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논문 기본 정보

자료유형
학술저널
저자정보
김주현 (울산의대 서울아산병원 소아과학교실, 아산생명과학연구소, 선천성기형 및 유전질환 유전체 연구센터) 김구환 (울산의대 서울아산병원 소아과학교실, 아산생명과학연구소, 선천성기형 및 유전질환 유전체 연구센터) 유한욱 (울산의대 서울아산병원 소아과학교실, 아산생명과학연구소, 선천성기형 및 유전질환 유전체 연구센터)
저널정보
대한유전성대사질환학회 대한유전성대사질환학회지 대한유전성대사질환학회지 제6권 제1호
발행연도
2006.1
수록면
96 - 107 (12page)

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초록· 키워드

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Citrin deficiency resulting from mutations of SLC25A13is associated with two major clinical phenotypes; neonatal intrahepatic cholestasis caused by citrin deficiency (NICCD) and adult-onset type 2 citrullinemia (CTLN2). In Korea, 7 cases of citrin deficiency have been diagnosed based on biochemical and molecular findings. Four NICCD cases were identified by newborn screening using MS/MS or presenting symptoms like cholestatic jaundice. They are all males, presenting with conjugated hyperbilirubinemia, elevated liver enzymes, hypoalbuminemia, mild hyperammonemia, elevated citrullin, methionine and threonine. All of them have been spontaneously recovered from hepatic manifestation by the age of 6-8 months. Mutation analysis has been performed using their genomic & cDNAs obtained from skin fibroblasts. They turned out to be compound heterozygotes carrying each of 851del4, IVS11+1G>A, and IVS13+1G>A. Three CTLN2 patients were identified. Two adult male patients presented with a sudden loss of consciousness, seizure, vomiting, hyperammonemia and citrullinemia in their twenties. They carried an IVS13+1G>A, 851del4, and IVS11+1G>A mutant alleles. The other CTLN2 patient was 52 year old female patient, manifesting lethargy, altered consciousness, irritability and hyperammonemia. Similar clinical symptoms had recurred at the delivery of first and second babies in her past medical history. She was managed by hemodialysis and survived with neurological sequellae. Also, we screened the presence of 9 common mutations in 500 Korean newborns using dried blood spot of filter papers. Only a allele carried 854del4 mutation. In conclusion, the entire picture of citrin deficiency in Korea including incidence, genotype, clinical features and natural courses, is still vague at the present time.

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