3-Hydroxy-3-Methylglutaryl-CoA Lyase Deficiency

What is 3-hydroxy-3-methylglutaryl-CoA lyase deficiency?

3-hydroxy-3-methylglutaryl-CoA lyase deficiency (also referred to as HMG-CoA lyase deficiency) is an uncommon inherited disorder in which the body cannot properly process a particular amino acid (a building block of proteins). Additionally, the disorder prevents the body from making ketones, which are used for energy during fasting (periods without food). This disorder usually appears within the first year of life. The signs and symptoms of HMG-CoA lyase deficiency include vomiting, dehydration, extreme tiredness (lethargy), convulsions, and coma. When episodes occur in an infant or child, blood sugar becomes extremely low (hypoglycemia), and harmful compounds can build up and cause the blood to become too acidic (metabolic acidosis). These episodes are often triggered by an infection, fasting, strenuous exercise, or sometimes other types of stress.

This condition is sometimes mistaken for Reye syndrome, a severe disorder that develops in children while they appear to be recovering from viral infections such as chicken pox or flu. Most cases of Reye syndrome are associated with the use of aspirin during these viral infections.

How common is 3-hydroxy-3-methylglutaryl-CoA lyase deficiency?

This is a rare condition that has been reported in fewer than 100 individuals throughout the world.

What genes are related to 3-hydroxy-3-methylglutaryl-CoA lyase deficiency?

Mutations in the HMGCL gene cause 3-hydroxy-3-methylglutaryl-CoA lyase deficiency.

The enzyme made by the HMGCL gene plays an essential role in breaking down dietary proteins and fats for energy. Specifically, the enzyme is responsible for processing leucine, an amino acid that is part of many proteins. This enzyme also produces ketones during the breakdown of fats. If a mutation in the HMGCL gene reduces or eliminates the activity of this enzyme, the body is unable to process leucine or make ketones properly. A lack of ketones leads to hypoglycemia, and compounds called organic acids (which are formed as products of amino acid and fat breakdown) can cause the blood to become too acidic. Metabolic acidosis and hypoglycemia impair tissue function, especially in the central nervous system.

How do people inherit 3-hydroxy-3-methylglutaryl-CoA lyase deficiency?

This condition is inherited in an autosomal recessive pattern, which means two copies of the gene in each cell are altered. Most often, the parents of an individual with an autosomal recessive disorder are carriers of one copy of the altered gene but do not show signs and symptoms of the disorder.

What other names do people use for 3-hydroxy-3-methylglutaryl-CoA lyase deficiency?

  • Deficiency of hydroxymethylglutaryl-CoA lyase
  • HMG-CoA lyase deficiency
  • Hydroxymethylglutaric aciduria
  • 3-OH 3-CH3 glutaric aciduria

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