Abstract
Carbamoylphosphate synthetase I deficiency (CPS1D) is a urea-cycle disorder characterized by episodes of life-threatening hyperammonemia. Correct diagnosis is crucial for patient management, but is difficult to make from clinical presentation and conventional laboratory tests alone. Enzymatic or genetic diagnoses have also been hampered by difficult access to the appropriate organ and the large size of the gene (38 exons). In this study, in order to address this diagnostic dilemma, we performed the largest mutational and clinical analyses of this disorder to date in Japan. Mutations in CPS1 were identified in 16 of 18 patients with a clinical diagnosis of CPS1D. In total, 25 different mutations were identified, of which 19 were novel. Interestingly, in contrast to previous reports suggesting an extremely diverse mutational spectrum, 31.8% of the mutations identified in Japanese were common to more than one family. We also identified two common polymorphisms that might be useful for simple linkage analysis in prenatal diagnosis. The accumulated clinical data will also help to reveal the clinical presentation of this rare disorder in Japan.
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Acknowledgments
We are grateful to the families who participated in the study. We also thank the following doctors who referred the patients, Drs Hidemasa Hayashibe (Department of Pediatrics, Yamanashi University School of Medicine), Yoichi Murakami (Department of Pediatrics, Kitakami Saiseikai Hospital), Atsuko Ishihara and Mitsuyoshi Okumura (Department of Pediatrics, Japanese Red Cross Society Wakayama Medical Center).
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Kurokawa, K., Yorifuji, T., Kawai, M. et al. Molecular and clinical analyses of Japanese patients with carbamoylphosphate synthetase 1 (CPS1) deficiency. J Hum Genet 52, 349–354 (2007). https://doi.org/10.1007/s10038-007-0122-9
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DOI: https://doi.org/10.1007/s10038-007-0122-9
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