Creatine transporter deficiency: prevalence among patients with mental retardation and pitfalls in metabolite screening.
OBJECTIVE
To report the prevalence of creatine transporter deficiency in males with mental retardation and to study whether a protein-rich food intake might be a potential diagnostic pitfall.


METHODS
We determined creatine/creatinine ratio in urine samples from 1600 unrelated male patients with mental retardation and/or autism. Urine creatine was analyzed by HPLC-MS/MS.


RESULTS
Thirty-three of 1600 cases showed increased urine creatine/creatinine ratio. Four out of these thirty-three cases were definitively diagnosed with creatine transporter deficiency, while the other 29 were false positive results. Significantly higher values were observed for urine Cr/Crn ratio in healthy volunteers after a meal based on beef or oily fish as compared to eggs, pasta or salad (Wilcoxon test: p<0.005).


CONCLUSIONS
False positive results may be observed in biochemical screening for creatine transporter deficiency, and they may be due to intake of meals rich in creatine prior to urine samples analysis.
Arias
Angela
A
Institut de Bioquímica Clínica, Servicio de Bioquímica y Genética Molecular, Hospital Clínic and Centre for Biomedical Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Barcelona, Spain.
Corbella
Marc
M
Fons
Carmen
C
Sempere
Angela
A
García-Villoria
Judit
J
Ormazabal
Aida
A
Poo
Pilar
P
Pineda
Mercé
M
Vilaseca
María Antonia
MA
Campistol
Jaume
J
Briones
Paz
P
Pàmpols
Teresa
T
Salomons
Gajja S
GS
Ribes
Antonia
A
Artuch
Rafael
R
D001321:Autistic Disorder / Q000235:genetics / Q000652:urine; D002648:Child; D002675:Child, Preschool; D003401:Creatine / Q000652:urine; D003404:Creatinine / Q000652:urine; D005998:Glycine / Q000031:analogs & derivatives / Q000378:metabolism; D006801:Humans; D007223:Infant; D008607:Intellectual Disability / Q000235:genetics / Q000652:urine*; D008297:Male; D008403:Mass Screening / Q000379:methods*; D026901:Membrane Transport Proteins / Q000172:deficiency* / Q000235:genetics; D008661:Metabolism, Inborn Errors / Q000175:diagnosis* / Q000235:genetics / Q000378:metabolism; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity