Expanding the clinical spectrum of cytosolic phosphoenolpyruvate carboxykinase deficiency: novel PCK1 variants in four Arabian Gulf families

Bibliographic Details
Title: Expanding the clinical spectrum of cytosolic phosphoenolpyruvate carboxykinase deficiency: novel PCK1 variants in four Arabian Gulf families
Authors: Marwa Al Busaidi, Feda E. Mohamed, Eiman Al-Ajmi, Nadia Al Hashmi, Khalid Al-Thihli, Amna Al Futaisi, Watfa Al Mamari, Fathiya Al-Murshedi, Fatma Al-Jasmi
Source: Orphanet Journal of Rare Diseases, Vol 18, Iss 1, Pp 1-10 (2023)
Publisher Information: BMC, 2023.
Publication Year: 2023
Collection: LCC:Medicine
Subject Terms: Phosphoenolpyruvate Carboxykinase, Hypoglycemia, Encephalopathy, PCK1, Medicine
More Details: Abstract Background In metabolic stress, the cytosolic phosphoenolpyruvate carboxykinase (PEPCK-C) enzyme is involved in energy production through the gluconeogenesis pathway. PEPCK-C deficiency is a rare childhood-onset autosomal recessive metabolic disease caused by PCK1 genetic defects. Previous studies showed a broad clinical spectrum ranging from asymptomatic to recurrent hypoglycemia with/without lactic acidosis, encephalopathy, seizures, and liver failure. Results In this article, we discuss the occurrence of PEPCK-C deficiency in four families from the United Arab Emirates and Oman. All patients presented with unexplained hypoglycemia as a common feature. Two out of the seven patients presented with episodes of encephalopathy that resulted in seizures and neuroregression leading to global developmental delay and one patient had a neonatal presentation. Observed biochemical abnormalities include elevated lactate, transaminases, and tricarboxylic acid cycle metabolites in most patients. Elevated creatine kinase was documented in two patients. Whole exome sequencing revealed two novel (c.574T > C, and c.1268 C > T) and a previously reported splice site (c.961 + 1G > A) PCK1 variant in the affected families. Conclusion Patients become vulnerable during intercurrent illness; thus, prevention and prompt reversal of a catabolic state are crucial to avoid irreversible brain damage. This report will help to expand the clinical understanding of this rare disease and recommends screening for PEPCK-C deficiency in unexplained hypoglycemia.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 1750-1172
Relation: https://doaj.org/toc/1750-1172
DOI: 10.1186/s13023-023-02946-5
Access URL: https://doaj.org/article/4c46b9ee8ba94f4794bc083e28077f10
Accession Number: edsdoj.4c46b9ee8ba94f4794bc083e28077f10
Database: Directory of Open Access Journals
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More Details
ISSN:17501172
DOI:10.1186/s13023-023-02946-5
Published in:Orphanet Journal of Rare Diseases
Language:English