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Gamma-glutamyl cycle is a six-enzyme cycle that represents the primary pathway for glutathione synthesis and degradation. 5-Oxoprolinase deficiency is an extremely rare disorder of the gamma-glutamyl cycle with only eight patients reported to date. Debate continues as to whether this is a benign biochemical defect because of the heterogeneity of the clinical presentation which ranges from normal to significant neurological involvement. Here, we report the first molecularly characterized patients with 5-oxoprolinase deficiency due to a mutation in OPLAH (which encodes 5-oxoprolinase). The largely benign clinical course of the patients described herein despite persistent 5-oxoprolinuria highlights the importance of establishing a molecular diagnosis in the few cases with abnormal neurological outcome to exclude potentially overlapping biochemical defects and to explore potential genotype/phenotype correlation. © 2011 John Wiley & Sons A/S.

Citation

I A Almaghlouth, J Y Mohamed, M Al-Amoudi, L Al-Ahaidib, A Al-Odaib, F S Alkuraya. 5-Oxoprolinase deficiency: report of the first human OPLAH mutation. Clinical genetics. 2012 Aug;82(2):193-6

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PMID: 21651516

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