PEDIATRIC REVIEW TABLE - Genetic Flashcards (3)
methylmalonic acidemia
D-methylmalonate mutase - MM-CoA + propionyl-CoA accumulate Hyperglycinemia Ketosis Hyperammonemia
cystathionine B deficiency
AR-
Homocystinuria, high cystathionine + methionine
Marfanoid habitus
Rx w B6.
biotinidase deficiency
Ketoacidosis
hyperammonemia
organic aciduria
Glycine encephalopathy
Glycine decarboxylase -
cerebellar hypoplasia -
burst suppression/hypsarrhythmia
Tuberous Sclerosis
AD - TSC1(tuberin) +TSC2 (hamartin)
Menkes
XR - ATP7A - kinky hair + skin hyperelasticity
Abetalipoproteinemia
AR - microsomal TG transfer (P) -
acanthocytes -
DC dysfunction-
acq vitamin E deficiency
X linked lissencephaly
XR - DCX (doublecortin)
Rett
XD - MeCP2
NF1
AD - neurofibromin - chromosome 17
Lisch nodules/axillary freckling/spots/cut neurofibroma
NF2
AD -
merlin - chromosome 22
b/l vestib schwannoma / meningioma
Incontinentia pigmenti
XD - NEMO gene
Glut1 transporter deficiency
Epileptic encephalopathy -
hypoglycorrhachia
Lesch-Nyhan
XR - HGPRT -
self mutilation + dystonia, choreoathetosis
Alexander
AD - GFAP -
U fibers always involved
Canavan
AR
Aspartoacylase - central myelin ONLY
U fibers always involved
Pelizaeus Merzbacher
XR - PLP1
U fibers spared
Vanishing WM disease
AR - eIF2B-TRP
Metachromatic leukodystrophy
arylsulfatase A "optic atrophy, ataxia, dementia behavioral change, spastic ataxia psychosis, dementia" Increased urine sulfatides
Adrenoleukodystrophy
XR (neonate) AR (child/adult Acyl Coa synthetase "adrenal failure, testicular atrophy, cirrhosis dementia, ataxia, seizures" U fibers spared
Aicardi
XD - infantile spasms + corpus callosum agenesis + chorioretinal malformations
Zellweger
AR - PEX1-
MICROcephaly, leukodystrophy, hypotonia, coarse facial features
Phenylketonuria
AR - phenylalanine hydroxylase
propionic acidemia
AR-
propionyl CoA carboxylase-
ketoacidosis, high pCOA serum
Ataxia w oculomotor apraxia type I
Aprataxin -
onset childhood -
neuropathy
Ataxia w oculomotor apraxia type II
Senataxin -
onset adolescence -
myoclonus/chorea
SCA-11
AD - tau-tubulin kinase
(only non-trinucleotide rpt SCA) -
pure cerebellar symptoms w mild pyramidal signs
Wilson disease
AR - ATP7B -
copper is not adequately secreted into bile –> Cu increases in serum
SCA-1
AD - ATXN1 -
hypermetric saccades + hyperreflexia
SCA-2
AD - ATXN2 -
hypometric saccades + parkinsonism and dementia
PKAN
AR - pantothenate kinase 2 - dystonia - choreathetosis - EYE OF THE TIGER sign
Primary generalized dystonia
AD - torsin A - aka DYT1 dystonia - kinesogenic at 1st then generalized
dopa responsive dystonia/Segawa syndrome
AD - GTP cyclohydrolase1 -
THB synthesis, req’d by tyr hydroxylase to make DA
aka DYT5
ADNFLE
AD - nicotinic AcH (R)
Ataxia telangiectasia
AR - ATM1 (DNA repair)
Fragile X linked ataxia
XR -
CGG repeat in FMR1 gene (>200 repeats)
parkinson+ataxia in grandparent of Fragile X kid
episodic ataxia type 1
KCN1A - ep. ataxia +facial twitching - Rx = CMZ
episodic ataxia type 2
CACN1A4 - ep. ataxia + nystagmus/dysarthria - Rx = diamox
Cerebrotendinous xathomatosis
AR -
27-sterol hydroxylase -
cholesterol/stanol deposited in tendons + CNS
- neuropsych sx/ataxia/parkinsonism
Galactosemia
3 mutations: epimerase - galactokinase - uridyltransferase
Gaucher
AR - glucocerebrosidase - type1: no CNS involvement; type2: 2y, HSM, ataxia, EOM inv. - wrinkled tissue paper cells
Fabry
XR -
a-galactosidase -
arrhythmia + ESRD + sm fiber neuropathy + ANGIOKERATOMA + ischemic stroke
Niemann Pick A
AR - sphingomyelinase -
CHERRY RED SPOT + HSM
Niemann Pick C
AR - NPC1 -
positive filipin test -
HSM, ataxia, MR
GM1 gangliosidosis
AR - beta galactosidase -
coarse facial features + HSM
Tay Sachs disease
AR - hexosaminidase A -
CHERRY RED SPOT
Sandhoff
AR - hexosaminidase A+B -
CHERRY RED SPOT + HSM
Krabbe
AR - galactocerebrosidase -
optic atrophy, spasticity, b regression -
peripheral neuropathy (PNS myelin)
U FIBERS spared
Glutaric aciduria type I
Macrocephaly, bilateral SDHs
Leukodystrophy
LRRK2
Leucine rich repeat kinase 2.
Encoded by PARK8 gene.
The Gly2019Ser mutation in PARK8 (LRRK2) = AD.
Most common cause of AD, adult-onset PD
Parkin
Encoded by PARK2 gene.
Mutations in PARK2 =MCC of juvenile onset AR PD.
Do not form Lewy bodies.
Refsum disease
AR
phytanoyl-CoA-hydroxylase
Ataxia, neuropathy, scaly skin
High phytanic acid level
Megalencephalic leukodystrophy w subcortical cyst
aka MLC. AR.
MLC1 gene.
Leukopathy, large head, multiple TEMPORAL cysts.