The remarkable journey of one female individual with ornithine transcarbamylase deficiency diagnosed post-mortem

JIMD Rep. 2023 Jan 29;64(3):233-237. doi: 10.1002/jmd2.12361. eCollection 2023 May.

Abstract

Urea cycle disorders (UCDs) comprise a group of inborn errors of metabolism with impaired ammonia clearance and an incidence of ~1:35 000 individuals. First described in the 1970s, the diagnosis and management of these disorders has evolved dramatically. We report on a 59-year-old woman with a UCD who contributed to advances in the understanding and treatment of this group of disorders. This individual was diagnosed with carbamoyl phosphate synthetase 1 deficiency based on a biochemical assay under a research context predating genetic sequencing, treated longitudinally as having this metabolic disorder, and was among the first participants to trial UCD pharmaceutical therapies. She ultimately succumbed to a SARS-CoV-2 infection while maintaining unexpectedly normal ammonium levels. Postmortem genetic testing revealed ornithine transcarbamylase deficiency. This individual's contributions to the field of UCDs is discussed herein.

Keywords: CPS1; OTC; hypothermia; intellectual disability; ornithine transcarbamylase deficiency; severe SARS‐CoV‐2 infection.

Publication types

  • Case Reports