Outcome of infants diagnosed with 3-methyl-crotonyl-CoA-carboxylase deficiency by newborn screening

Georgianne L. Arnold, Denise Salazar, Julie A. Neidich, Pim Suwannarat, Brett H. Graham, Uta Lichter-Konecki, Annet M. Bosch, Kristina Cusmano-Ozog, Greg Enns, Erica L. Wright, Brendan C. Lanpher, Natalie N. Owen, Mark H. Lipson, Roberto Cerone, Paul Levy, Lee Jun C. Wong, Antal Dezsofi

Research output: Contribution to journalArticle

13 Scopus citations

Abstract

Introduction: 3-Methyl CoA carboxylase (3-MCC) deficiency is an inborn error of metabolism in the catabolism of the amino acid leucine. Original reports suggested this disorder was associated with significant neurological and biochemical effects. However newborn screening has identified a higher than expected incidence of this disorder with apparent normal outcome in most cases. Method: A retrospective analysis of thirty-five cases of 3-MCC deficiency identified by newborn screening and diagnosed by enzyme or molecular analysis. Results: There was a strong inverse correlation between initial C5OH level and residual enzyme activity. A few reports of hypoglycemia, ketosis, poor feeding/failure to thrive or fasting intolerance were reported, but there was no clear relationship between symptoms and residual enzyme activity. Developmental outcome included several children with mental retardation (including one with Down syndrome and one with schizencephaly) and two with Autism Spectrum disorders but there was no apparent relationship to residual enzyme activity. Free carnitine deficiency was relatively common. Discussion: Although residual enzyme activity was clearly related to metabolite elevation, there was no apparent relationship with other measures of outcome. The number of reports of neurologic abnormalities or metabolic symptoms (poor feeding, hypoglycemia, fasting intolerance, etc.) is concerning, but the significance is unclear in this retrospective sample.

Original languageEnglish (US)
Pages (from-to)439-441
Number of pages3
JournalMolecular Genetics and Metabolism
Volume106
Issue number4
DOIs
StatePublished - Aug 1 2012

Keywords

  • 3-Methylcrotonyl CoA carboxylase deficiency
  • Newborn screening
  • Organic acidemia

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Biochemistry
  • Molecular Biology
  • Genetics
  • Endocrinology

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    Arnold, G. L., Salazar, D., Neidich, J. A., Suwannarat, P., Graham, B. H., Lichter-Konecki, U., Bosch, A. M., Cusmano-Ozog, K., Enns, G., Wright, E. L., Lanpher, B. C., Owen, N. N., Lipson, M. H., Cerone, R., Levy, P., Wong, L. J. C., & Dezsofi, A. (2012). Outcome of infants diagnosed with 3-methyl-crotonyl-CoA-carboxylase deficiency by newborn screening. Molecular Genetics and Metabolism, 106(4), 439-441. https://doi.org/10.1016/j.ymgme.2012.04.006