1. Liver neoplasms in methylmalonic aciduria: An emerging complication.
- Author
-
Forny P, Hochuli M, Rahman Y, Deheragoda M, Weber A, Baruteau J, and Grunewald S
- Subjects
- Acidosis, Lactic complications, Adult, Age of Onset, Amino Acid Metabolism, Inborn Errors diagnosis, Brain Diseases, Metabolic, Inborn complications, Child, Female, Humans, Infant, Infant, Newborn, Liver diagnostic imaging, Male, Metabolism, Inborn Errors complications, Methylmalonyl-CoA Mutase deficiency, Tomography, X-Ray Computed, Ultrasonography, Young Adult, Amino Acid Metabolism, Inborn Errors complications, Liver pathology, Liver Neoplasms etiology, Liver Neoplasms pathology
- Abstract
Methylmalonic aciduria (MMA) is an inherited metabolic disease caused by methylmalonyl-CoA mutase deficiency. Early-onset disease usually presents with a neonatal acute metabolic acidosis, rapidly causing lethargy, coma, and death if untreated. Late-onset patients have a better prognosis but develop common long-term complications, including neurological deterioration, chronic kidney disease, pancreatitis, optic neuropathy, and chronic liver disease. Of note, oncogenesis has been reported anecdotally in organic acidurias. Here, we present three novel and two previously published cases of MMA patients who developed malignant liver neoplasms. All five patients were affected by a severe, early-onset form of isolated MMA (4 mut
0 , 1 cblB subtype). Different types of liver neoplasms, that is, hepatoblastoma and hepatocellular carcinoma, were diagnosed at ages ranging from infancy to adulthood. We discuss pathophysiological hypotheses involved in MMA-related oncogenesis such as mitochondrial dysfunction, impairment of tricarboxylic acid cycle, oxidative stress, and effects of oncometabolites. Based on the intriguing occurrence of liver abnormalities, including neoplasms, we recommend close biochemical and imaging monitoring of liver disease in routine follow-up of MMA patients., (© 2019 SSIEM.)- Published
- 2019
- Full Text
- View/download PDF