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Clinical features and management of organic acidemias in Japan.

Abstract
Organic acidemias (OAs) are rare inborn errors of metabolism. The clinical presentations of methylmalonic acidemia (MMA) and propionic acidemia (PA) in Japan have not yet been examined in detail. We aimed to investigate the clinical presentations of OAs in Japan and evaluate current therapies for improving long-term outcomes, especially in MMA and PA cases. Questionnaires were sent to 928 institutions in 2009 inquiring about OAs, and secondary questionnaires were sent to those who confirmed that they had diagnosed and/or treated such cases; 119 cases were eventually included for analysis. In Japan, the majority of OAs was MMA, which was associated with a high mortality rate. The survival rates at 20 years of age in vitamin B12-unresponsive MMA, vitamin B12-responsive MMA and PA patients were 69.8%, 94.4% and 95.8%, respectively. Factors associated with mortality in MMA were failure to thrive, hypoglycemia and pancreatitis. Factors associated with mental retardation in vitamin B12-unresponsive MMA, vitamin B12-responsive MMA, and PA were seizure and liver dysfunction, seizure and failure to thrive, and failure to thrive, respectively. We advocated that avoiding failure to thrive due to too restricted protein diet, hypoglycemia and pancreatitis associated with mortality lead to improve outcome, especially in vitamin B12-unresponsive MMA patients.
AuthorsDaisuke Fujisawa, Kimitoshi Nakamura, Hiroshi Mitsubuchi, Toshihiro Ohura, Yosuke Shigematsu, Tohru Yorifuji, Mureo Kasahara, Reiko Horikawa, Fumio Endo
JournalJournal of human genetics (J Hum Genet) Vol. 58 Issue 12 Pg. 769-74 (Dec 2013) ISSN: 1435-232X [Electronic] England
PMID24067294 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Vitamin B 12
Topics
  • Adolescent
  • Adult
  • Amino Acid Metabolism, Inborn Errors (drug therapy, mortality)
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Japan
  • Male
  • Propionic Acidemia (drug therapy, mortality)
  • Survival Rate
  • Vitamin B 12 (therapeutic use)
  • Young Adult

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