ABSTRACT
CASO CLÍNICO: Paciente de 5 años de edad remitido para valoración oftalmológica con el diagnóstico de déficit de 3-hidroxiacil-CoA deshidrogenasa de cadena larga. Presentaba como antecedente la aparición de crisis metabólicas agudas precipitadas por infecciones banales y rabdomiólisis. El examen oftalmoscópico reveló una atrofia coriorretiniana peripapilar y una maculopatía granular difusa. La agudeza visual era de 6/6 en ambos ojos y las pruebas electrofisiológicas normales. DISCUSIÓN: Se realiza una revisión de la bibliografía y los conocimientos recientes de esta enfermedad mediante la descripción de un caso clínico documentando los hallazgos obtenidos mediante autofluorescencia y tomografía de coherencia óptica para mejorar el conocimiento existente sobre ella
CLINICAL CASE: A five-year-old patient, with a diagnosis of long-chain 3-hydroxyacyl-CoA dehydrogenase deficiency, was referred for an ophthalmological examination. He had a history of acute metabolic crises precipitated by intercurrent infections,as well as rhabdomyolysis. The fundoscopic examination revealed a peripapillary chorioretinal atrophy and a diffuse granular appearance of the macular retinal pigment epithelium. Best corrected visual acuity was 6/6 in both eyes, and he had a normal electroretinography test. DISCUSSION: We perform a review of the literature and recent findings in relation to this disease through the description of a clinical case in order to improve the knowledge of this uncommon disorder
Subject(s)
Humans , Male , Child , 3-Hydroxyacyl CoA Dehydrogenases/administration & dosage , 3-Hydroxyacyl CoA Dehydrogenases/analysis , 3-Hydroxyacyl CoA Dehydrogenases/deficiency , Long-Chain-3-Hydroxyacyl-CoA Dehydrogenase/analysis , Long-Chain-3-Hydroxyacyl-CoA Dehydrogenase/deficiency , Long-Chain-3-Hydroxyacyl-CoA Dehydrogenase/metabolism , Fatty Acids/analysis , Fatty Acids/physiology , Fatty Acids/therapeutic use , Early Diagnosis , Central Serous Chorioretinopathy/etiology , Central Serous Chorioretinopathy/pathology , Central Serous Chorioretinopathy/prevention & controlABSTRACT
INTRODUCTION: Abnormal fatty acid oxidation (FAO) and lipid metabolism have been found related to preeclampsia (PE). Antiphospholipid syndrome (APS) as a clinical risk factor for PE has also been reported with abnormal lipid metabolism. However, the role of FAO in PE accompanied with APS is unknown. We aimed to investigate long-chain FAO changes in a PE-like rodent model induced by beta 2-glycoprotein I (ß2GPI). METHODS: The PE-like model was established by injection of ß2GPI (ß2GPI group) or normal saline (control group) into C57BL/6J mice which were sacrificed on day 14 or 18 of gestation. Serum levels of anti-cardiolipin antibodies (aCL), anti-ß2GPI antibodies (aß2GPI) and serum lipids were assayed. Lipid deposition in the placenta and maternal liver was detected by lipid staining. Long-chain 3-hydroxyacyl-CoA dehydrogenase (LCHAD) mRNA and protein expression in the placenta and maternal liver was analyzed. RESULTS: The ß2GPI group showed PE-like symptoms including hypertension, proteinuria and adverse pregnancy outcomes. Serum aCL, aß2GPI, free fatty acid (FFA) and triglyceride (TG) levels in the ß2GPI group were significantly elevated compared with the corresponding control group (P < 0.05), while cholesterol showed no significant changes. Placenta and maternal liver fatty infiltration was found in the ß2GPI group. LCHAD mRNA and protein expression in the placenta and maternal liver in the ß2GPI group were significantly elevated compared with the corresponding control group (P < 0.05). CONCLUSION: ß2GPI can induce PE-like symptoms, elevated serum FFA and TG, and abnormal LCHAD expression in pregnant mice. Changes in long-chain FAO could be a factor linking PE and APS.