A Case of Late Onset Riboflavin-responsive Multiple Acyl-CoA Dehydrogenase Deficiency Manifesting as Recurrent Rhabdomyolysis and Acute Renal Failure

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  • Izumi Rumiko
    Department of Neurology, Tohoku University School of Medicine, Japan
  • Suzuki Naoki
    Department of Neurology, Tohoku University School of Medicine, Japan
  • Nagata Mari
    Department of Neurology, Tohoku University School of Medicine, Japan
  • Hasegawa Takafumi
    Department of Neurology, Tohoku University School of Medicine, Japan
  • Abe Yu
    Department of Medical Genetics, Tohoku University School of Medicine, Japan
  • Saito Yuka
    Department of Medical Genetics, Tohoku University School of Medicine, Japan
  • Mochizuki Hiroshi
    Department of Neurology, South Miyagi Medical Center, Japan
  • Tateyama Maki
    Department of Neurology, Tohoku University School of Medicine, Japan
  • Aoki Masashi
    Department of Neurology, Tohoku University School of Medicine, Japan

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抄録

We report an adult case of late-onset riboflavin-responsive multiple acyl-CoA dehydrogenase deficiency (MADD) characterized by episodic recurrent rhabdomyolysis and acute renal failure after the age of 46. Muscle biopsy revealed lipid storage myopathy and the finding of serum acylcarnitine and urine organic acid analyses were consistent with MADD. A compound heterozygous mutation was identified in the electron-transferring-flavoprotein dehydrogenase (ETFDH) gene, including a novel missense mutation, which confirmed the diagnosis of MADD. After administration of riboflavin and L-carnitine, the muscle weakness and fatigability gradually improved. Acylcarnitine and urine organic acid were also normalized after supplementation. Thus, MADD should be included in one of the differential diagnoses for adult recurrent rhabdomyolysis. Gene analysis is useful to confirm the diagnosis, and early diagnosis is important because riboflavin treatment has been effective in a significant number of patients with MADD.<br>

収録刊行物

  • Internal Medicine

    Internal Medicine 50 (21), 2663-2668, 2011

    一般社団法人 日本内科学会

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