title: Antenatal and postnatal radiologic diagnosis of holocarboxylase synthetase deficiency: a systematic review.
abstract: BACKGROUND
  Holocarboxylase synthetase deficiency results in impaired activation of enzymes implicated in glucose, fatty acid and amino acid metabolism. Antenatal imaging and postnatal imaging are useful in making the diagnosis. Untreated holocarboxylase synthetase deficiency is fatal, while antenatal and postnatal biotin supplementation is associated with good clinical outcomes. Although biochemical assays are required for definitive diagnosis, certain radiologic features assist in the diagnosis of holocarboxylase synthetase deficiency.
  
  
  OBJECTIVE
  To review evidence regarding radiologic diagnostic features of holocarboxylase synthetase deficiency in the antenatal and postnatal period.
  
  
  METHODS
  A systematic review of all published cases of holocarboxylase synthetase deficiency identified by a search of Pubmed, Scopus and Web of Science.
  
  
  RESULTS
  A total of 75 patients with holocarboxylase synthetase deficiency were identified from the systematic review, which screened 687 manuscripts. Most patients with imaging (19/22, 86%) had abnormal findings, the most common being subependymal cysts, ventriculomegaly and intraventricular hemorrhage.
  
  
  CONCLUSIONS
  Although the radiologic features of subependymal cysts, ventriculomegaly, intraventricular hemorrhage and intrauterine growth restriction may be found in the setting of other pathologies, these findings should prompt consideration of holocarboxylase synthetase deficiency in at-risk children.
authors.affiliation: Gold Coast Hospital and Health Service, Southport, Queensland, 4215, Australia.|School of Medicine, Griffith University, Southport, Queensland, 4215, Australia.
authors.forename: Sahan P Semasinghe
authors.initials: SP
authors.lastname: Bandaralage
authors.affiliation: Caboolture Hospital, Caboolture, Queensland, 4510, Australia.
authors.forename: Soheil
authors.initials: S
authors.lastname: Farnaghi
authors.affiliation: Redcliffe Hospital, Redcliffe, Queensland, 4020, Australia.|School of Medicine, The University of Queensland, Herston, Queensland, 4006, Australia.
authors.forename: Joel M
authors.initials: JM
authors.lastname: Dulhunty
authors.affiliation: Redcliffe Hospital, Redcliffe, Queensland, 4020, Australia. alka.kothari@uq.edu.au.|School of Medicine, The University of Queensland, Herston, Queensland, 4006, Australia. alka.kothari@uq.edu.au.
authors.forename: Alka
authors.initials: A
authors.lastname: Kothari
mesh_terms: D020863:Central Nervous System Cysts / Q000000981:diagnostic imaging* / Q000453:epidemiology; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging* / Q000453:epidemiology; D003937:Diagnosis, Differential; D005260:Female; D028922:Holocarboxylase Synthetase Deficiency / Q000000981:diagnostic imaging* / Q000453:epidemiology; D006801:Humans; D006849:Hydrocephalus / Q000000981:diagnostic imaging* / Q000453:epidemiology; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data*; D008297:Male; D015995:Prevalence; D015203:Reproducibility of Results; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D016216:Ultrasonography, Prenatal / Q000706:statistics & numerical data*; D051598:Whole Body Imaging / Q000379:methods / Q000706:statistics & numerical data
keywords: Biotin; Fetus; Holocarboxylase synthetase deficiency; Intraventricular hemorrhage; Neonate; Subependymal cysts; Ventriculomegaly