Severe neurological crisis in adult patients with Tyrosinemia type 1.


Journal

Annals of clinical and translational neurology
ISSN: 2328-9503
Titre abrégé: Ann Clin Transl Neurol
Pays: United States
ID NLM: 101623278

Informations de publication

Date de publication:
09 2020
Historique:
received: 05 06 2020
revised: 17 07 2020
accepted: 20 07 2020
pubmed: 21 8 2020
medline: 21 10 2021
entrez: 22 8 2020
Statut: ppublish

Résumé

We report six adult patients with Tyrosinaemia type 1 (HT-1) who presented with recurrent porphyria-like neurological crises after discontinuation/interruption of 2-(2-nitro-4-trifluoro-methylbenzyol)-1,3 cyclohexanedione (NTBC) treatment. The crises were life-threatening for some of the patients, with respiratory muscle paralysis requiring ventilatory support, hemodynamic disturbance due to autonomic changes requiring resuscitation, acute progressive ascending motor neuropathy causing profound impairment, recurrent seizures, and neuropathic pain. Our patients' porphyria-like presentations were variably misdiagnosed, with delay to diagnosis resulting in more severe recurrent attacks. We report the first series of neurological crises in adult patients with HT-1. These crises, which may be fatal, can be prevented and treated effectively with neurologist/physician awareness and patient education.

Identifiants

pubmed: 32820610
doi: 10.1002/acn3.51160
pmc: PMC7480904
doi:

Types de publication

Case Reports Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1732-1737

Informations de copyright

© 2020 The Authors. Annals of Clinical and Translational Neurology published by Wiley Periodicals LLC on behalf of American Neurological Association.

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Auteurs

Charlotte Dawson (C)

Department of Diabetes, Endocrinology and Metabolism, Queen Elizabeth Hospital Birmingham, NHS Foundation Trust, Birmingham, United Kingdom.

Radha Ramachandran (R)

Adult Inherited Metabolic Disease Unit, Guy's and St Thomas NHS Foundation Trust, London, United Kingdom.

Samreen Safdar (S)

Department of Diabetes, Endocrinology and Metabolism, Queen Elizabeth Hospital Birmingham, NHS Foundation Trust, Birmingham, United Kingdom.

Elaine Murphy (E)

Charles Dent Metabolic Unit, National Hospital for Neurology and Neurosurgery, London, United Kingdom.

Orlando Swayne (O)

Neurorehabilitation Unit, National Hospital for Neurology and Neurosurgery, London, United Kingdom.

Jonathan Katz (J)

Department of Endocrinology, Royal Free London NHS Foundation Trust, London, United Kingdom.

Philip N Newsome (PN)

National Institute for Health Research, Birmingham Biomedical Research Centre at University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom.
Centre for Liver & Gastrointestinal Research, Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, United Kingdom.

Tarekegn Geberhiwot (T)

Department of Diabetes, Endocrinology and Metabolism, Queen Elizabeth Hospital Birmingham, NHS Foundation Trust, Birmingham, United Kingdom.
Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, United Kingdom.

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