Abstract:
BACKGROUND AND PURPOSE:Very-long-chain acyl-CoA dehydrogenase deficiency (VLCADD) is a hereditary disorder of mitochondrial long-chain fatty acid oxidation that has variable presentations, including exercise intolerance, cardiomyopathy and liver disease. The aim of this study was to describe the clinical and genetic manifestations of six patients with adult-onset VLCADD. METHODS:In this study, the clinical, pathological and genetic findings of six adult patients (four from Iran and two from Serbia) with VLCADD and their response to treatment are described. RESULTS:The median (range) age of patients at first visit was 31 (27-38) years, and the median (range) age of onset was 26.5 (19-33) years. Parental consanguinity was present for four patients. Four patients had a history of rhabdomyolysis, and the recorded CK level ranged between 67 and 90 000 IU/l. Three patients had a history of exertional myalgia, and one patient had a non-fluctuating weakness. Through next-generation sequencing analysis, we identified six cases with variants in the ACADVL gene and a confirmed diagnosis of VLCADD. Of the total six variants identified, five were missense, and one was a novel frameshift mutation identified in two unrelated individuals. Two variants were novel, and three were previously reported. We treated the patients with a combination of L-carnitine, Coenzyme Q10 and riboflavin. Three patients responded favorably to the treatment. CONCLUSION:Adult-onset VLCADD is a rare entity with various presentations. Patients may respond favorably to a cocktail of L-carnitine, Coenzyme Q10, and riboflavin.
journal_name
Eur J Neuroljournal_title
European journal of neurologyauthors
Fatehi F,Okhovat AA,Nilipour Y,Mroczek M,Straub V,Töpf A,Palibrk A,Peric S,Rakocevic Stojanovic V,Najmabadi H,Nafissi Sdoi
10.1111/ene.14402subject
Has Abstractpub_date
2020-11-01 00:00:00pages
2257-2266issue
11eissn
1351-5101issn
1468-1331journal_volume
27pub_type
杂志文章abstract:BACKGROUND AND PURPOSE:Elevation of cardiac troponin (cTn), a sensitive biomarker of myocardial injury, is frequently observed in severe acute neurological disorders. Case reports suggest that cardiac dysfunction may also occur in patients with transient global amnesia (TGA). Until now, no study has systematically asse...
journal_title:European journal of neurology
pub_type: 杂志文章
doi:10.1111/ene.13920
更新日期:2019-07-01 00:00:00
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journal_title:European journal of neurology
pub_type: 杂志文章
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journal_title:European journal of neurology
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journal_title:European journal of neurology
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journal_title:European journal of neurology
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journal_title:European journal of neurology
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journal_title:European journal of neurology
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journal_title:European journal of neurology
pub_type: 杂志文章,评审
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journal_title:European journal of neurology
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更新日期:1995-09-01 00:00:00
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journal_title:European journal of neurology
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