[Diagnosis and treatment of 3-hydroxyisobutyryl-CoA hydrolase deficiency: a case report and literature review]

Zhongguo Dang Dai Er Ke Za Zhi. 2018 Aug;20(8):647-651. doi: 10.7499/j.issn.1008-8830.2018.08.009.
[Article in Chinese]

Abstract

A case of 3-hydroxyisobutyryl-CoA hydrolase deficiency was reported, and its clinical features, gene mutation characteristics, and diagnosis and treatment were analyzed with reference to related literature. The patient aged 1 year and 6 months had developmental regression and paroxysmal dystonia after pyrexia and diarrhea, and head MRI showed symmetrical lesions in the bilateral basal ganglia. No pathogenic mutation was found in the full-length detection of mitochondrial genome. Nuclear gene detection of mitochondrial-related diseases found new compound heterozygous mutations in the HIBCH gene, i.e., c.439-2A>G and c.958A>G (p.K320E), which were inherited from his father and mother, respectively. The boy was given cocktail therapy, dietary valine restriction, and symptomatic treatment. After 2 weeks of treatment, there were improvements in dystonia and motor and intellectual development.

报道一例3-羟基异丁酰辅酶A水解酶缺乏症,并结合文献,探讨其临床特征、基因突变特点和诊疗现状。患儿,男,1岁6个月,发热、腹泻后出现发育倒退、阵发性肌张力不全等症状;头部MRI提示双侧基底节对称性病变。线粒体基因组全长检测未发现致病突变。线粒体相关疾病核基因检测发现患儿HIBCH基因新发复合杂合突变:c.439-2A > G和c.958A > G(p.K320E),分别遗传自其父母。予以患儿"鸡尾酒疗法"、限制缬氨酸饮食及对症治疗,2周后患儿肌张力不全症状改善,运动以及智能较前缓慢进步。

Publication types

  • Case Reports
  • Review

MeSH terms

  • Abnormalities, Multiple / diagnosis*
  • Abnormalities, Multiple / enzymology
  • Abnormalities, Multiple / genetics
  • Abnormalities, Multiple / therapy*
  • Amino Acid Metabolism, Inborn Errors / diagnosis*
  • Amino Acid Metabolism, Inborn Errors / enzymology
  • Amino Acid Metabolism, Inborn Errors / genetics
  • Amino Acid Metabolism, Inborn Errors / therapy*
  • Base Sequence
  • Humans
  • Infant
  • Male
  • Molecular Sequence Data
  • Point Mutation
  • Thiolester Hydrolases / deficiency*
  • Thiolester Hydrolases / genetics

Substances

  • Thiolester Hydrolases
  • 3-hydroxyisobutyryl-CoA hydrolase

Supplementary concepts

  • Beta-Hydroxyisobutyryl CoA Deacylase Deficiency

Grants and funding

国家自然科学基金(81671297)