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Difficulties in assessing the effect of strychnine on the outcome of non-ketotic hyperglycinaemia. Observations on sisters with a mild T-protein defect

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Abstract

Sisters with a mild variant of non-ketotic hyperglycinaemia resulting from a defect in the T-protein of the glycine cleavage system had different clinical outcomes. The older sister was ascertained at 6 months of age because of mental retardation. She received only brief treatment with sodium benzoate from 11–15 months and at 15 years of age is profoundly retarded and has epilepsy. The younger sister was diagnosed 36h after birth, was treated with strychnine, sodium benzoate and arginine from the neonatal period and at 27 months of age is only moderately retarded and free of seizures. The possible role of strychnine in the improved outcome is discussed.

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Abbreviations

NKH:

non-ketotic hyperglycinaemia

CSF:

cerebrospinal fluid

References

  1. Ando T, Nyhan WL, Bicknell J, Harris R, Stern J (1978) Nonketotic hyperglycinaemia in a family with an unusual phenotype. J Inherited Metab Dis 1:79–83

    Google Scholar 

  2. Applegarth DA, Edelsten AD, Wong LTK, Morrison BJ (1979) Observed range of assay values for plasma and cerebrospinal fluid amino acid levels in infants and children aged 3 months to 10 years. Clin Biochem 12:173–178

    Google Scholar 

  3. Arneson D, Chien LT, Chance P, Wilroy RS (1979) Strychnine therapy in non-ketotic hyperglycinemia. Pediatrics 63:369–373

    Google Scholar 

  4. Bank WJ, Morrow G (1972) A familial spinal cord disorder with hyperglycinaemia. Arch Neurol 27:136–144

    Google Scholar 

  5. Carson NAJ (1982) Non-ketotic hyperglycinaemia — a review of 70 patients. J Inherited Metab Dis 5 [Suppl 2]:126–128

    Google Scholar 

  6. Cole EC, Meek DC (1985) Juvenile non-ketotic hyperglycinaemia (NKH) in 3 siblings. J Inherited Metab Dis 8[Suppl 2]:123–124

    Google Scholar 

  7. Degroot CJ, Troelstra HA, Hommes FA (1970) Non-ketotic hyperglycinaemia: an in vitro study of the glycine-serine conversion in liver of three patients and the effect of dietary methionine. Pediatr Res 4:238–243

    Google Scholar 

  8. Dickinson JC, Hamilton PB (1966) The free amino acids of human spinal fluid determined by ion exchange chromatography. J Neurochem 13:1179–1187

    Google Scholar 

  9. Flannery DB, Pellock J, Bousounis D, Hunt P, Nance C, Wolf B (1983) Non-ketotic hyperglycinemia in two retarded adults: a mild form of infantile non-ketotic hyperglycinemia. Neurology 33: 1064–1066

    Google Scholar 

  10. Frazier DM, Summer GK, Chamberlin HR (1978) Hyperglycinuria and hyperglycinemia in two siblings with mild developmental delays. Am J Dis Child 132:777–781

    Google Scholar 

  11. Gitzelmann R, Steinmann B, Otten A, Dumermuth G, Herdan M, Reubi JC, Cuenod M (1977) Non-ketotic hyperglycinemia treated with strychine, a glycine receptor antagonist. Helv Paediatr Acta 32:517–525

    Google Scholar 

  12. Hayasaka K, Tada K, Kikuchi G, Winter S, Nyhan WL (1983) Non-ketotic hyperglycinemia: two patients with primary defects of P-protein and T-protein, respectively, in the glycine cleavage system. Pediatr Res 17:967–975

    Google Scholar 

  13. Holmgren G, Blomquist K (1977) Non-ketotic hyperglycinemia in two siblings with mild psycho-neurological symptoms. Neuropaediatrie 8:67–72

    Google Scholar 

  14. Krieger I, Winbaum ES, Eisenbrey AB (1977) Cerebrospinal fluid glycine in non-ketotic hyperglycinemia. Effect of treatment with sodium benzoate and a ventricular shunt. Metabolism 26:517

    Google Scholar 

  15. Lefauconnier JM, Trouve R (1983) Developmental changes in the pattern of amino acid transport at the blood-brain barrier in rats. Dev Brain Res 6:175–182

    Google Scholar 

  16. MacDermot KD, Nelson W, Soutter V, Towne D, Schulman JD (1981) Glycine and benzoate conjugation and glycine acyl transferase activity in the developing and adult rat: possible relationship to non-ketotic hyperglycinemia. Dev Pharmacol Ther 3:150–159

    Google Scholar 

  17. Nyhan WL (1983) In: Stanbury JB, Wyngaarden JB, Fredrickson DS, Goldstein JL, Brown MS (eds) The metabolic basis of inherited disease, (5th edn.) McGraw-Hill, New York, pp 561–569

    Google Scholar 

  18. Okken A, Degroot CJ, Hommes FA (1970) Non-ketotic hyperglycinemia. J Pediatr 77:164–165

    Google Scholar 

  19. Parvey Ph, Huang Y, Kamoun P (1979) Age related reference values for urinary free amino acids: a simple method of evaluation. J Clin Chem Clin Biochem 17:205–210

    Google Scholar 

  20. Perry TL, Hansen S, Kennedy J (1975) CSF amino acids and plasma-CSF amino acid ratios in adults. J Neurochem 24:587–589

    Google Scholar 

  21. Pohlandt F (1978) Plasma amino acid concentrations in newborn infants breast-fed ad libitum. J Pediatr 92:614–616

    Google Scholar 

  22. Steiman GS, Yudkoff M, Berman PH, Blazer-Yost B, Segal S (1979) Late-onset non-ketotic hyperglycinemia and spinocerebellar degeneration. J Pediatr 94:907–911

    Google Scholar 

  23. Steinmann B, Gitzelmann R (1979) Strychnine treatment attempted in newborn twins with severe non-ketotic hyperglycinemia. Helv Paediatr Acta 34:589–599

    Google Scholar 

  24. Trauner DA, Page T, Greco C, Sweetman L, Kulovich S, Nyhan WL (1981) Progressive neurodegenerative disorder in a patient with non-ketotic hyperglycinemia. J Pediatr 98:272–277

    Google Scholar 

  25. Von Wendt L, Simila S, Saukkonen A-L, Koivisto M (1980) Failure of strychnine therapy during the neonatal period in three Finnish children with non-ketotic hyperglycinemia. Pediatrics 65: 1166–1169

    Google Scholar 

  26. Von Wendt L, Simila S, Saukkonen A-L, Koivisto M, Kouvalainen K (1981) Prenatal brain damage in non-ketotic hyperglycinemia. Am J Dis Child 135:1072

    Google Scholar 

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Haan, E.A., Kirby, D.M., Tada, K. et al. Difficulties in assessing the effect of strychnine on the outcome of non-ketotic hyperglycinaemia. Observations on sisters with a mild T-protein defect. Eur J Pediatr 145, 267–270 (1986). https://doi.org/10.1007/BF00439398

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  • DOI: https://doi.org/10.1007/BF00439398

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