Startseite Medizin Carnitine insufficiency in children with inborn errors of metabolism: prevalence and treatment efficacy
Artikel
Lizenziert
Nicht lizenziert Erfordert eine Authentifizierung

Carnitine insufficiency in children with inborn errors of metabolism: prevalence and treatment efficacy

  • Ilgar Mamedov , Irina Zolkina , Ekaterina Nikolaeva , Pavel Glagovsky EMAIL logo und Vladimir Sukhorukov
Veröffentlicht/Copyright: 18. Juli 2015

Abstract

Background: Carnitine is necessary for the transfer of long-chain fatty acids from the cytosol into mitochondria for subsequent β-oxidation. A carnitine deficiency results in impaired energy production from fatty acids.

Methods: We reviewed the plasma level of total carnitine, free carnitine, and acylcarnitines in 1270 children with psychomotor retardation, low growth, and weight parameters. Tandem mass spectrometry (MS/MS) was applied. Low free carnitine level in plasma was used as a marker of carnitine deficiency.

Results: A total of 102 (8%) children had free carnitine level <19 μmol/L (norm 19–60 μmol/L). As a result of the subsequent investigation, hereditary diseases were diagnosed in 76 (¾) children and out of that 19 had very low free carnitine plasma level (<10 μmol/L). Fanconi syndrome, fat oxidation defects, primary systemic carnitine deficiency, mitochondrial encephalomyopathy, and Noonan syndrome were revealed in these 19 children.

Conclusion: Efficacy of levocarnitine treatment in children with very low free carnitine level differs according to pathogenesis of diseases. The highest efficacy was observed in primary systemic carnitine deficiency.


Corresponding author: Pavel Glagovsky, Doctor, Clinical Laboratory Diagnosis of Experimental and Theoretical Studies of Mechanisms of Behavior and Brain Protection SRI Cerebrovascular Disease and Stroke, Pirogov Russian National Research Medical University, 9a Bolshaya Pirogovskaya Street, Moscow, Russia, Phone: +7 (499) 245 74-62, 119021, E-mail:

References

1. Sharma S, Black SM. Carnitine homeostasis, mitochondrial function, and cardiovascular disease. Drug Discov Today Dis Mech 2009;6:e31–9.10.1016/j.ddmec.2009.02.001Suche in Google Scholar PubMed PubMed Central

2. Das AM, Steuerwald U, Illsinger S. Inborn errors of energy metabolism associated with myopathies. J Biomed Biotechnol 2010:340849.10.1155/2010/340849Suche in Google Scholar PubMed PubMed Central

3. Marcovina SM, Sirtori C, Peracino A, Gheorghiade M, Borum P, et al. Translating the basic knowledge of mitochondrial functions to metabolic therapy: role of L-carnitine. Transl Res 2013;161:73–84.10.1016/j.trsl.2012.10.006Suche in Google Scholar PubMed PubMed Central

4. Lee B, Scaglia F. Inborn errors of metabolism: from neonatal screening to metabolic pathways. New York: Oxford University Press, 2014:19.Suche in Google Scholar

5. Yang LL, Huang XW, Yang JB, Zhou XL, Huang XL, et al. Screening and diagnosis of children with primary carnitine deficiency in Zhejiang Province, China HK. J Paediatr (new series). 2013;18:167–73.Suche in Google Scholar

6. Bonafe´L, Bergerb MM, Queb YA, Mechanick JI. Carnitine deficiency in chronic critical illness. Curr Opin Clin Nutr Metab Care 2014;17:200–9.10.1097/MCO.0000000000000037Suche in Google Scholar PubMed

7. Winter SC.Treatment of carnitine deficiency. J Inherit Metab Dis 2003;26:171–80.10.1023/A:1024433100257Suche in Google Scholar

8. Binienda Z, Przybyla-Zawislak B, Virmani A, Schmued L. L-carnitine and neuroprotection in the animal model of mitochondrial dysfunction. Ann N Y Acad Sci 2005;1053: 174–82.10.1196/annals.1344.015Suche in Google Scholar PubMed

9. Wang C, Sadovova N, Ali HK, Duhart HM, Fu X, et al. L-carnitine protects neurons from 1-methyl-4-phenylpyridinium-induced neuronal apoptosis in rat forebrain culture. Neuroscience 2007;144:46–55.10.1016/j.neuroscience.2006.08.083Suche in Google Scholar PubMed

10. Bueno R, Alvarez de Sotomayor M, Perez-Guerrero C, Gomez-Amores L, Vazquez CM, et al. L-carnitine and propionyl-L-carnitine improve endothelial dysfunction in spontaneously hypertensive rats: different participation of NO and COX-products. Life Sci 2005;77:2082–97.10.1016/j.lfs.2005.01.035Suche in Google Scholar PubMed

