• Am. J. Med. Genet. A · Jul 2020

    Review Case Reports

    Expanding the clinical spectrum of mitochondrial 3-hydroxy-3-methylglutaryl-CoA synthase deficiency with Turkish cases harboring novel HMGCS2 gene mutations and literature review.

    • Mustafa Kılıç, Sevil Dorum, Ali Topak, Mutlu U Yazıcı, Fatih S Ezgu, and Turgay Coskun.
    • Sami Ulus Children Hospital, Metabolism Unit, Ankara, Turkey.
    • Am. J. Med. Genet. A. 2020 Jul 1; 182 (7): 1608-1614.

    AbstractMitochondrial 3-hydroxy-3-methylglutaryl-CoA synthase (mHS) deficiency is a very rare autosomal recessive inborn error of ketone body synthesis and presents with hypoketotic hypoglycemia, metabolic acidosis, lethargy, encephalopathy, and hepatomegaly with fatty liver precipitated by catabolic stress. We report acute presentation of two patients from unrelated two families with novel homozygous c.862C>T and c.725-2A>C mutations, respectively, in HMGCS2 gene. Affected patients had severe hypoketotic hypoglycemia, lethargy, encephalopathy, severe metabolic and lactic acidosis and hepatomegaly after infections. Surprisingly, molecular screening of the second family showed more affected patients without clinical findings. These cases expand the clinic spectrum of this extremely rare disease.© 2020 Wiley Periodicals, Inc.

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