant, Newborn, Diseases etiology, Infant, Newborn, Diseases genetics, Liver Failure, Acute diagnosis, Liver Failure, Acute metabolism, Metabolism, Inborn Errors diagnosis, Metabolism, Inborn Errors genetics, Monosaccharides urine, Mutation, Missense, Polymers metabolism, Transaldolase deficiency, Cardiomyopathies etiology, Liver Failure, Acute etiology, Metabolism, Inborn Errors complications, Severity of Illness Index, Transaldolase genetics
- Abstract
This paper describes the second patient found to be affected with a deficiency of transaldolase (TALDO1; EC 2.2.1.2). Clinically, this patient presented in the neonatal period with several signs of severe liver failure: severe coagulopathy, low serum protein, elevated blood ammonia, and hypoglycaemia. She had generalized oedema, moderate muscular hypotonia, and dysmorphic signs. Liver size was decreased, and the spleen was moderately enlarged. There was severe cardiomegaly. The clinical course was characterized by intractable liver failure and progressive myocardial hypertrophy. The child died at the age of 18 days from respiratory failure. In urine, elevations of erythritol, arabitol and ribitol were found, suggesting a deficiency of transaldolase. Enzyme studies in cultured fibroblasts showed undetectable transaldolase activity. DNA sequence analysis of the TALDO1 gene showed a homozygous missense mutation (575G>A), resulting in an amino acid alteration at position 192 (arginine to histidine, R192H). This amino acid is part of the catalytic site of the transaldolase protein. Discovery of this second patient affected with transaldolase deficiency and liver failure suggests that this disorder has a heterogeneous clinical presentation with highly variable severity.
- Published
- 2005
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