Adult-onset combined methylmalonic acidemia and hyperhomocysteinemia, cblC type with aortic dissection and acute kidney injury: a case report.
BMC Nephrol
; 25(1): 13, 2024 01 04.
Article
in En
| MEDLINE
| ID: mdl-38178022
ABSTRACT
BACKGROUND:
Combined methylmalonic acidemia (MMA) and hyperhomocysteinemia, cobalamin C (cblC) type, also named cblC deficiency is a rare autosomal recessive genetic metabolic disease. It progressively causes neurological, hematologic, renal and other system dysfunction. The clinical manifestations are relatively different due to the onset time of disease. CASE PRESENTATION This report describes a rare case of a 26 year old man with cblC deficiency who developed life-threatening aortic dissection and acute kidney injury (AKI) and showed neuropsychiatric symptoms with elevated serum homocysteine and methylmalonic aciduria. After emergent operation and intramuscular cobalamin supplementation therapy, the male recovered from aortic dissection, neurological disorder and AKI. Finally, two previously published compound heterozygous variants, c.482G > A (p.R161Q) and c.658_660del (p.K220del) in the MMACHC gene were detected in this patient and he was confirmed to have cblC deficiency.CONCLUSIONS:
Poor cognizance of presenting symptoms and biochemical features of adult onset cblC disease may cause delayed diagnosis and management. This case is the first to depict a case of adult-onset cblC deficiency with aortic dissection. This clinical finding may contribute to the diagnosis of cblC deficiency.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Hyperhomocysteinemia
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Acute Kidney Injury
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Amino Acid Metabolism, Inborn Errors
Type of study:
Diagnostic_studies
/
Etiology_studies
Limits:
Adult
/
Humans
/
Male
Language:
En
Journal:
BMC Nephrol
Journal subject:
NEFROLOGIA
Year:
2024
Document type:
Article
Affiliation country: