Yang Caifei, Chen Tao, Lei Xiaoguang, Liu Yuexian, Xu Mengyuan, Yang Dan
Department of Neurology, the First Affiliated Hospital of Kunming Medical University, Kunming, Yunan 650032, China.
Zhonghua Yi Xue Yi Chuan Xue Za Zhi. 2019 Jul 10;36(7):737-741. doi: 10.3760/cma.j.issn.1003-9406.2019.07.021.
Maple syrup disease (MSUD) is a rare autosomal recessive disorder caused primarily by mutations of branched-chain keto acid dehydrogenase complex (BCKDC). BCKDC includes at least four pathogenic genes of BCKDHA, BCKDHB, DLD and DBT. The clinical manifestations of MSUD are complex, and the main symptoms at the early stage include difficulty in feeding, drowsiness, change in muscle tone and special urine flavor of maple syrup. As the disease progresses, convulsion, hypoglycemia, coma and systemic failure may occur. MSUD is easily missed or misdiagnosed during the neonatal period. This paper provides a review for recent progress made in research on MSUD including etiology, physiopathology, clinical manifestation, auxiliary examination and treatment, with a particular emphasis on genetic testing and treatment.
枫糖尿症(MSUD)是一种罕见的常染色体隐性疾病,主要由支链酮酸脱氢酶复合体(BCKDC)突变引起。BCKDC至少包括四个致病基因,即BCKDHA、BCKDHB、DLD和DBT。MSUD的临床表现复杂,早期主要症状包括喂养困难、嗜睡、肌张力改变以及具有枫糖浆特殊气味的尿液。随着病情进展,可能会出现惊厥、低血糖、昏迷及全身衰竭。MSUD在新生儿期很容易被漏诊或误诊。本文对MSUD的病因、生理病理学、临床表现、辅助检查及治疗等方面的研究进展进行综述,尤其着重于基因检测与治疗。