Movement Disorders (revue)

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Long-term follow-up and adult outcome of 6-pyruvoyl-tetrahydropterin synthase deficiency.

Identifieur interne : 002E74 ( PubMed/Corpus ); précédent : 002E73; suivant : 002E75

Long-term follow-up and adult outcome of 6-pyruvoyl-tetrahydropterin synthase deficiency.

Auteurs : Emmanuel Roze ; Marie Vidailhet ; Nenad Blau ; Lisbeth Birk Moller ; Diane Doummar ; Thierry Billette De Villemeur ; Anne Roubergue

Source :

RBID : pubmed:16161143

English descriptors

Abstract

Little information is available on the long-term course and adult outcome of patients with 6-pyruvoyl-tetrahydropterin synthase (PTPS) deficiency. We describe the course of a 32-year-old woman with hypotonia, dystonia, choreoathetosis, mental retardation, behavioral disturbances, and incomplete puberty due to PTPS deficiency. From the age of 6 months she developed progressive hypotonia and choreoathtetoid movements despite good control of hyperphenylalaninemia. Tetrahydrobiopterin deficiency was diagnosed at age 3 years. She had a dramatic response to L-dopa, which persisted at a stable dose for 29 years. Reducing the L-dopa dose led to severe axial hypotonia and limb dystonia, and increasing it led to florid abnormal movements and behavioral disorders. This report illustrates the role of dopamine modulation in motor, psychiatric, and endocrine functions.

DOI: 10.1002/mds.20699
PubMed: 16161143

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pubmed:16161143

Le document en format XML

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<nlm:affiliation>Department of Neurology, Saint-Antoine Hospital, Paris, France, and Division of Clinical Chemistry and Biochemistry, University Children's Hospital, Zurich, Switzerland. emmanuel.roze@sat.aphp.fr</nlm:affiliation>
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<name sortKey="Moller, Lisbeth Birk" sort="Moller, Lisbeth Birk" uniqKey="Moller L" first="Lisbeth Birk" last="Moller">Lisbeth Birk Moller</name>
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<term>Athetosis (diagnosis)</term>
<term>Athetosis (drug therapy)</term>
<term>Athetosis (enzymology)</term>
<term>Child</term>
<term>Child, Preschool</term>
<term>Chorea (diagnosis)</term>
<term>Chorea (drug therapy)</term>
<term>Chorea (enzymology)</term>
<term>Dose-Response Relationship, Drug</term>
<term>Dystonia (diagnosis)</term>
<term>Dystonia (drug therapy)</term>
<term>Dystonia (enzymology)</term>
<term>Female</term>
<term>Follow-Up Studies</term>
<term>Humans</term>
<term>Infant</term>
<term>Infant, Newborn</term>
<term>Levodopa (therapeutic use)</term>
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<term>Muscle Hypotonia (drug therapy)</term>
<term>Muscle Hypotonia (enzymology)</term>
<term>Neurologic Examination</term>
<term>Phenylketonurias (diagnosis)</term>
<term>Phenylketonurias (drug therapy)</term>
<term>Phenylketonurias (enzymology)</term>
<term>Phosphorus-Oxygen Lyases (deficiency)</term>
<term>Pterins (metabolism)</term>
<term>Treatment Outcome</term>
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<term>Follow-Up Studies</term>
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<term>Infant</term>
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<div type="abstract" xml:lang="en">Little information is available on the long-term course and adult outcome of patients with 6-pyruvoyl-tetrahydropterin synthase (PTPS) deficiency. We describe the course of a 32-year-old woman with hypotonia, dystonia, choreoathetosis, mental retardation, behavioral disturbances, and incomplete puberty due to PTPS deficiency. From the age of 6 months she developed progressive hypotonia and choreoathtetoid movements despite good control of hyperphenylalaninemia. Tetrahydrobiopterin deficiency was diagnosed at age 3 years. She had a dramatic response to L-dopa, which persisted at a stable dose for 29 years. Reducing the L-dopa dose led to severe axial hypotonia and limb dystonia, and increasing it led to florid abnormal movements and behavioral disorders. This report illustrates the role of dopamine modulation in motor, psychiatric, and endocrine functions.</div>
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