Clinical characteristics and molecular genetic analysis of ten cases of ornithine carbamoyltransferase deficiency in southeastern China.


Journal

Italian journal of pediatrics
ISSN: 1824-7288
Titre abrégé: Ital J Pediatr
Pays: England
ID NLM: 101510759

Informations de publication

Date de publication:
11 Sep 2024
Historique:
received: 14 11 2023
accepted: 31 08 2024
medline: 11 9 2024
pubmed: 11 9 2024
entrez: 10 9 2024
Statut: epublish

Résumé

This study aimed to investigate the clinical and molecular genetic characteristics of ten children with ornithine carbamoyltransferase deficiency (OTCD) in southeastern China, as well as the correlation between the genotype and phenotype of OTCD. A retrospective analysis was performed on the clinical manifestations, laboratory testing, and genetic test findings of ten children with OTCD admitted between August 2015 and October 2021 at Quanzhou Maternity and Children's Hospital of Fujian Province in China. Five boys presented with early-onset symptoms, including poor appetite, drowsiness, groaning, seizures, and liver failure. In contrast, five patients (one boy and four girls) had late-onset gastrointestinal symptoms as the primary clinical manifestation, all presenting with hepatic impairment, and four with hepatic failure.Nine distinct variants of the OTC gene were identified, including two novel mutations: c.1033del(p.Y345Tfs*50) and c.167T > A(p.M56K). Of seven patients who died, five had early-onset disease despite active treatment. Three patients survived, and two of them underwent liver transplantation. The clinical manifestations of OTCD lack specificity. However, elevated blood ammonia levels serve as a crucial diagnostic clue for OTCD. Genetic testing aids in more accurate diagnosis and prognosis assessment by clinicians. In addition, we identified two novel pathogenic variants and expand the mutational spectrum of the gene OTC, which may contribute to a better understanding of the clinical and genetic characteristics of OTCD patients.

Sections du résumé

BACKGROUND BACKGROUND
This study aimed to investigate the clinical and molecular genetic characteristics of ten children with ornithine carbamoyltransferase deficiency (OTCD) in southeastern China, as well as the correlation between the genotype and phenotype of OTCD.
METHODS METHODS
A retrospective analysis was performed on the clinical manifestations, laboratory testing, and genetic test findings of ten children with OTCD admitted between August 2015 and October 2021 at Quanzhou Maternity and Children's Hospital of Fujian Province in China.
RESULTS RESULTS
Five boys presented with early-onset symptoms, including poor appetite, drowsiness, groaning, seizures, and liver failure. In contrast, five patients (one boy and four girls) had late-onset gastrointestinal symptoms as the primary clinical manifestation, all presenting with hepatic impairment, and four with hepatic failure.Nine distinct variants of the OTC gene were identified, including two novel mutations: c.1033del(p.Y345Tfs*50) and c.167T > A(p.M56K). Of seven patients who died, five had early-onset disease despite active treatment. Three patients survived, and two of them underwent liver transplantation.
CONCLUSIONS CONCLUSIONS
The clinical manifestations of OTCD lack specificity. However, elevated blood ammonia levels serve as a crucial diagnostic clue for OTCD. Genetic testing aids in more accurate diagnosis and prognosis assessment by clinicians. In addition, we identified two novel pathogenic variants and expand the mutational spectrum of the gene OTC, which may contribute to a better understanding of the clinical and genetic characteristics of OTCD patients.

Identifiants

pubmed: 39256843
doi: 10.1186/s13052-024-01740-8
pii: 10.1186/s13052-024-01740-8
doi:

Substances chimiques

Ornithine Carbamoyltransferase EC 2.1.3.3

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

171

Subventions

Organisme : Science and Technology Bureau of Quanzhou
ID : 2022C002

Informations de copyright

© 2024. The Author(s).

