Treatment of arginase deficiency revisited: guanidinoacetate as a therapeutic target and biomarker for therapeutic monitoring.

Abstract

Hyperargininaemia is a disorder of the last step of the urea cycle. It is an autosomal recessive disease caused by deficiency of liver arginase-1 and usually presents later in childhood with progressive neurological symptoms including marked spasticity. In contrast with other urea cycle disorders, hyperammonaemia is not usually present but can be a feature. A number of guanidine compounds may accumulate in the blood and cerebrospinal fluid of these patients, which could play an important pathophysiological role. Guanidinoacetate is of particular interest as a well-known potent epileptogenic compound in guanidinoacetate methyltransferase deficiency. We found markedly elevated guanidinoacetate levels in a patient with arginase deficiency, which dropped significantly in response to dietary and medical treatment. Measurement of guanidinoacetate and other guanidino compounds may, therefore, be important for therapeutic monitoring in arginase deficiency.

• Authors: Wajdi Amayreh, Uta Meyer, Anibh M Das
• Journal: Developmental medicine and child neurology (Dev Med Child Neurol) Vol. 56 Issue 10 Pg. 1021-4 (Oct 2014) ISSN: 1469-8749 [Electronic] England
• PMID: 24814679 (Publication Type: Case Reports, Journal Article)
• Copyright: © 2014 Mac Keith Press.

Chemical References

• Benzoates
• Biomarkers
• Ornithine
• glycocyamine
• Creatine
• Glycine

Topics

• Benzoates (administration & dosage, pharmacology)
• Biomarkers
• Child
• Creatine (administration & dosage, pharmacology)
• Glycine (analogs & derivatives, blood)
• Humans
• Hyperargininemia (diet therapy, drug therapy, physiopathology)
• Male
• Ornithine (administration & dosage, pharmacology)
• Treatment Outcome