Chinese Journal of Contemporary Pediatrics 2011;13(5):392-395

Leucodystrophy induced by late onset 3-hydroxy-3-methylglutaric aciduria.

Yan-Yan MA 1 ; Jin-Qing SONG ; Tong-Fei WU ; Yu-Peng LIU ; Jiang-Xi XIAO ; Yu-Wu JIANG ; Yan-Ling YANG

Affiliations

+expand

Country

China

Language

Chinese

Abstract

3-Hydroxy-3-methylglutaric aciduria is a rare disorder of organic acid metabolism caused by 3-hydroxy-3-methylglutaryl-coenzyme A lyase deficiency. The disorder was common in neonatal or infant period. Here a case of late onset 3-hydroxy-3-methylglutaric aciduria complicated by leucodystrophy was reported. The patient was a 7-year-old boy. He presented with progressive headache, drowsiness and vomiting. Hepatic lesions, ketosis and leucopenia were found. Symmetrical diffused leucodystrophy was shown by MRI. Blood levels of isovalerylcarnitine and acetylcarnitine increased significantly. Urinary levels of 3-hydroxy-3-methylglutaric, 3-methylglutaconic, 3-hydroxyglutaric acids and 3-methyl-crotonylglycine increased significantly. Symptoms were released by intravenous infusion of L-carnitine and glucose. After treatment for 6 months, urinary levels of 3-hydroxy-3-methylglutaric aciduria decreased in the boy and his health improved.