title: 3-Ketothiolase deficiency: a review and four new patients with neurologic symptoms.
abstract: 3-Ketothiolase deficiency (3KTD) manifests with intermittent acidosis and is due to deficiency of mitochondrial 2-methylacetoacetate thiolase. Only 22 patients have been previously reported. Although its variable clinical presentation is recognized, the associated neurological findings have not been detailed. We report four new patients all with significant neurological symptoms. Three patients were examined with MRI of the brain which showed increased T2 intensity within the posterior lateral part of the putamen bilaterally. In two the MRI was otherwise normal; in one delayed myelination was also seen. These MRI putaminal findings may be typical enough to suggest the diagnosis of 3KTD. Two of the three had abnormal EEGs; one had an abnormal VEP. 3KTD can thus occur as an organic acidemia associated with encephalopathy.
authors.affiliation: Department of Pediatrics, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
authors.forename: P T
authors.initials: PT
authors.lastname: Ozand
authors.forename: M
authors.initials: M
authors.lastname: Rashed
authors.forename: G G
authors.initials: GG
authors.lastname: Gascon
authors.forename: A
authors.initials: A
authors.lastname: al Odaib
authors.forename: A
authors.initials: A
authors.lastname: Shums
authors.forename: M
authors.initials: M
authors.lastname: Nester
authors.forename: J
authors.initials: J
authors.lastname: Brismar
mesh_terms: D000102:Acetyl-CoA C-Acyltransferase / Q000172:deficiency*; D001921:Brain / Q000473:pathology; D002331:Carnitine / Q000097:blood; D002675:Child, Preschool; D004569:Electroencephalography; D005260:Female; D005347:Fibroblasts / Q000201:enzymology; D008401:Gas Chromatography-Mass Spectrometry; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D013058:Mass Spectrometry; D008661:Metabolism, Inborn Errors / Q000201:enzymology* / Q000235:genetics / Q000473:pathology; D008928:Mitochondria / Q000201:enzymology; D009422:Nervous System Diseases / Q000201:enzymology* / Q000235:genetics / Q000473:pathology; D010641:Phenotype
chemical_list: D000102:Acetyl-CoA C-Acyltransferase; D002331:Carnitine