Expanding the clinical spectrum of mitochondrial 3-hydroxy-3-methylglutaryl-CoA synthase deficiency with Turkish cases harboring novel HMGCS2 gene mutations and literature review


Kilic M., Dorum S., Topak A., Yazici M., EZGÜ F. S., COŞKUN T.

AMERICAN JOURNAL OF MEDICAL GENETICS PART A, vol.182, no.7, pp.1608-1614, 2020 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Review
  • Volume: 182 Issue: 7
  • Publication Date: 2020
  • Doi Number: 10.1002/ajmg.a.61590
  • Journal Name: AMERICAN JOURNAL OF MEDICAL GENETICS PART A
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, CAB Abstracts, EMBASE, MEDLINE
  • Page Numbers: pp.1608-1614
  • Keywords: 3-hydroxy-3-methylglutaryl-CoA synthase deficiency, encephalopathy, HMG-CoA synthase deficiency, HMGCS2, hypoglycemia, DIAGNOSIS
  • Gazi University Affiliated: Yes

Abstract

Mitochondrial 3-hydroxy-3-methylglutaryl-CoA synthase (mHS) deficiency is a very rare autosomal recessive inborn error of ketone body synthesis and presents with hypoketotic hypoglycemia, metabolic acidosis, lethargy, encephalopathy, and hepatomegaly with fatty liver precipitated by catabolic stress. We report acute presentation of two patients from unrelated two families with novel homozygous c.862C>T and c.725-2A>C mutations, respectively, in HMGCS2 gene. Affected patients had severe hypoketotic hypoglycemia, lethargy, encephalopathy, severe metabolic and lactic acidosis and hepatomegaly after infections. Surprisingly, molecular screening of the second family showed more affected patients without clinical findings. These cases expand the clinic spectrum of this extremely rare disease.