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Homocystinuria




Homocystinuria
Classification & external resources
Homocysteine
ICD-10 E72.1
ICD-9 270.4
OMIM 236200
DiseasesDB 5991
MedlinePlus 001199
eMedicine derm/708 
MeSH D006712

Homocystinuria, also known as Cystathionine beta synthase deficiency, is an inherited disorder of the metabolism of the amino acid methionine, often involving cystathionine beta synthase. It is an inherited autosomal recessive trait, which means a child needs to inherit the defective gene from both parents to be affected.

Additional recommended knowledge

Contents

Presentation

This defect leads to a multisystemic disorder of the connective tissue, muscles, CNS, and cardiovascular system. Homocystinuria represents a group of hereditary metabolic disorders characterized by an accumulation of homocysteine in the serum and an increased excretion of homocysteine in the urine. Infants appear to be normal and early symptoms, if any are present, are vague.

Symptoms

  • A family history of homocystinuria
  • Nearsightedness
  • Flush across the cheeks
  • Tall, thin build
  • Long limbs
  • High-arched feet (pes cavus)
  • Knock-knees (genu valgum)
  • Pectus excavatum
  • Pectus carinatum
  • Mental retardation
  • Psychiatric disease
  • Eye anomalies:
  • 90% have ectopia lentis
  • Myopia
  • Glaucoma
  • Optic atrophy
  • Seizure
  • extensive atheroma formation at young age which affects many arteries but not the coronary arteries

Mortality/morbidity

The life expectancy of patients with homocystinuria is reduced only if untreated. It is known that before the age of 30, almost one fourth of patients die as a result of thrombotic complications (e.g. heart attack).

Treatment

No specific cure has been discovered for homocystinuria; however, many people are treated using high doses of vitamin B6 (also known as pyridoxine). Slightly less than 50% respond to this treatment and need to intake supplemental vitamin B6 for the rest of their lives. Those who do not respond require a low methionine diet, and most will need treatment with trimethylglycine. A normal dose of folic acid supplement and occasionally added cysteine in the diet is helpful.

Recommended diet

Low-protein food is recommended for this disorder requires food products which are low in particular types of amino-acid (i.e. methonine).

See also

 
This article is licensed under the GNU Free Documentation License. It uses material from the Wikipedia article "Homocystinuria". A list of authors is available in Wikipedia.
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