11. Winter SC, Szabo-Aczel S, Curry CJ, Hutchinson HT, Hogue R, et al. Plasma carnitine deficiency. Clinical observations in 51 pediatric patients. Am J Dis Child 1987;141:660–5.10.1001/archpedi.1987.04460060076039Suche in Google Scholar PubMed

12. Magoulas PL, El-Hattab AW. Systemic primary carnitine deficiency: an overview of clinical manifestations, diagnosis, and management. Orphanet J Rare Dis 2012;7:68.10.1186/1750-1172-7-68Suche in Google Scholar PubMed PubMed Central

13. Nasser M, Javaheri H, Fedorowicz Z, Noorani Z. Carnitine supplementation for inborn errors of metabolism. Cochrane Database Syst Rev. 2012;2:CD006659.10.1002/14651858.CD006659.pub3Suche in Google Scholar PubMed PubMed Central

14. Nikolaeva ЕА, Leont’eva IV, Kalachanova EP, Zolkina IV. Physical retardation and cardiomyopathy in a child with a primary systemic carnitine deficiency. Trudnyj patsient (Moscow) 2012;2–3:50–4.Suche in Google Scholar

15. Pivovarova АM, Sukhorukov VS, Belousova ED, Celine SA, Dorofeeva my, et al. (2003) Cell’s bioenergetics disturbances in children with tuberous sclerosis. Ros Vestn Perinatol I Pediatr (Moscow) 2003;5:19–23.Suche in Google Scholar

16. TSaregorodtsev АD, Nikolaeva EА, Sukhorukov VS. Metabolic disturbances’ correction in children with different pathological conditions. Мoscow: Medpraktika-М, 2006:1–87.Suche in Google Scholar

17. Bernardini I, Rizzo WB, Dalakas M, Bernar J, Gahl WA. Plasma and muscle free carnitine deficiency due to renal Fanconi syndrome. J Clin Invest 1985;75:1124–30.10.1172/JCI111806Suche in Google Scholar PubMed PubMed Central

18. Gahl WA, Bernardini I, Dalakas M, Rizzo WB, Harper GS, et al. Oral carnitine therapy in children with cystinosis and renal Fanconi syndrome. J Clin Invest 1988;81:549–60.10.1172/JCI113353Suche in Google Scholar PubMed PubMed Central

19. Wilmer MJ, Schoeber JP, van den Heuvel LP, Levtchenko EN. Cystinosis: practical tools for diagnosis and treatment. Pediatr Nephrol 2011;26:205–15.10.1007/s00467-010-1627-6Suche in Google Scholar PubMed PubMed Central

20. Besouw MT, Cornelisse E, Cassiman D, Kluijtmans LA, Heuvel LP, et al. Carnitine profile and effect of suppletion in children with renal Fanconi syndrome due to cystinosis. JIMD reports 2014; doi: 10.1007/8904_2014_312.10.1007/8904_2014_312Suche in Google Scholar PubMed PubMed Central

21. Novikov PV, Nikolaeva EА, YAblonskaya MI, Novikova IM, Osavchuk EA, et al. Fanconi – Bickel syndrome in children. Ros vestn perinatol pediatr (Moscow) 2012;3:65–70.Suche in Google Scholar

22. Desnuelle C. Mitochondrial disorders: from pathophysiology to acquired defects. New York: Springer Science & Business Media, 2013:238.Suche in Google Scholar

23. Hu C, Lancaster CS, Zuo Z, Hu S, Chen Z, et al. Inhibition of OCTN2-mediated transport of carnitine by etoposide. Mol Cancer Ther 2012;11:921–9.10.1158/1535-7163.MCT-11-0980Suche in Google Scholar PubMed PubMed Central

24. Hitomi T, Matsuura N, Shigematsu Y, Okano Y, Shinozaki E, et al. Importance of molecular diagnosis in the accurate diagnosis of systemic carnitine deficiency. J Genet 2015;94:147–50.10.1007/s12041-015-0486-0Suche in Google Scholar PubMed

25. Shibbani K, Fahed AC, Al-Shaar L, Arabi M, Nemer G, et al. Primary carnitine deficiency: novel mutations and insights into the cardiac phenotype. Clin Genet 2014;85:127–37.10.1111/cge.12112Suche in Google Scholar PubMed

26. Hsu CC, Chuang YH, Tsai JL, Jong HJ, Shen YY, et al. CPEO and carnitine deficiency overlapping in MELAS syndrome. Acta Neurol Scand 1995;92:252–5.10.1111/j.1600-0404.1995.tb01697.xSuche in Google Scholar PubMed

27. Pancrudo J, Shanske S, Coku J, Lu J, Mardach R, et al. Mitochondrial myopathy associated with a novel mutation in mtDNA. Neuromuscul Disord 2007;17:651–4.10.1016/j.nmd.2007.04.005Suche in Google Scholar PubMed PubMed Central

28. Haas RH, Parikh S, Falk MJ, Saneto RP, Wolf NI, et al. The in-depth evaluation of suspected mitochondrial disease. Mol Genet Metab 2008;94:16–37.10.1016/j.ymgme.2007.11.018Suche in Google Scholar PubMed PubMed Central

29. Ling P, Lee DJ, Yoshida EM, Sirrs S. Carnitine deficiency presenting with encephalopathy and hyperammonemia in a patient receiving chronic enteral tube feeding: a case report. J Clin Med Case Rep 2012;6:227.10.1186/1752-1947-6-227Suche in Google Scholar PubMed PubMed Central

30. Nikolaeva EА. Correction of carnitine insufficiency in children with mitochondrial diseases. In: Suchorukov VS, editor. Mitochondrial pathology outlines. Moscow: Medpraktika, 2011:177–83.Suche in Google Scholar

Received: 2015-5-14
Accepted: 2015-6-15
Published Online: 2015-7-18
Published in Print: 2015-11-1

©2015 by De Gruyter

Artikel in diesem Heft

  1. Frontmatter
  2. Highlight: Turner syndrome
  3. Turner syndrome – working together with patients and their families
  4. Turner syndrome patients with bicuspid aortic valves and renal malformations exhibit abnormal expression of X-linked inhibitor of apoptosis protein (XIAP)
  5. Inhibin B in adolescents and young adults with Turner syndrome
  6. Mode of initial presentation and chromosomal abnormalities in Irish patients with Turner syndrome: a single-centre experience
  7. Retrospective evaluation of pubertal development and linear growth of girls with Turner Syndrome treated with oral and transdermal estrogen
  8. Turner syndrome in Albania and the efficacy of its treatment with growth hormone
  9. Review articles
  10. The relation of vitamin D status with metabolic syndrome in childhood and adolescence: an update
  11. Putting the pieces together: cryptorchidism – do we know everything?
  12. Original articles
  13. Investigation of androgen receptor gene mutations in a series of 21 patients with 46,XY disorders of sex development
  14. Molecular diagnosis of maturity-onset diabetes of the young (MODY) in Turkish children by using targeted next-generation sequencing
  15. Association of physical activity level with depression, anxiety, and quality of life in children with type 1 diabetes mellitus
  16. Neonatal diabetes in Ukraine: incidence, genetics, clinical phenotype and treatment
  17. The effect of intraoperative administration of dexamethasone for PONV prophylaxis on perioperative blood glucose level in obese and normal weight children
  18. Are obesity and metabolic syndrome associated with plasma adropin levels in children?
  19. Carnitine insufficiency in children with inborn errors of metabolism: prevalence and treatment efficacy
  20. Comparison of energy expenditure, body composition, metabolic disorders, and energy intake between obese children with a history of craniopharyngioma and children with multifactorial obesity
  21. Effect of serum cholesterol on bone mineral density in normal-weight children and adolescents
  22. Assessment of bone turnover markers and bone mineral density in normal short boys
  23. Long-term treatment for hyperphenylalaninemia and phenylketonuria: a risk for nutritional vitamin B12 deficiency?
  24. Risk factors affecting the development of nephrocalcinosis, the most common complication of hypophosphatemic rickets
  25. Children with hyperthyroidism younger than age 7 require higher mg/kg doses of methimazole to normalize free T4 compared to older children
  26. Effects of bisphosphonates to treat osteoporosis in children with cerebral palsy: a meta-analysis
  27. AMH levels at central precocious puberty and premature thelarche: is it a parameter?
  28. Validating Paediatric Morphometrics: body proportion measurement using photogrammetric anthropometry
  29. Treatment of central precocious puberty and early puberty with GnRH analog in girls with Williams-Beuren syndrome
  30. Short communication
  31. Pilot study on the dietary habits and lifestyles of girls with idiopathic precocious puberty from the city of Rome: potential impact of exposure to flame retardant polybrominated diphenyl ethers
  32. Patient reports
  33. Hypomagnesemia due to two novel TRPM6 mutations
  34. A novel mutation of AMH in three siblings with persistent Mullerian duct syndrome
  35. Kocher-Debré-Semelaigne syndrome with rhabdomyolysis and increased creatinine
  36. Anaphylaxis to gonadorelin acetate in a girl with central precocious puberty
  37. Efficacy and safety of sirolimus in a neonate with persistent hypoglycaemia following near-total pancreatectomy for hyperinsulinaemic hypoglycaemia
Heruntergeladen am 19.12.2025 von https://www.degruyterbrill.com/document/doi/10.1515/jpem-2015-0193/pdf
Button zum nach oben scrollen