Genetic counseling is the process of providing individuals Alkaptonuria is inherited in an autosomal recessive manner. – ALKAPTONURIA; AKU – HOMOGENTISIC ACID OXIDASE in the homogentisate 1,2-dioxygenase gene (HGD; ) on chromosome 3q Alkaptonuria is a rare inherited genetic disorder in which the body cannot process the amino acids phenylalanine and tyrosine, which occur in protein.
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Rapidly progressive hip osteoarthrosis: Inborn error of amino acid metabolism E70—E72 Ochronosis bluish-black pigmentation of connective tissue. Garrod AE The incidence of alkaptonuria: In such cases, ochronosis occurs secondary to exposure to a variety of substances including benzene, phenol and trinitrophenol.
According to O’Brien et al. Tyrosine is specifically required for a number of functions, such as hormones e. Differential diagnosis Differential diagnosis includes acute intermittent porphyria, rheumatoid arthritis, ankylosing spondylitis see these terms and osteoarthritis.
Areas with increased frequencies of the disorder have been identified in Slovakia, the Dominican Republic and Germany. The majority of pathogenic variants are missense ; nonsenseframe shift, and splice-site variants also occur. Alkaptonuria is a rare inherited genetic disorder in which the body cannot process the amino acids phenylalanine and tyrosinewhich occur in protein.
The diagnosis of alkaptonuria is established in a proband with the following:. Molecular Genetic Findings Identification of biallelic pathogenic variants in HGD on molecular genetic testing see Table 1 is not required to establish the diagnosis in a proband.
They based the review on geneyics evaluation of 58 patients with the disorder ranging in age from 4 to 80 years. Arthritis, often beginning in the spine and resembling ankylosing spondylitis in its large-joint distribution. D ICD – In the same study, seven individuals were treated for up to 15 weeks with nitisinone while receiving normal alkaptonuriw intake; all had elevated plasma tyrosine concentrations.
Years Published,alkaptonuia,,, This accumulation causes thickening of the valves and narrowing stenosis of the openings of the valves. Nitisinone inhibits the enzyme 4-hydroxyphenylpyruvate dioxygenaseresponsible for converting tyrosine to homogentisic acid, thereby blocking the production and accumulation of HGA.
It is appropriate to evaluate apparently alkatponuria older and younger sibs of a proband in order to identify as early as possible those who would benefit from preventive measures.
OMIM Entry – # – ALKAPTONURIA; AKU
Pharmacologic treatment of alkaptonuria with oral administration of 2- 2-nitrotrifluoromethylbenzoyl -1,3-cyclohexanedione NTBC or nitisinone has been proposed [ Anikster alkapronuria al ]. Alkaptonuria is alkaptonruia by deficiency of homogentisate 1,2-dioxygenase, an enzyme that converts homogentisic acid HGA to maleylacetoacetic acid in the tyrosine degradation pathway.
Prevention of Primary Manifestations Although several therapeutic modalities have been investigated, no preventive or curative treatment is available. Side effects were minimal. There are reports of urolithiasis in AKU patients in middle and late adulthood who have already developed the full clinical picture of the disorder e. Nitisinone is approved for the treatment of tyrosinemia type I.
Alkaptonuria in the Trencin district of Czechoslovakia. Other manifestations include pigment deposition, aortic or mitral valve calcification or regurgitation and occasionally aortic dilatation, renal stones, and prostate stones. Because it is likely that testing methodology and our understanding of genes, allelic variants, and diseases will improve in the future, consideration should be given to banking DNA of affected individuals.
For information about clinical trials sponsored by private sources, contact: Coronary artery calcification has been demonstrated on chest CT [ Hannoush et al ]. Pigment deposition may also be seen in the conjunctiva and cornea.
Rare Disease Database
GeneReviews is a registered trademark of the University of Washington, Seattle. Together we are strong. Evaluation of Relatives at Risk It is appropriate to evaluate apparently asymptomatic older and younger sibs of a proband in order to identify as early aloaptonuria possible those who would benefit from preventive measures.
Theoretically, neurologic complications associated with tyrosinemia type III may develop.