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[甘油苯丁酸盐治疗儿童鸟氨酸转氨甲酰酶缺乏症]

[Treatment of ornithine transcarbamylase deficiency in a child with glyceryl phenylbutyrate].

作者信息

Yang Fan, Wang Li-Rui, Li Xin, Hu Jia-Yue, Ying Ling-Wen, Feng Bi-Yun, Li Yun-Yun, Lin Ka-Na, She Jia-Xiao, Li Hao, Chang Guo-Ying, Wang Xiu-Min

机构信息

Clinical Research Ward, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China.

出版信息

Zhongguo Dang Dai Er Ke Za Zhi. 2024 May 15;26(5):512-517. doi: 10.7499/j.issn.1008-8830.2310050.

Abstract

Glyceryl phenylbutyrate (GPB) serves as a long-term management medication for Ornithine transcarbamylase deficiency (OTCD), effectively controlling hyperammonemia, but there is a lack of experience in using this medicine in China. This article retrospectively analyzes the case of a child diagnosed with OTCD at Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, including a review of related literature. After diagnosis, the patient was treated with GPB, followed by efficacy follow-up and pharmacological monitoring. The 6-year and 6-month-old male patient exhibited poor speech development, disobedience, temper tantrums, and aggressive behavior. Blood ammonia levels peaked at 327 μmol/L; urine organic acid analysis indicated elevated uracil levels; cranial MRI showed extensive abnormal signals in both cerebral hemispheres. Genetic testing revealed mutation in the gene (c.241T>C, p.S81P). Blood ammonia levels were approximately 43, 80, and 56 μmol/L at 1, 2, and 3 months after starting GPB treatment, respectively. During treatment, blood ammonia was well-controlled without drug-related adverse effects. The patient showed improvement in developmental delays, obedience, temperament, and absence of aggressive behavior.

摘要

苯丁酸钠甘油酯(GPB)是用于鸟氨酸转氨甲酰酶缺乏症(OTCD)的长期治疗药物,能有效控制高氨血症,但在中国使用该药缺乏经验。本文回顾性分析了上海交通大学医学院附属上海儿童医学中心一名诊断为OTCD的患儿病例,并对相关文献进行了综述。确诊后,该患者接受了GPB治疗,随后进行疗效随访和药物监测。该6岁6个月大的男性患者表现出语言发育迟缓、不听话、发脾气和攻击性行为。血氨水平最高达到327μmol/L;尿有机酸分析显示尿嘧啶水平升高;头颅磁共振成像显示双侧大脑半球广泛异常信号。基因检测显示该基因发生突变(c.241T>C,p.S81P)。开始GPB治疗后1、2和3个月时,血氨水平分别约为43、80和56μmol/L。治疗期间,血氨得到良好控制,且未出现药物相关不良反应。患者在发育迟缓、顺从性、脾气以及攻击性行为方面均有改善。

相似文献

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[Treatment of ornithine transcarbamylase deficiency in a child with glyceryl phenylbutyrate].
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