title: 3-Methylglutaconic aciduria in the Iraqi-Jewish 'optic atrophy plus' (Costeff) syndrome.
abstract: Eleven new patients of Iraqi-Jewish origin with bilateral optic atrophy, neurological abnormalities ('optic atrophy plus' syndrome) and 3-methylglutaconic aciduria (type III) are described. Clinical abnormalities in decreasing order of frequency were bilateral optic atrophy, extrapyramidal signs, spasticity, ataxia, dysarthria and cognitive deficit. An association with age was found only for spasticity. Spasticity, extrapyramidal signs and optic atrophy frequently led to major disability, in contrast to ataxia, dysarthria and cognitive deficit. The combined excretion of 3-methylglutaconic and 3-methylglutaric acid ranged between 9 and 187 mmol/mol creatinine. The primary enzymatic defect possibly may reside in the mitochondrial respiratory chain.
authors.affiliation: Metabolic Unit, Shaare Zedek Medical Center, Jerusalem, Israel.
authors.forename: O N
authors.initials: ON
authors.lastname: Elpeleg
authors.forename: H
authors.initials: H
authors.lastname: Costeff
authors.forename: A
authors.initials: A
authors.lastname: Joseph
authors.forename: Y
authors.initials: Y
authors.lastname: Shental
authors.forename: R
authors.initials: R
authors.lastname: Weitz
authors.forename: K M
authors.initials: KM
authors.lastname: Gibson
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003072:Cognition Disorders / Q000208:ethnology / Q000652:urine; D005260:Female; D005977:Glutarates / Q000652:urine*; D006801:Humans; D007493:Iraq; D007585:Jews; D008297:Male; D015093:Meglutol / Q000031:analogs & derivatives / Q000652:urine; D009069:Movement Disorders / Q000208:ethnology* / Q000652:urine; D009896:Optic Atrophy / Q000208:ethnology* / Q000652:urine; D013577:Syndrome
chemical_list: D005977:Glutarates; C033686:3-methylglutaric acid; C022034:3-methylglutaconic acid; D015093:Meglutol