5-oxoprolinase deficiency

From WikiMD's WELLNESSPEDIA

Other Names: Oxoprolinuria due to 5-oxoprolinase deficiency; 5-alpha-oxoprolinase deficiency

A very heterogeneous condition characterized by 5-oxoprolinuria.

Epidemiology[edit]

It has been detected in eight patients worldwide. All affected patients have been identified because of 5-oxoprolinuria.

Cause[edit]

5-Oxoprolinase catalyses a step in the gamma-glutamyl cycle (glutathione metabolism).

Inheritance[edit]

File:Autorecessive.svg
Autosomal recessive inheritance, a 25% chance

The disease is transmitted as an autosomal recessive trait.

Signs and symptoms[edit]

Symptoms reported in individual patients include renal stone formation, enterocolitis, intellectual deficiency, neonatal hypoglycemia, microcytic anemia and microcephaly.

Diagnosis[edit]

The diagnosis is based on the finding of 5-oxoprolinuria and on the low activity of 5-oxoprolinase.

Differential diagnosis

Other causes of 5-oxoprolinuria include glutathione synthetase deficiency , diet (certain infant formulas and tomato juice), severe burns, Stevens-Johnson syndrome , inborn errors of metabolism not involving the gamma-glutamyl cycle, e.g. X-linked ornithine trancarbamylase deficiency, urea cycle defects, or tyrosinemia, as well as homocystinuria , drug metabolism (paracetamol, vigabatrin, flucloxacillin, netilmicin), prematurity, malnutrition, pregnancy and nephropatic cystinosis.

Treatment[edit]

No specific treatment has been proposed or tested.

Prognosis[edit]

The prognosis is difficult to predict as only eight patients with different clinical symptoms have been described.

NIH genetic and rare disease info[edit]

5-oxoprolinase deficiency is a rare disease.