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IllnessZitrullinämie Typ I, Differentialdiagnose

Summary

Short information

Comprehensive differential diagnostic panel for Citrullinemia type I containing 3 guideline-curated genes and altogether 7 curated genes according to the clinical signs

ID
ZP9240
Number of genes
5 Accredited laboratory test
Examined sequence length
1,3 kb (Core-/Core-canditate-Genes)
7,3 kb (Extended panel: incl. additional genes)
Analysis Duration
on request
Material
  • EDTA-anticoagulated blood (3-5 ml)
Diagnostic indications

NGS +

 

Gene panel

Selected genes

NameExon Length (bp)OMIM-GReferenz-Seq.Heredity
ASS11239NM_000050.4AR
ASL1395NM_000048.4AR
DLD1530NM_000108.5AR
OTC1065NM_000531.6XLR
SLC25A132031NM_001160210.2AR

Informations about the disease

Clinical Comment

Citrullinemia represents a disorder of the urea cycle and occurs in 2 types due to mutations in different genes. Type I (classic) citrullinemia usually occurs in the first few days of life. Affected infants usually appear normal at birth but soon suffer from progressive lethargy, poor feeding, vomiting, seizures and loss of consciousness. The health problems associated with type I citrullinemia are life-threatening in many cases, including severe liver problems. A milder form of type I citrullinemia develops later in childhood or adulthood. This later-onset form is associated with severe headaches, scotomas, ataxia and lethargy. In rare cases, symptoms of the disease never occur in these mutation carriers. Citrullinemia type II primarily affects the nervous system, causing confusion, agitation, memory loss, abnormal behavior, seizures and coma. Symptoms typically occur in adults and are triggered by medications, infections, surgical procedures and alcohol, they can also be life-threatening. Type II citrullinemia in adults can also occur in people who had a liver disease, neonatal intrahepatic cholestasis, due to citrine deficiency (NICCD) as infants. Mutations in the ASS1 gene cause type I citrullinemia. Mutations in the SLC25A13 gene are responsible for type II citrullinemia and adult-onset NICCD. Both types are inherited in an autosomal recessive manner. Since the molecular genetic diagnostic yield is not really known, a negative DNA test result cannot exclude the clinical diagnosis.

References: https://www.ncbi.nlm.nih.gov/books/NBK1458/

https://www.ncbi.nlm.nih.gov/books/NBK1181/

https://www.ncbi.nlm.nih.gov/books/NBK1217/

 

Synonyms
  • Alias: ASS-Mangel
  • Alias: Argininosuccinat-Synthase-Mangel
  • Alias: Citrullinämie Typ I
  • Alias: Klassische Zitrullinämie
  • Allelic: Pulmonary hypertension, neonatal, susceptibility to (CPS1)
  • Argininosuccinic aciduria (ASL)
  • Carbamoylphosphate synthetase I deficiency (CPS1)
  • Citrullinemia (ASS1)
  • Citrullinemia, adult-onset type II (SLC25A13)
  • Citrullinemia, type II, neonatal-onset (SLC25A13)
  • Dihydrolipoamide dehydrogenase deficiency (DLD)
  • Ornithine transcarbamylase deficiency (OTC)
  • Pyruvate carboxylase deficiency (PC)
Heredity, heredity patterns etc.
  • AR
  • XLR
OMIM-Ps
  • Multiple OMIM-Ps
ICD10 Code

Bioinformatics and clinical interpretation

No text defined