Références

Choi JH, Lee BH, Kim JH, Kim GH, Kim YM, Cho J, et al. Clinical outcomes and the Mutation Spectrum of the Otc Gene in patients with Ornithine Transcarbamylase Deficiency. J Hum Genet. 2015;60(9):501–7.
doi: 10.1038/jhg.2015.54 pubmed: 25994866
Musalkova D, Sticova E, Reboun M, Sokolova J, Krijt J, Honzikova J, et al. Variable X-Chromosome inactivation and enlargement of Pericentral glutamine synthetase zones in the liver of heterozygous females with Otc Deficiency. Virchows Arch. 2018;472(6):1029–39.
doi: 10.1007/s00428-018-2345-x pubmed: 29623395
Wraith JE. Ornithine Carbamoyltransferase Deficiency. Arch Dis Child. 2001;84(1):84–8.
doi: 10.1136/adc.84.1.84 pubmed: 11124797 pmcid: 1718609
Häberle J, Burlina A, Chakrapani A, Dixon M, Karall D, Lindner M, et al. Suggested guidelines for the diagnosis and management of Urea Cycle disorders: first revision. J Inherit Metab Dis. 2019;42(6):1192–230.
doi: 10.1002/jimd.12100 pubmed: 30982989
Richards S, Aziz N, Bale S, Bick D, Das S, Gastier-Foster J, et al. Standards and guidelines for the interpretation of sequence variants: a Joint Consensus recommendation of the American College of Medical Genetics and Genomics and the Association for Molecular Pathology. Genet Med. 2015;17(5):405–24.
doi: 10.1038/gim.2015.30 pubmed: 25741868 pmcid: 4544753
Lu D, Han F, Qiu W, Zhang H, Ye J, Liang L, et al. Clinical and molecular characteristics of 69 Chinese patients with Ornithine Transcarbamylase Deficiency. Orphanet J Rare Dis. 2020;15(1):340.
doi: 10.1186/s13023-020-01606-2 pubmed: 33272297 pmcid: 7712605
Brassier A, Gobin S, Arnoux JB, Valayannopoulos V, Habarou F, Kossorotoff M, et al. Long-term outcomes in Ornithine Transcarbamylase Deficiency: a Series of 90 patients. Orphanet J Rare Dis. 2015;10:58.
doi: 10.1186/s13023-015-0266-1 pubmed: 25958381 pmcid: 4443534
Barkovich E, Gropman AL. Late Onset Ornithine Transcarbamylase Deficiency triggered by an Acute increase in protein intake: a review of 10 cases reported in the literature. Case Rep Genet. 2020;2020:7024735.
pubmed: 32373372 pmcid: 7197010
Ranucci G, Rigoldi M, Cotugno G, Bernabei SM, Liguori A, Gasperini S, et al. Chronic liver involvement in Urea Cycle disorders. J Inherit Metab Dis. 2019;42(6):1118–27.
doi: 10.1002/jimd.12144 pubmed: 31260111
Gallagher RC, Lam C, Wong D, Cederbaum S, Sokol RJ. Significant hepatic involvement in patients with Ornithine Transcarbamylase Deficiency. J Pediatr. 2014;164(4):720–e56.
doi: 10.1016/j.jpeds.2013.12.024 pubmed: 24485820 pmcid: 4070427
Laemmle A, Gallagher RC, Keogh A, Stricker T, Gautschi M, Nuoffer JM, et al. Frequency and pathophysiology of Acute Liver failure in Ornithine Transcarbamylase Deficiency (Otcd). PLoS ONE. 2016;11(4):e0153358.
doi: 10.1371/journal.pone.0153358 pubmed: 27070778 pmcid: 4829252
Rajabi F, Rodan LH, Jonas MM, Soul JS, Ullrich NJ, Wessel A, et al. Liver failure as the presentation of Ornithine Transcarbamylase Deficiency in a 13-Month-Old Female. JIMD Rep. 2018;40:17–22.
doi: 10.1007/8904_2017_55 pubmed: 28887792
Samuel N, Politansky AK, Hoffman R, Itzkovich S, Mandel H. Coagulopathy Unmasking Hepatic Failure in a child with Ornithine Transcarbamylase Deficiency. Isr Med Assoc J. 2013;15(12):777–9.
pubmed: 24449986
Serra G, Felice S, Antona V, et al. Cardio-facio-cutaneous syndrome and gastrointestinal defects: report on a newborn with 19p13.3 deletion including the MAP 2 K2 gene. Ital J Pediatr. 2022;48(1):65.
doi: 10.1186/s13052-022-01241-6 pubmed: 35509048 pmcid: 9069788
Shih VE, Safran AP, Ropper AH, Tuchman M. Ornithine Carbamoyltransferase Deficiency: unusual clinical findings and Novel Mutation. J Inherit Metab Dis. 1999;22(5):672–3.
doi: 10.1023/A:1005502718790 pubmed: 10399103
Yamaguchi S, Brailey LL, Morizono H, Bale AE, Tuchman M. Mutations and polymorphisms in the human ornithine transcarbamylase (otc) gene. Hum Mutat. 2006;27(7):626–32.
