Late Diagnosis of Hereditary Tyrosinemia Type I: The Case of Two First Cousins


Authors : K. Kabbaj; R. Jahouer; C. Nahi; K. Mouadine; N. Oulehyane; T. Benouachane; B. Chkirat

Volume/Issue : Volume 9 - 2024, Issue 10 - October


Google Scholar : https://tinyurl.com/5n6ek2wf

Scribd : https://tinyurl.com/n29h6jbk

DOI : https://doi.org/10.38124/ijisrt/IJISRT24OCT259

Note : A published paper may take 4-5 working days from the publication date to appear in PlumX Metrics, Semantic Scholar, and ResearchGate.


Abstract : Hereditary Tyrosinemia Type I (HT1) is a rare metabolic disorder caused by a deficiency in fumarylacetoacetate hydrolase, leading to the accumulation of toxic metabolites and resulting in hepatic and renal complications. This case report details a 10-year-old patient from a consanguineous family with a significant history of hepatic failure due to hepatocellular carcinoma. The patient presented with abdominal pain, jaundice, and urinary abnormalities, which led to the diagnosis of HT1, confirmed by elevated succinylacetone levels. Despite initial treatment with nitisinone and a low-protein diet, surgical resection of the hepatic mass was impeded by vascular invasion, necessitating preoperative chemotherapy. This case underscores the importance of early detection and a multidisciplinary approach in managing HT1, highlighting ongoing research into advanced therapies and genetic interventions to improve patient outcomes.

References :

  1. Brito Dos SantosS. et al. Tyrosinemia type 1 in pediatric nephrology: Not always straightforward Arch Pediatr(2021)
  2. DweikatI. et al. Phenotype, genotype, and outcome of 25 Palestinian patients with hereditary tyrosinemia type 1Metabol Open(2021)
  3. PengM. et al. Evaluation of factors influencing accuracy in the analysis of succinylacetone in dried blood spotsClinica chimica acta; international journal of clinical chemistry(2012)
  4. Al-Dirbashi O.Y. et al. Quantification of succinylacetone in urine of hepatorenal tyrosinemia patients by HPLC with fluorescence detectionClin Chim Acta(2006)
  5. Äärelä, Linnea, Pasi I. Nevalainen, Kalle Kurppa, et Pauliina Hiltunen. 2020. « First Scandinavian Case of Successful Pregnancy during Nitisinone Treatment for Type 1 Tyrosinemia ». Journal of Pediatric Endocrinology & Metabolism: JPEM 33 (5): 661-64. https://doi.org/10.1515/jpem-2019-0540.
  6. Allard, Pierre, André Grenier, Mark S. Korson, et Thomas H. Zytkovicz. 2004. « Newborn Screening for Hepatorenal Tyrosinemia by Tandem Mass Spectrometry: Analysis of Succinylacetone Extracted from Dried Blood Spots ». Clinical Biochemistry 37 (11): 1010-15. https://doi.org/10.1016/j.clinbiochem.2004.07.006.
  7. Angelico, Roberta, Silvia Trapani, Michele Colledan, Umberto Cillo, Tullia Maria De Feo, et Marco Spada. 2018. « Higher Retransplantation Rate Following Extended Right SplitLiver Transplantation: An Analysis from the Eurotransplant Liver Follow-up Registry ». Liver Transplantation: Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society 24 (6): 849-50. https://doi.org/10.1002/lt.25035.
  8. Arnon, Ronen, Rachel Annunziato, Tamir Miloh, Melissa Wasserstein, Hiroshi Sogawa, Monique Wilson, Frederick Suchy, et Nanda Kerkar. 2011. « Liver Transplantation for Hereditary Tyrosinemia Type I: Analysis of the UNOS Database ». Pediatric Transplantation 15 (4): 400-405. https://doi.org/10.1111/j.1399-3046.2011.01497.x.
  9. Arora, N., O. Stumper, J. Wright, D. A. Kelly, et P. J. McKiernan. 2006. « Cardiomyopathy in Tyrosinaemia Type I Is Common but Usually Benign ». Journal of Inherited Metabolic Disease 29 (1): 54-57. https://doi.org/10.1007/s10545-006-0203-5.
  10. Barone, Helene, Yngve T. Bliksrud, Irene B. Elgen, Peter D. Szigetvari, Rune Kleppe, Sadaf Ghorbani, Eirik V. Hansen, et Jan Haavik. 2020. « Tyrosinemia Type 1 and Symptoms of ADHD: Biochemical Mechanisms and Implications for Treatment and Prognosis ». American Journal of Medical Genetics. Part B, Neuropsychiatric Genetics: The Official Publication of the International Society of Psychiatric Genetics 183 (2): 95-105. https://doi.org/10.1002/ajmg.b.32764.
  11. Barthelmes, Ludger, et Iain S. Tait. 2005. « Liver Cell Adenoma and Liver Cell Adenomatosis ». HPB: The Official Journal of the International Hepato Pancreato Biliary Association 7 (3): 186-96. https://doi.org/10.1080/13651820510028954. Bartlett, David C., Mary Anne Preece, Elisabeth Holme, Carla Lloyd, Phil N.
  12. Newsome, et Patrick J. McKiernan. 2013. « Plasma Succinylacetone Is Persistently Raised after Liver Transplantation in Tyrosinaemia Type 1 ». Journal of Inherited Metabolic Disease 36 (1): 15-20. https://doi.org/10.1007/s10545-012-9482-1.
  13. Baumann, Ulrich, René Adam, Christophe Duvoux, Rafael Mikolajczyk, Vincent Karam, Lorenzo D’Antiga, Christophe Chardot, et al. 2018. « Survival of Children after Liver Transplantation for Hepatocellular Carcinoma ». Liver Transplantation 24 (2): 246-55. https://doi.org/10.1002/lt.24994

Hereditary Tyrosinemia Type I (HT1) is a rare metabolic disorder caused by a deficiency in fumarylacetoacetate hydrolase, leading to the accumulation of toxic metabolites and resulting in hepatic and renal complications. This case report details a 10-year-old patient from a consanguineous family with a significant history of hepatic failure due to hepatocellular carcinoma. The patient presented with abdominal pain, jaundice, and urinary abnormalities, which led to the diagnosis of HT1, confirmed by elevated succinylacetone levels. Despite initial treatment with nitisinone and a low-protein diet, surgical resection of the hepatic mass was impeded by vascular invasion, necessitating preoperative chemotherapy. This case underscores the importance of early detection and a multidisciplinary approach in managing HT1, highlighting ongoing research into advanced therapies and genetic interventions to improve patient outcomes.

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