title: Syndrome of encephalopathy, petechiae, and ethylmalonic aciduria.
abstract: We report a boy 20 months of age with encephalopathy, petechiae, and ethylmalonic aciduria (EPEMA). Other clinical features were severe hypotonia, orthostatic acrocyanosis, and chronic diarrhea. Magnetic resonance imaging (MRI) of the brain demonstrated bilateral lesions in the lenticular and caudate nuclei, periaqueductal region, subcortical areas, white matter, and brainstem. Short and medium chain Acyl-CoA dehydrogenase and cytochrome c oxidase (COX) activities in fibroblasts were normal. Muscle histochemistry disclosed diffuse COX deficiency, and respiratory chain activities in muscle disclosed severe COX deficiency. Twelve other patients with similar clinical features have been reported. Muscle COX activity, studied only in four, demonstrated a clear-cut defect.
authors.affiliation: Department of Pediatrics; Hospital 12 Octubre; Madrid, Spain.
authors.forename: M T
authors.initials: MT
authors.lastname: García-Silva
authors.forename: A
authors.initials: A
authors.lastname: Ribes
authors.forename: Y
authors.initials: Y
authors.lastname: Campos
authors.forename: B
authors.initials: B
authors.lastname: Garavaglia
authors.forename: J
authors.initials: J
authors.lastname: Arenas
mesh_terms: D001921:Brain / Q000473:pathology; D030401:Cytochrome-c Oxidase Deficiency; D004272:DNA, Mitochondrial / Q000235:genetics; D006801:Humans; D007223:Infant; D007888:Leigh Disease / Q000175:diagnosis / Q000201:enzymology / Q000235:genetics*; D008297:Male; D008314:Malonates / Q000652:urine*; D018482:Muscle, Skeletal / Q000473:pathology; D011693:Purpura / Q000175:diagnosis / Q000201:enzymology / Q000235:genetics*
chemical_list: D004272:DNA, Mitochondrial; D008314:Malonates; C038080:ethylmalonic acid