caa a22 4500 467933634 CHVBK 20180406152950.0 cr unu---uuuuu 170328e20061001xx s 000 0 eng 10.1007/s10545-006-0321-0 doi (NATIONALLICENCE)springer-10.1007/s10545-006-0321-0 Fumaric aciduria: Mild phenotype in a 8-year-old girl with novel mutations [Elektronische Daten] [M. Maradin, K. Fumić, H. Hansikova, M. Tesarova, L. Wenchich, S. Dorner, V. Sarnavka, J. Zeman, I. Barić] Summary: Fumaric aciduria is a rare, autosomal recessive disorder caused by deficient acitivity of fumarate hydratase (FH). Common clinical features are hypotonia, failure to thrive, severe psychomotor retardation and seizures. Facial dysmorphism and brain malformations are frequent. Recently, some FH gene mutations have been associated with inherited cutaneous and uterine leiomyomas and papillary renal cell cancer. Our patient had a relatively mild phenotype, a previously not reported genotype and familial tumour predisposition. The mother and grandmother had uterine myomas. The paternal grandfather and his two brothers died from lung and laryngeal cancers. The pregnancy was complicated by bleeding and intrauterine growth retardation. Delivery was after 35 weeks, with normal Apgar score. The girl was hypotonic since birth. At age 2 months the parents noticed short apnoeic crises. She could sit at age 1.5 years, and walk with assistance at 4 years. At age 8 years highly increased excretion of fumaric acid was found twice (217 and 445 mmol/mol creatinine). Shortly before that the girl started to have leg and arm spasms. Grand mal seizures occurred twice. Facial dysmorphism included depressed nasal bridge, anteverted ears, hypertelorism and microcephaly. Speech was limited to few disyllables. She was atactic with spastic paraparesis. Brain MRI showed slight ventriculomegaly, white-matter atrophy and hypoplasia of corpus callosum. Activity of FH in fibroblasts was 1.9 nmol/min/mg protein (controls 40-80). Analysis of the FH gene revealed the maternally derived c.1029_1031delAGT mutation, resulting in Val deletion and substitution of Gln by His, and paternally derived c.976C > T mutation, resulting in substitution of Pro by Ser. SSIEM and Springer, 2006 Maradin M. Clinical Institute of Laboratory Diagnosis, University Hospital Center Zagreb, Croatia aut Fumić K. Clinical Institute of Laboratory Diagnosis, University Hospital Center Zagreb, Croatia aut Hansikova H. Department of Pediatrics and Centre of Applied Genomics, Charles University, Prague, Czech Republic aut Tesarova M. Department of Pediatrics and Centre of Applied Genomics, Charles University, Prague, Czech Republic aut Wenchich L. Department of Pediatrics and Centre of Applied Genomics, Charles University, Prague, Czech Republic aut Dorner S. Department of Paediatrics, University Hospital Center Zagreb, Croatia aut Sarnavka V. Department of Paediatrics, University Hospital Center Zagreb, Croatia aut Zeman J. Department of Pediatrics and Centre of Applied Genomics, Charles University, Prague, Czech Republic aut Barić I. Department of Paediatrics, University Hospital Center Zagreb, Croatia aut Journal of Inherited Metabolic Disease Kluwer Academic Publishers 29/5(2006-10-01), 683-683 0141-8955 29:5<683 2006 29 10545 https://doi.org/10.1007/s10545-006-0321-0 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10545-006-0321-0 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Maradin M. Clinical Institute of Laboratory Diagnosis, University Hospital Center Zagreb, Croatia aut NATIONALLICENCE 700 1- Fumić K. Clinical Institute of Laboratory Diagnosis, University Hospital Center Zagreb, Croatia aut NATIONALLICENCE 700 1- Hansikova H. Department of Pediatrics and Centre of Applied Genomics, Charles University, Prague, Czech Republic aut NATIONALLICENCE 700 1- Tesarova M. Department of Pediatrics and Centre of Applied Genomics, Charles University, Prague, Czech Republic aut NATIONALLICENCE 700 1- Wenchich L. Department of Pediatrics and Centre of Applied Genomics, Charles University, Prague, Czech Republic aut NATIONALLICENCE 700 1- Dorner S. Department of Paediatrics, University Hospital Center Zagreb, Croatia aut NATIONALLICENCE 700 1- Sarnavka V. Department of Paediatrics, University Hospital Center Zagreb, Croatia aut NATIONALLICENCE 700 1- Zeman J. Department of Pediatrics and Centre of Applied Genomics, Charles University, Prague, Czech Republic aut NATIONALLICENCE 700 1- Barić I. Department of Paediatrics, University Hospital Center Zagreb, Croatia aut NATIONALLICENCE 773 0- Journal of Inherited Metabolic Disease Kluwer Academic Publishers 29/5(2006-10-01), 683-683 0141-8955 29:5<683 2006 29 10545 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer