Molybdenum cofactor deficiency
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ogheneochuko Ajari, MB.BS, MS [2]
Overview
Molybdenum cofactor deficiency is a rare human disease in which the absence of molybdenum cofactor leads to accumulation of toxic levels of sulphite and neurological damage. Usually this leads to death within months of birth, due to the lack of active sulfite oxidase. Furthermore, a mutational block in molybdenum cofactor biosynthesis causes absence of enyzme activity of xanthine dehydrogenase/oxidase and aldehyde oxidase.
Pathophysiology
Molybdenum cofactor deficiency is caused by a mutation in the MOCS1 gene of the type A variant. It can also be caused by a mutation in the MOCS2 gene or the GEPH gene.[1]
Epidemiology and Demographics
As of 2010, there had been approximately 132 reported cases.[2]
Differentiating Molybdenum cofactor deficiency from other Diseases
It should not be confused with molybdenum deficiency.
Diagnosis
History and Symptoms
- Early seizures
Laboratory Findings
- Low blood levels of uric acid
- High levels of sulphite, xanthine, and uric acid in urine
MRI
The disease produces characteristic MRI images that can aid in diagnosis.
Treatment
In 2009, Monash Children's Hospital at Southern Health in Melbourne, Australia reported that a patient known as Baby Z became the first person to be successfully treated for molybdenum cofactor deficiency type A. The patient was treated with cPMP, a precursor of the molybdenum cofactor.[3][4] Baby Z will require daily injections of cyclic pyranopterin monophosphate (cPMP) for the rest of her life.[5]
Related Chapter
References
- ↑ Reiss J, Johnson JL (2003). "Mutations in the molybdenum cofactor biosynthetic genes MOCS1, MOCS2, and GEPH". Hum Mutat. 21 (6): 569–76. doi:10.1002/humu.10223. PMID 12754701.
- ↑ Ichida K, Aydin HI, Hosoyamada M, Kalkanoglu HS, Dursun A, Ohno I; et al. (2006). "A Turkish case with molybdenum cofactor deficiency". Nucleosides Nucleotides Nucleic Acids. 25 (9–11): 1087–91. doi:10.1080/15257770600894022. PMID 17065069.
- ↑ McArthur, Grant (November 5, 2009). "Doctor cures 'Baby Z' of molybdenum cofactor deficiency in medical world first". news.com.au. Retrieved November 5, 2009.
- ↑ Samantha Donovan (2009-11-05). "Dying baby cured in world first". abc.net.au/news (Australian Broadcasting Corporation). Retrieved 2009-11-05.
- ↑ Tedmanson, Sophie (November 5, 2009). "Doctors risk untried drug to stop babys brain dissolving". The Times (London). Retrieved May 13, 2010.