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Disorders of Tyrosine Metabolism

  • Chapter
Inborn Metabolic Diseases

Abstract

Five inherited disorders of tyrosine catabolism are known and depicted in Fig. 15.1. Hereditary tyrosinaemia type I is characterized by progressive liver disease and renal tubular dysfunction with rickets. Hereditary tyrosinaemia type II (Richner-Hanhart syndrome) presents with keratitis and blisterous lesions of the palms and soles. Tyrosinaemia type III may be asymptomatic or associated with mental retardation. Hawkinsinuria may be asymptomatic or presents with failure to thrive and metabolic acidosis in infancy. In alkaptonuria symptoms of osteoarthritis usually appear at an advanced age. Other inborn errors of tyrosine metabolism include oculocutaneous albinism caused by a deficiency of melanocyte-specific tyrosinase, converting tyrosine into DOPA-quinone; the deficiency of tyrosine hydroxylase, the first enzyme in the synthesis of dopamine from tyrosine; and the deficiency of aromatic l-amino acid decarboxylase, which also affects tryptophan metabolism. The latter two disorders are covered in Chap. 26.

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References

  1. Gibbs TC, Payan J, Brett EM, Lindstedt S, Holme E, Clayton PT (1993) Peripheral neuropathy as the presenting feature of tyrosinaemia type I and effectively treated with an inhibitor of 4-hydroxyphenylpyruvate dioxygenase. J Neurol Neurosurg Psychiatr 56: 1129–1132

    Article  PubMed  CAS  Google Scholar 

  2. Mitchell G, Larochelle J, Lambert M, Michaud J, Grenier A, Ogier H, Gauthier M, Lacroix J, Vanasse M, Larbrisseau A, Paradis K, Weber A, Lefevre Y, Melancon S, Daillaire L (1990) Neurologic crisis in hereditary tyrosinemia. N Engl J Med 322: 432–437

    Article  PubMed  CAS  Google Scholar 

  3. Macvicar D, Dicks-Mireaux C, Leonard JV, Wight DG (1990) Hepatic imaging with computed tomography of chronic tyrosin-aemia type I. Br J Radiol 63: 605–608

    Article  PubMed  CAS  Google Scholar 

  4. Kvittingen EA, Talseth T, Halvorsen S, Jakobs C, Hovig T, Flatmark A (1991) Renal failure in adult patients with hereditary tyrosinaemia type I. J Inherit Metab Dis 14: 53–62

    Article  PubMed  CAS  Google Scholar 

  5. Weinberg AG, Mize CE, Worthen HG (1976) The occurrence of hepatoma in the chronic form of hereditary tyrosinemia. J Pediatr 88: 434–438

    Article  PubMed  CAS  Google Scholar 

  6. Jakobs C, Dorland L, Wikkerink B, Kok RM, de Jong APJM, Wadman SK (1988) Stable isotope dilution analysis of succinylacetone using electron capture negative ion mass fragmentography: an accurate approach to the pre-and neonatal diagnosis of hereditary tyrosinemia type I. Clin Chim Acta 223: 223–232

    Article  Google Scholar 

  7. Kvittingen EA (1991) Tyrosinaemia type I–an update. J Inherit Metab Dis 14: 554–562

    Article  PubMed  CAS  Google Scholar 

  8. Kvittingen EA, Rootwelt H, Brandtzaeg P, Bergan A, Berger R (1993) Hereditary tyrosinemia type I. Self-induced correction of the fumarylacetoacetase defect. J Clin Invest 91: 1816–1821

    Google Scholar 

  9. Lindstedt S, Holme E, Lock EA, Hjalmarson O, Strandvik B (1992) Treatment of hereditary tyrosinaemia type I by inhibition of 4-hydroxyphenylpyruvate dioxygenase. Lancet 340: 813–817

    Article  PubMed  CAS  Google Scholar 

  10. Holme E, Lindstedt S (1998) Tyrosinaemia type I and NTBC (2-(2-nitro-4-trifluoromethylbenzoyl) -1,3-cyclohexanedione). J Inherit Metab Dis 21: 507–517

    Article  PubMed  CAS  Google Scholar 

  11. n. Pronicka E, Rowinska E, Bentkowski Z, Zawadski J, Holme E, Lindstedt S (1996) Treatment of two children with hereditary tyrosinaemia type I and long-standing renal disease with a 4hydroxyphenylpyruvate dioxygenase ( NTBC ). J Inherit Metab Dis 19: 234–238

    Google Scholar 

  12. Dionisi-Vici C, Boglino C, Marcellini M, De Sio L, Inserra A, Cotugnu G, Sabetta G, Donfrancesco A (1997) Tyrosinemia type I with early metastatic hepatocellular carcinoma: combined treatment with NTBC, chemotherapy and surgical mass removal. J Inherit Metab Dis 20 [Supp] 11: 15

    Google Scholar 

  13. Mieles LA, Esquivel CO, van Thiel DH, Koneru B, Makowka L, Tzakis AG, Starzl TE (1990) Liver transplantation for tyrosinemia. A review of 10 cases from the University of Pittsburgh. Dig Dis Sci 35: 153–157

