title: [Clinical follow up of Chilean patients with tyrosinemia type 1 treated with 2-(2-nitro-4-trifluoromethylbenzoyl)-1,3-ciclohexanedione (NTBC)].
abstract: BACKGROUND
  Tyrosinemia type I is an inborn error of metabolism due to deficiency of fumarilacetoacetase. Acute presentation is with liver failure, hypophosphatemic rickets and peripheral neuropathy. Chronic presentation is with visceromegaly and subclinical rickets. The most severe complications are hepatic cancer and acute neurological crises. Without treatment, tyrosinemia type 1 is fatal. In 1992 treatment for tyrosinemia type 1 with 2-(2-nitro-4-trifluoromethybenzoyl)-1,3-ciclohexanedione (NTBC) was proposed. A clinical response was reported in 90% of patients. In cases that did not respond, a successful liver transplantation was performed, reducing mortality to 5%.
  
  
  OBJECTIVE
  To report the follow up of 12 patients treated with NTBC.
  
  
  METHODS
  Review of clinical records of 12 Chilean cases treated with NTBC at the Instituto de Nutrición y Tecnología de los Alimentos (INTA) from January 2004 until June 2010.
  
  
  RESULTS
  In all patients, a rapid metabolic control was achieved. Two patients developed hepatocarcinoma. One of these patients died and one was successfully treated with liver transplantation. One patient died after receiving a liver transplantation. Nine patients have at present good liver function, but 2 had peripheral neuropathy due to late diagnosis and discontinuing NTBC treatment.
  
  
  CONCLUSIONS
  Treatment with NTBC allows metabolic normalization in tyrosinemia type 1, prevents liver cirrhosis and hepatic cancer, improving survival rates and quality of life in the patients. Neonatal screening is essential for the early diagnosis of this treatable disease, that otherwise may be lethal.
authors: Laboratorio de genética y enfermedades metabólicas, Instituto de Nutrición y Tecnología de los Alimentos, Universidad de Chile, Chile. eraimann@inta.uchile.cl
authors: Erna
authors: E
authors: Raimann
authors: Verónica
authors: V
authors: Cornejo
authors: Carolina
authors: C
authors: Arias
authors: Juan Francisco
authors: JF
authors: Cabello
authors: Gabriela
authors: G
authors: Castro
authors: Eloina
authors: E
authors: Fernández
authors: Alicia
authors: A
authors: de la Parra
mesh_terms: D002675:Child, Preschool; D002677:Chile; D003512:Cyclohexanones / Q000627:therapeutic use*; D004791:Enzyme Inhibitors / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008113:Liver Neoplasms / Q000209:etiology / Q000517:prevention & control; D016031:Liver Transplantation / Q000009:adverse effects / Q000401:mortality; D008297:Male; D009579:Nitrobenzoates / Q000627:therapeutic use*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D020176:Tyrosinemias / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism
chemical_list: D003512:Cyclohexanones; D004791:Enzyme Inhibitors; D009579:Nitrobenzoates; C077073:nitisinone