Clinical and molecular characteristics of carnitineacylcarnitine translocase deficiency with c.270delC and a novel c.408C>A variant

Background. Carnitine-acylcarnitine translocase deficiency (CACTD) is a rare, autosomal recessive, and highly lethal fatty acid oxidation (FAO) disorder caused by defective acylcarnitine transport across the mitochondrial membrane. CACTD is characterized by severe episodes of hypoglycemia and...

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Main Authors: Berrak Bilginer Gürbüz, Didem Yücel Yılmaz, Rıza Köksal Özgül, Can Koşukcu, Ali Dursun, Hatice Serap Sivri, Turgay Coşkun, Ayşegül Tokatlı
Format: Article
Language:English
Published: Hacettepe University Institute of Child Health 2021-08-01
Series:The Turkish Journal of Pediatrics
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Online Access:https://turkjpediatr.org/article/view/348
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author Berrak Bilginer Gürbüz
Didem Yücel Yılmaz
Rıza Köksal Özgül
Can Koşukcu
Ali Dursun
Hatice Serap Sivri
Turgay Coşkun
Ayşegül Tokatlı
author_facet Berrak Bilginer Gürbüz
Didem Yücel Yılmaz
Rıza Köksal Özgül
Can Koşukcu
Ali Dursun
Hatice Serap Sivri
Turgay Coşkun
Ayşegül Tokatlı
author_sort Berrak Bilginer Gürbüz
collection DOAJ
description Background. Carnitine-acylcarnitine translocase deficiency (CACTD) is a rare, autosomal recessive, and highly lethal fatty acid oxidation (FAO) disorder caused by defective acylcarnitine transport across the mitochondrial membrane. CACTD is characterized by severe episodes of hypoglycemia and hyperammonemia, seizures, cardiomyopathy, liver dysfunction, severe neurological damage, and muscle weakness. Herein, we described the clinical features, biochemical, and molecular findings of three patients with CACTD, presented with poor feeding, hypoglycemia, liver dysfunctions, and hyperammonemia, but died despite intensive treatment. Cases. All cases had similar signs and symptoms like poor feeding and respiratory failure associated with liver dysfunction. Urinary organic acid profiles in the presence of hypoglycemia and hyperammonemia led us to the possible diagnosis of one of fatty acid β-oxidation defects. Results of the molecular analyses were compatible with CACTD. In addition to known mutation (c.270delC;p.Phe91Leufs*38) we detected a novel one (c.408C > A;p.Cys136*). Conclusions. All three cases died despite a very intensive therapy. Based on our experience with these three cases, it can be said that CACTD has a relatively poor prognosis, molecular studies are of most importance in suspected cases for the final diagnosis and such studies might be of help while giving genetic counselling and guidance to parents for future pregnancies.
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spelling doaj-art-8d9df55cc47c47378eb149c8dc245a442025-08-20T02:01:46ZengHacettepe University Institute of Child HealthThe Turkish Journal of Pediatrics0041-43012791-64212021-08-0163410.24953/turkjped.2021.04.017Clinical and molecular characteristics of carnitineacylcarnitine translocase deficiency with c.270delC and a novel c.408C>A variantBerrak Bilginer Gürbüz0Didem Yücel Yılmaz1Rıza Köksal Özgül2Can Koşukcu3Ali Dursun4Hatice Serap Sivri5Turgay Coşkun6Ayşegül Tokatlı7Department of Pediatric Metabolism, Hacettepe University Faculty of Medicine, Ankara.Department of Pediatric Metabolism, Hacettepe University Institute of Child Health, Ankara.Department of Pediatric Metabolism, Hacettepe University Institute of Child Health, Ankara.Department of Bioinformatics, Hacettepe University Institute of Health Sciences, Ankara, Turkey.Department of Pediatric Metabolism, Hacettepe University Faculty of Medicine, Ankara.Department of Pediatric Metabolism, Hacettepe University Faculty of Medicine, Ankara.Department of Pediatric Metabolism, Hacettepe University Faculty of Medicine, Ankara.Department of Pediatric Metabolism, Hacettepe University Faculty of Medicine, Ankara. Background. Carnitine-acylcarnitine translocase deficiency (CACTD) is a rare, autosomal recessive, and highly lethal fatty acid oxidation (FAO) disorder caused by defective acylcarnitine transport across the mitochondrial membrane. CACTD is characterized by severe episodes of hypoglycemia and hyperammonemia, seizures, cardiomyopathy, liver dysfunction, severe neurological damage, and muscle weakness. Herein, we described the clinical features, biochemical, and molecular findings of three patients with CACTD, presented with poor feeding, hypoglycemia, liver dysfunctions, and hyperammonemia, but died despite intensive treatment. Cases. All cases had similar signs and symptoms like poor feeding and respiratory failure associated with liver dysfunction. Urinary organic acid profiles in the presence of hypoglycemia and hyperammonemia led us to the possible diagnosis of one of fatty acid β-oxidation defects. Results of the molecular analyses were compatible with CACTD. In addition to known mutation (c.270delC;p.Phe91Leufs*38) we detected a novel one (c.408C > A;p.Cys136*). Conclusions. All three cases died despite a very intensive therapy. Based on our experience with these three cases, it can be said that CACTD has a relatively poor prognosis, molecular studies are of most importance in suspected cases for the final diagnosis and such studies might be of help while giving genetic counselling and guidance to parents for future pregnancies. https://turkjpediatr.org/article/view/348aclycarnitinescarnitinecarnitine acylcarnitine translocasecarnitine acyltransferasesfatty acid oxidation defects
spellingShingle Berrak Bilginer Gürbüz
Didem Yücel Yılmaz
Rıza Köksal Özgül
Can Koşukcu
Ali Dursun
Hatice Serap Sivri
Turgay Coşkun
Ayşegül Tokatlı
Clinical and molecular characteristics of carnitineacylcarnitine translocase deficiency with c.270delC and a novel c.408C>A variant
The Turkish Journal of Pediatrics
aclycarnitines
carnitine
carnitine acylcarnitine translocase
carnitine acyltransferases
fatty acid oxidation defects
title Clinical and molecular characteristics of carnitineacylcarnitine translocase deficiency with c.270delC and a novel c.408C>A variant
title_full Clinical and molecular characteristics of carnitineacylcarnitine translocase deficiency with c.270delC and a novel c.408C>A variant
title_fullStr Clinical and molecular characteristics of carnitineacylcarnitine translocase deficiency with c.270delC and a novel c.408C>A variant
title_full_unstemmed Clinical and molecular characteristics of carnitineacylcarnitine translocase deficiency with c.270delC and a novel c.408C>A variant
title_short Clinical and molecular characteristics of carnitineacylcarnitine translocase deficiency with c.270delC and a novel c.408C>A variant
title_sort clinical and molecular characteristics of carnitineacylcarnitine translocase deficiency with c 270delc and a novel c 408c a variant
topic aclycarnitines
carnitine
carnitine acylcarnitine translocase
carnitine acyltransferases
fatty acid oxidation defects
url https://turkjpediatr.org/article/view/348
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