title: Successful intrauterine treatment of a patient with cobalamin C defect.
abstract: Cobalamin C (cblC) defect is an inherited autosomal recessive disorder that affects cobalamin metabolism. Patients are treated with hydroxycobalamin to ameliorate the clinical features of early-onset disease and prevent clinical symptoms in late-onset disease. Here we describe a patient in whom prenatal maternal treatment with 30 mg/week hydroxycobalamin and 5 mg/day folic acid from week 15 of pregnancy prevented disease manifestation in a girl who is now 11 years old with normal IQ and only mild ophthalmic findings. The affected older sister received postnatal treatment only and is severely intellectually disabled with severe ophthalmic symptoms. This case highlights the potential of early, high-dose intrauterine treatment in a fetus affected by the cblC defect.
authors.affiliation: University Children's Hospital, Department of Metabolism and Pediatric Medicine, Heidelberg, Germany.
authors.forename: Friedrich K
authors.initials: FK
authors.lastname: Trefz
authors.affiliation: Klinik für Kinder und Jugendmedizin Reutlingen, Germany.
authors.forename: Dagmar
authors.initials: D
authors.lastname: Scheible
authors.affiliation: Klinik für Kinder und Jugendmedizin Reutlingen, Germany.
authors.forename: Georg
authors.initials: G
authors.lastname: Frauendienst-Egger
authors.affiliation: Department of Paediatrics, Landeskrankenhaus Bregenz, Austria; University Children's Hospital Zürich, Switzerland.
authors.forename: Martina
authors.initials: M
authors.lastname: Huemer
authors.affiliation: University Children's Hospital Zürich, Switzerland.
authors.forename: Terttu
authors.initials: T
authors.lastname: Suomala
authors.affiliation: University Children's Hospital Zürich, Switzerland.
authors.forename: Brian
authors.initials: B
authors.lastname: Fowler
authors.affiliation: University Children's Hospital, Department of Metabolism and Pediatric Medicine, Heidelberg, Germany.
authors.forename: Dorothea
authors.initials: D
authors.lastname: Haas
authors.affiliation: University Children's Hospital Zürich, Switzerland.
authors.forename: Matthias R
authors.initials: MR
authors.lastname: Baumgartner
keywords: AdoCbl, adenosylcobalamin; CNCbl, cyanocobalamin; Cobalamin C defect; Hcy, homocysteine; Homocysteine; Hydroxycobalamin; Inborn error of metabolism; Intrauterine treatment; MeCbl, methylcobalamin; OHCbl, hydroxycobalamin; cblC, cobalamin C; tHcy, total homocysteine