title: Clinical consequences of enzyme deficiencies in the erythrocyte.
abstract: The anucleate mature erythrocyte also lacks ribosomes and mitochondria and thus cannot synthesize enzymes or derive energy from the Krebs citric acid cycle. Nevertheless, the red blood cell is metabolically active and contains numerous residual enzymes and their products which are essential for its survival and normal functioning. Enzyme deficiencies in the Embden-Myerhoff glycolytic pathway can result in nonspherocytic hemolytic anemia (NSHA), and some are also associated with neuromuscular or neurologic disorders. Glucose-6-phosphate dehydrogenase deficiency in the hexose monophosphate shunt also results in hemolytic anemia, especially following exposure to various drugs. Defects in glutathione synthesis and pyrimidine 5'-nucleotidase deficiency also cause NSHA, as does increased adenosine deaminase activity. Gluthathione synthetase deficiency which is not limited to the red cell also presents as oxoprolinuria with neurologic signs. All red cell enzyme defects appear as single gene errors, in most cases recessive in inheritance, either autosomal of X-linked.
mesh_terms: D015720:5'-Nucleotidase; D000243:Adenosine Deaminase / Q000097:blood; D000746:Anemia, Hemolytic, Congenital Nonspherocytic / Q000097:blood* / Q000235:genetics; D001731:Bisphosphoglycerate Mutase / Q000172:deficiency; D004912:Erythrocytes / Q000201:enzymology*; D005634:Fructose-Bisphosphate Aldolase / Q000172:deficiency; D005955:Glucosephosphate Dehydrogenase Deficiency / Q000097:blood; D005978:Glutathione / Q000096:biosynthesis; D005987:Glyceraldehyde-3-Phosphate Dehydrogenases / Q000172:deficiency; D006593:Hexokinase / Q000172:deficiency; D006801:Humans; D009708:Nucleotidases / Q000172:deficiency; D010732:Phosphofructokinase-1 / Q000172:deficiency; D010735:Phosphoglycerate Kinase / Q000172:deficiency; D010751:Phosphopyruvate Hydratase / Q000172:deficiency; D010744:Phosphoric Monoester Hydrolases / Q000172:deficiency; D011742:Pyrimidine Nucleotides / Q000172:deficiency; D011770:Pyruvate Kinase / Q000172:deficiency; D014305:Triose-Phosphate Isomerase / Q000172:deficiency
chemical_list: D011742:Pyrimidine Nucleotides; C019794:bisphosphoglycerate phosphatase; D005987:Glyceraldehyde-3-Phosphate Dehydrogenases; D006593:Hexokinase; D010732:Phosphofructokinase-1; D011770:Pyruvate Kinase; D010735:Phosphoglycerate Kinase; D009708:Nucleotidases; D010744:Phosphoric Monoester Hydrolases; D015720:5'-Nucleotidase; D000243:Adenosine Deaminase; D005634:Fructose-Bisphosphate Aldolase; D010751:Phosphopyruvate Hydratase; D014305:Triose-Phosphate Isomerase; D001731:Bisphosphoglycerate Mutase; D005978:Glutathione