Methylmalonic Acidemia with Optic Nerve Disease: A Case Report
Journal Name:
- İnönü Üniversitesi Tıp Fakültesi Dergisi
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Keywords (Original Language):
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Abstract (2. Language):
Methyl malonic acidemia is a rare form of organic acidemias (that frequently observed with the
neurological findings). It was noted that optic atrophy could be developed as a rare complication. An 8-
year-old girl presented to our hospital with growth retardation, weight loss and vomiting. Her weight and
length were (<3 P) and neutropenia was determined. During follow-up, metabolic acidosis was diagnosed
in this patient after detection of acidotic respiration, (midriatic pupils, loss of light reflex and optic atrophy
)- an indicative of optic nerve disease. Cranial MRI revealed mild atrophy and symmetrical hyperintensity
in peritrigonal and lentiform nuclei in T2-weighted images. The patient had lactic acidemia and methyl
malonic acidemia was detected with urinary organic acid screening. It was emphasized that methymalonic
acidemia patients required to follow-up for optic nerve involvement.
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Abstract (Original Language):
Metilmalonik asidemi (sıklıkla) nörolojik bulgularla seyreden organik asidemilerden biridir. Literatürde
(nadir bir) komplikasyon olarak optik atrofi gelişebileceği bildirilmektedir. Sekiz yaşında kız hasta büyüme
geriliği, kusma ve kilo kaybı yakınmalarıyla getirildi. Ağırlık ve boyu (<3 P) olan olguda nötropeni
saptandı. İzlem sırasında (pupillerin midriatik olması, ışık refleksi kaybı ve optik atrofi şeklinde) optik sinir
tutulumu bulgusu ile birlikte asidotik solunumu olan hastada metabolik asidoz gelişti. Beyin MRI’inde
serebral atrofi, peritrigonal ve lentiform nukleuslarda T2 ağırlıklı kesitlerde hiperintens alanlar saptandı.
Laktik asidemisi olan olgunun idrar organik asit incelemesinde metilmalonik asidemi saptandı.
Metilmalonik asidemili olguların optik sinir tutulumu yönünden izlenmesi gerektiği vurgulandı.
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283-285