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$Unique_ID{BRK03829}
$Pretitle{}
$Title{Homocystinuria}
$Subject{Homocystinuria Homocystinemia Cystathioninuria Marfan Syndrome }
$Volume{}
$Log{}
Copyright (C) 1987, 1988, 1990 National Organization for Rare Disorders,
Inc.
463:
Homocystinuria
** IMPORTANT **
It is possible the main title of the article (Homocystinuria) is not the
name you expected. Please check the SYNONYMS listing on the next page to
find alternate names, disorder subdivisions, and related disorders covered by
this article.
Synonyms
Homocystinemia
Information on the following disorders can be found in the Related
Disorders section of this report:
Cystathioninuria
Marfan Syndrome
General Discussion
** REMINDER **
The information contained in the Rare Disease Database is provided for
educational purposes only. It should not be used for diagnostic or treatment
purposes. If you wish to obtain more information about this disorder, please
contact your personal physician and/or the agencies listed in the "Resources"
section of this report.
Homocystinuria is a rare hereditary error of metabolism. The amino acid
methionine is not properly metabolized due to a defect in the enzyme
cystathionine synthetase.
Symptoms
Homocystinuria is a genetic disorder characterized by mental retardation,
dislocated lenses, sparse hair, chronic flushing of the face (malar flush),
and relaxation of ligaments. Patients may exhibit the symptoms of Marfan
Syndrome. This hereditary connective tissue disorder is characterized by an
elongated body, long, thin arms and legs, spiderlike hands and fingers,
cardiovascular defects, and depression of the breast bone (pectus excavatum).
The enzyme cystathionine synthetase is deficient in homocystinuria. The
amino acids homocystine and methionine are elevated in the blood plasma,
cerebro-spinal fluid and urine. The lenses of one or both eyes, may be out
of their normal position (ectopic), fibers of the lens may degenerate, and
zonal cataracts are possible. Porous bones (Osteoporosis) may also occur.
The walls of the blood vessels may show degeneration. Blood clots
(thromboemboli) may block the blood flow, possibly in the lung vessels
(pulmonary embolism), or in the blood vessels feeding the heart muscle
(coronary occlusion). These conditions may be life-threatening. (For more
information on cataracts, choose "cataracts" as your search term in the Rare
Disease Database; for more information on Osteoporosis, see the articles in
the Prevalent Health Conditions/Concerns area of NORD Services.)
Causes
Homocystinuria is a genetic disorder inherited through autosomal recessive
genes. Symptoms are caused by an inborn error of amino acid metabolism
resulting from deficiency of the enzyme cystathionine synthetase, responsible
for synthesis of the amino acid cystathionine.
Human traits including the classic genetic diseases, are the product of
the interaction of two genes for that condition, one received from the father
and one from the mother. In recessive disorders, the condition does not
appear unless a person inherits the same defective gene from each parent. If
one receives one normal gene and one gene for the disease, the person will be
a carrier for the disease, but usually will show no symptoms. The risk of
transmitting the disease to the children of a couple, both of whom are
carriers for a recessive disorder, is twenty-five percent. Fifty percent of
their children will be carriers, but healthy as described above. Twenty-five
percent of their children will receive both normal genes, one from each
parent and will be genetically normal.
Affected Population
Homocystinuria starts at birth. Males and females are affected in equal
numbers. Like other inborn errors of metabolism, it is a very rare disorder.
Related Disorders
Cystathioninuria is a genetic disorder transmitted through autosomal
recessive genes. It is caused by an inborn error of metabolism,
cystathionase. An excessive amount of cystathionine in the urine can be
identified by tests. Mental retardation sometimes also occurs.
Marfan Syndrome is a genetic disorder of connective tissue. It primarily
affects the bones and ligaments, the eyes, the cardiovascular system, and the
lungs. Persons with Marfan Syndrome will be tall, slender, and somewhat
loose-jointed. The arms, legs, and fingers may be disproportionately long.
(For more information on this disorder, choose "Marfan" as your search term
in the Rare Disease Database.)
Therapies: Standard
Treatment for Homocystinuria consists in controlled supplemental intake of
the amino acids methionine, cystine, and folic acid. Massive doses of
pyridoxine (a form of Vitamin B6) may also be prescribed. Genetic counseling
will be helpful for families of children with Homocystinuria.
Therapies: Investigational
In patients with Homocystinuria who are also affected by reduced activity of
the enzyme methionine synthase, experimental treatment with Vitamin B-12 is
being tested. More research is needed to determine effectiveness of this
treatment.
This disease entry is based upon medical information available through
March 1990. Since NORD's resources are limited, it is not possible to keep
every entry in the Rare Disease Database completely current and accurate.
Please check with the agencies listed in the Resources section for the most
current information about this disorder.
Resources
For more information on Homocystinuria, please contact:
National Organization for Rare Disorders (NORD)
P.O. Box 8923
New Fairfield, CT 06812-1783
(203) 746-6518
National Digestive Diseases Information Clearinghouse
Box NDDIC
Bethesda, MD 20892
(301) 468-6344
For information on genetics and genetic counseling referrals, please
contact:
March of Dimes Birth Defects Foundation
1275 Mamaroneck Avenue
White Plains, NY 10605
(914) 428-7100
Alliance of Genetic Support Groups
35 Wisconsin Circle, Suite 440
Chevy Chase, MD 20815
(800) 336-GENE
(301) 652-5553
References
THE METABOLIC BASIS OF INHERITED DISEASE, 5th ed.,: John B. Stanbury, et
al., eds.; McGraw Hill, 1983.