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Evolución clínica de pacientes chilenos con tirosinemia tipo I tratados con 2-(2-nitro-4-trifluorometilbenzoil)-1,3-ciclohexanediona (NTBC) / Clinical follow up of Chilean patients with tyrosinemia type 1 treated with 2-(2-nitro-4-trifluoromethylbenzoyl)-1,3-ciclohexanedione (NTBC)
Raimann, Erna; Cornejo, Verónica; Arias, Carolina; Cabello, Juan Francisco; Castro, Gabriela; Fernández, Eloina; de la Parra, Alicia.
  • Raimann, Erna; Universidad de Chile. Instituto de Nutrición y Tecnología de los Alimentos. Laboratorio de genética y enfermedades metabólicas. CL
  • Cornejo, Verónica; Universidad de Chile. Instituto de Nutrición y Tecnología de los Alimentos. Laboratorio de genética y enfermedades metabólicas. CL
  • Arias, Carolina; Universidad de Chile. Instituto de Nutrición y Tecnología de los Alimentos. Laboratorio de genética y enfermedades metabólicas. CL
  • Cabello, Juan Francisco; Universidad de Chile. Instituto de Nutrición y Tecnología de los Alimentos. Laboratorio de genética y enfermedades metabólicas. CL
  • Castro, Gabriela; Universidad de Chile. Instituto de Nutrición y Tecnología de los Alimentos. Laboratorio de genética y enfermedades metabólicas. CL
  • Fernández, Eloina; Universidad de Chile. Instituto de Nutrición y Tecnología de los Alimentos. Laboratorio de genética y enfermedades metabólicas. CL
  • de la Parra, Alicia; Universidad de Chile. Instituto de Nutrición y Tecnología de los Alimentos. Laboratorio de genética y enfermedades metabólicas. CL
Rev. méd. Chile ; 140(2): 169-175, feb. 2012. graf, tab
Article in Spanish | LILACS | ID: lil-627623
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%.

Aim:

To report the follow up of 12 patients treated with NTBC. Patients and

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.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Tyrosinemias / Cyclohexanones / Enzyme Inhibitors / Nitrobenzoates Type of study: Etiology study / Observational study / Prognostic study / Risk factors / Screening study Limits: Child, preschool / Female / Humans / Infant / Male Country/Region as subject: South America / Chile Language: Spanish Journal: Rev. méd. Chile Journal subject: Medicine Year: 2012 Type: Article Affiliation country: Chile Institution/Affiliation country: Universidad de Chile/CL

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Full text: Available Index: LILACS (Americas) Main subject: Tyrosinemias / Cyclohexanones / Enzyme Inhibitors / Nitrobenzoates Type of study: Etiology study / Observational study / Prognostic study / Risk factors / Screening study Limits: Child, preschool / Female / Humans / Infant / Male Country/Region as subject: South America / Chile Language: Spanish Journal: Rev. méd. Chile Journal subject: Medicine Year: 2012 Type: Article Affiliation country: Chile Institution/Affiliation country: Universidad de Chile/CL