Bindi Verónica, Eiroa Hernán
Servicio de Errores Congénitos del Metabolismo, Hospital de Pediatría SAMIC "Prof. Dr. Juan P. Garrahan", Buenos Aires, Argentina.
Arch Argent Pediatr. 2017 Feb 1;115(1):e39-e42. doi: 10.5546/aap.2017.e39.
Citrullinemia type I is an autosomal recessive disorder caused by mutation of the gene expressing ASS1 argininosuccinate synthetase, limiting enzyme of the urea cycle. The classic variants are associated with neonatal/infantile forms that cause hyperammonemia leading to death if treatment is not established. Initial symptoms of disorders of the urea cycle include neurological impairment with mild or moderate liver damage. We report a case of recurrent liver failure in an infant diagnosed with type I citrullinemia without severe neurological involvement that was referred to our center for liver transplantation. Acute liver failure can be caused by a wide range of disorders in which inborn errors of metabolism are included. Appropriate treatment of disorders of the urea cycle and in particular citrullinemia I can avoid the need for a transplant.
I型瓜氨酸血症是一种常染色体隐性疾病,由表达精氨琥珀酸合成酶(ASS1)的基因突变引起,精氨琥珀酸合成酶是尿素循环的限速酶。典型变异型与新生儿/婴儿型相关,若不进行治疗,会导致高氨血症并致死。尿素循环障碍的初始症状包括神经功能损害以及轻度或中度肝损伤。我们报告了一例被诊断为I型瓜氨酸血症的婴儿反复出现肝衰竭的病例,该婴儿无严重神经受累情况,被转诊至我们中心进行肝移植。急性肝衰竭可由多种疾病引起,其中包括先天性代谢缺陷。对尿素循环障碍尤其是I型瓜氨酸血症进行恰当治疗可避免移植需求。