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First Chinese case of successful pregnancy with combined methylmalonic aciduria and homocystinuria, cblC type.
MedLine Citation:
PMID:  24974159     Owner:  NLM     Status:  Publisher    
Objective: Combined methylmalonic aciduria (MMA) and homocystinuria, cblC type, is the most common MMA in Mainland China. Its clinical spectrum varies from severe neonatal-onset forms with brain injury and high mortality to milder forms with late onset. Timely diagnosis and adequate treatment greatly improve the prognosis. In the past 15years, many Chinese patients with this condition have achieved favorable treatment outcomes, and some of them have reached childbearing age. Here, we report the first case of Chinese woman with cblC undergoing a successful pregnancy and delivering a healthy boy. Methods: A patient of late-onset cblC, who achieved successful pregnancy and delivery of a healthy boy, was enrolled in our studies. The patient and her disease characteristics were analyzed, including age at onset, age at diagnosis, clinical presentation, clinical classification, family history, laboratory findings and MMACHC gene mutation. Results: Our patient presented mild neurological symptoms at the age of 15 years. She had the compound heterozygous mutations, c.315C>G and c.482G>A, on the MMACHC gene. After long-term treatment with cobalamin, calcium folinate, l-carnitine and betaine, along with normal diet, she recovered completely. At age 23, she visited us for genetic counseling and fetal evaluation at 15weeks of gestation. Her general condition and the fetal growth were normal. At 20weeks of gestation, intramuscular cobalamin was changed to pure hydroxocobalamin (1mg, every other day) because of markedly elevated urine MMA and plasma total homocysteine. In addition, the dosages of l-carnitine (1g, p.o., tds), folic acid (5mg, p.o., tds) and betaine (1g, p.o., tds) were increased. Protein intake was not restricted. Conclusions: This is the first report of a Chinese woman with cblC, undergoing a successful pregnancy and delivering a healthy baby at term. The favorable outcome of the patient and her fetus should owe much to the mild phenotype of her disease.
Yupeng Liu; Qiao Wang; Xiyuan Li; Yuan Ding; Jinqing Song; Yanling Yang
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-6-25
Journal Detail:
Title:  Brain & development     Volume:  -     ISSN:  1872-7131     ISO Abbreviation:  Brain Dev.     Publication Date:  2014 Jun 
Date Detail:
Created Date:  2014-6-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7909235     Medline TA:  Brain Dev     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2014 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.
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