doi: 10.1002/humu.20339 pubmed: 16786505
Tuchman M, Morizono H, Rajagopal BS, Plante RJ, Allewell NM. Identification of ‘Private’ mutations in patients with Ornithine Transcarbamylase Deficiency. J Inherit Metab Dis. 1997;20(4):525–7.
doi: 10.1023/A:1005301513465 pubmed: 9266388
Caldovic L, Abdikarim I, Narain S, Tuchman M, Morizono H. Genotype-phenotype correlations in Ornithine Transcarbamylase Deficiency: a mutation update. J Genet Genomics. 2015;42(5):181–94.
doi: 10.1016/j.jgg.2015.04.003 pubmed: 26059767 pmcid: 4565140
Martín-Hernández E, Aldámiz-Echevarría L, Castejón-Ponce E, Pedrón-Giner C, Couce ML, Serrano-Nieto J, et al. Urea Cycle disorders in Spain: an Observational, cross-sectional and multicentric study of 104 cases. Orphanet J Rare Dis. 2014;9:187.
doi: 10.1186/s13023-014-0187-4 pubmed: 25433810 pmcid: 4258263
Hentzen D, Pelet A, Feldman D, Rabier D, Berthelot J, Munnich A. Fatal hyperammonemia resulting from a C-to-T mutation at a Mspi Site of the Ornithine Transcarbamylase Gene. Hum Genet. 1991;88(2):153–6.
doi: 10.1007/BF00206063 pubmed: 1721894
Liu N, Feng Y, Jiang M, Kong X. [Genetic testing and prenatal diagnosis in seven pedigrees affected with Ornithine Transcarbamylase Deficiency]. Zhonghua Yi Xue Yi Chuan Xue Za Zhi. 2020;37(2):106–9.
pubmed: 32034732
Shao Y, Jiang M, Lin Y, Mei H, Zhang W, Cai Y, et al. Clinical and mutation analysis of 24 Chinese patients with Ornithine Transcarbamylase Deficiency. Clin Genet. 2017;92(3):318–22.
doi: 10.1111/cge.13004 pubmed: 28266016
Matsuda I, Tanase S. The Ornithine transcarbamylase (otc) gene: mutations in 50 Japanese families with Otc Deficiency. Am J Med Genet. 1997;71(4):378–83.
doi: 10.1002/(SICI)1096-8628(19970905)71:4<378::AID-AJMG2>3.0.CO;2-Q pubmed: 9286441
García-Pérez MA, Climent C, Briones P, Vilaseca MA, Rodés M, Rubio V. Missense mutations in Codon 225 of Ornithine Transcarbamylase (Otc) result in decreased amounts of otc protein: a hypothesis on the molecular mechanism of the Otc Deficiency. J Inherit Metab Dis. 1997;20(6):769–77.
doi: 10.1023/A:1005363600268 pubmed: 9427144
Serra G, Antona V, Giuffrè M, et al. Interstitial deletions of chromosome 1p: novel 1p31.3p22.2 microdeletion in a newborn with craniosynostosis, coloboma and cleft palate, and review of the genomic and phenotypic profiles. Ital J Pediatr. 2022;48(1):38.
doi: 10.1186/s13052-022-01232-7 pubmed: 35246213 pmcid: 8896361
Pizzi MA, Alejos D, Hasan TF, Atwal PS, Krishnaiengar SR, Freeman WD. Adult Presentation of Ornithine Transcarbamylase Deficiency: 2 Illustrative Cases of Phenotypic Variability and Literature Review. Neurohospitalist (2019) 9(1):30 – 6.
Lee T, Misaki M, Shimomura H, Tanaka Y, Yoshida S, Murayama K, et al. Late-Onset Ornithine Transcarbamylase Deficiency caused by a somatic Mosaic mutation. Hum Genome Var. 2018;5:22.
doi: 10.1038/s41439-018-0022-x pubmed: 30131866 pmcid: 6095930

Auteurs

Gaopin Yuan (G)

The Graduate School of Fujian Medical University, Fuzhou, China.
Department of Endocrinology, Quanzhou Maternity and Children's Hospital, Quanzhou, China.

Zhiyong Liu (Z)

The Graduate School of Fujian Medical University, Fuzhou, China.
Department of Neonatology, Quanzhou Maternity and Children's Hospital, Quanzhou, China.

Zhixu Chen (Z)

Department of Intensive Care Medicine, Quanzhou Maternity and Children's Hospital, Quanzhou, China.

Xiaohong Zhang (X)

Department of Endocrinology, Quanzhou Maternity and Children's Hospital, Quanzhou, China.

Weifeng Zhang (W)

The Graduate School of Fujian Medical University, Fuzhou, China.
Department of Neonatology, Quanzhou Maternity and Children's Hospital, Quanzhou, China.

Dongmei Chen (D)

The Graduate School of Fujian Medical University, Fuzhou, China. chendm9090@163.com.
Department of Neonatology, Quanzhou Maternity and Children's Hospital, Quanzhou, China. chendm9090@163.com.

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