Expanding the phenotype of hawkinsinuria: new insights from response to N-acetyl-L-cysteine.

Abstract:

:Hawkinsinuria is a rare disorder of tyrosine metabolism that can manifest with metabolic acidosis and growth arrest around the time of weaning off breast milk, typically followed by spontaneous resolution of symptoms around 1 year of age. The urinary metabolites hawkinsin, quinolacetic acid, and pyroglutamic acid can aid in identifying this condition, although their relationship to the clinical manifestations is not known. Herein we describe clinical and laboratory findings in two fraternal twins with hawkinsinuria who presented with failure to thrive and metabolic acidosis. Close clinical follow-up and laboratory testing revealed previously unrecognized hypoglycemia, hypophosphatemia, combined hyperlipidemia, and anemia, along with the characteristic urinary metabolites, including massive pyroglutamic aciduria. Treatment with N-acetyl-L-cysteine (NAC) restored normal growth and normalized or improved most biochemical parameters. The dramatic response to NAC therapy supports the idea that glutathione depletion plays a key role in the pathogenesis of hawkinsinuria.

journal_name

J Inherit Metab Dis

authors

Gomez-Ospina N,Scott AI,Oh GJ,Potter D,Goel VV,Destino L,Baugh N,Enns GM,Niemi AK,Cowan TM

doi

10.1007/s10545-016-9963-8

subject

Has Abstract

pub_date

2016-11-01 00:00:00

pages

821-829

issue

6

eissn

0141-8955

issn

1573-2665

pii

10.1007/s10545-016-9963-8

journal_volume

39

pub_type

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