    Article  PubMed  CAS  Google Scholar 

  14. Burdelski M, Rodeck B, Latta A, Brodehl J, Ringe B, Pichlmayr R (1991) Treatment of inherited metabolic disorders by liver transplantation. J Inherit Metab Dis 14: 604–618

    Article  PubMed  CAS  Google Scholar 

  15. Kelly DA (1998) Current results and evolving indications for liver transplantation in children. J Pediatr Gastroenterol Nutr 27: 214–221

    Article  PubMed  CAS  Google Scholar 

  16. Halvorsen S, Gjessing LR (1964) Studies on tyrosinosis: 1. Effect of low-tyrosine and low-phenylalanine diet. Br Med J 2: 1171–1173

    Google Scholar 

  17. van Spronsen FJ, Thomasse Y, Smit GP, Leonard JV, Clayton PT, Fidler V, Berger R, Heymans HS (1994) Hereditary tyrosinemia type I: a new clinical classification with difference in prognosis on dietary treatment. Hepatology 20: 1187–1191

    Article  PubMed  Google Scholar 

  18. Grompe M, Al-Dhalimy M (1993) Mutations of the fumarylacetoacetate hydrolase gene in four patients with tyrosinemia type I. Hum Mutat 2: 85–93

    Article  PubMed  CAS  Google Scholar 

  19. Labelle Y, Phaneuf D, Leclerc B, Tanguay RM (1993) Characterization of the human fumarylacetoacetate hydrolase gene and identification of a missense mutation abolishing enzymatic activity. Hum Mol Genet 2: 941–946

    Article  PubMed  CAS  Google Scholar 

  20. Rootwelt H, Hoie K, Berger R, Kvittingen EA (1996) Fumarylacetoacetase mutations in tyrosinaemia type I. Hum Mutat 7: 239–243

    Article  PubMed  CAS  Google Scholar 

  21. Bergman AJ, van den Berg IE, Brink W, Poll-The BT, Ploos van Amstel JK, Berger R (1998) Spectrum of mutations in the fumarylacetoacetate hydrolase gene of tyrosinemia type 1 patients in northwestern Europe and Mediterranean countries. Hum Mutat 12: 19–26

    Article  PubMed  CAS  Google Scholar 

  22. Grompe M, St-Louis M, Demers SI, al-Dhalimy M, Leclerc B, Tanguay RM (1994) A single mutation of the fumarylacetoacetate hydrolase gene in French Canadians with hereditary tyrosinemia type I. N Engl J Med 331: 353–357

    Article  PubMed  CAS  Google Scholar 

  23. Kvittingen EA, Brodtkorb E (1986) The pre-and post-natal diagnosis of tyrosinemia type I and the detection of the carrier state by assay of fumarylacetoacetase. Scand J Clin Lab Invest 46 [Supp] 1841: 35–40

    Google Scholar 

  24. Buist NRM, Kennaway NG, Fellman JH (1985) Tyrosinaemia type II. In: Bickel H, Wachtel U (eds) Inherited diseases of amino-acid metabolism. Thieme, Stuttgart, pp 203–235

    Google Scholar 

  25. Heidemann DG, Dunn SP, Bawle EV, Shepherd DM (1989) Early diagnosis of tyrosinemia type II. Am J Ophthalmol 107: 559–560

    PubMed  CAS  Google Scholar 

  26. Paige DG, Clayton P, Bowron A, Harper JI (1992) RichnerHanhart syndrome (oculocutaneous tyrosinaemia type II). J R Soc Med 85: 759–760

    PubMed  CAS  Google Scholar 

  27. Barr DGD, Kirk JM, Laing SC (1991) Outcome of tyrosinaemia type II. Arch Dis Child 66: 1249–1250

    Article  PubMed  CAS  Google Scholar 

  28. Francis DEM, Kirby DM, Thompson GN (1992) Maternal tyrosinaemia type II: management and successful outcome. Eur J Pediatr 151: 196–199

    Article  PubMed  CAS  Google Scholar 

  29. Natt E, Kida K, Odievre M, Di Rocco M, Scherer G (1992) Point mutations in the tyrosine aminotransferase gene in tyrosinemia type II. Proc Natl Acad Sci USA 89: 9297–9301

    Article  PubMed  CAS  Google Scholar 

  30. Huhn R, Stoermer H, Klingele B, Bausch E, Fois A, Farnetani M, Di Rocco M, Boue J, Kirk JM, Coleman R, Scherer G (1998) Novel and recurrent tyrosine aminotransferase gene mutations in tyrosinemia type II. Hum Genet 102: 305–313

    Article  PubMed  CAS  Google Scholar 

  31. Endo F, Kitano A, Uehara I, Nagata N, Matsuda I, Shinka T, Kuhara T, Matsumoto I (1983) Four-hydroxyphenylpyruvic acid oxidase deficiency with normal fumarylacetoacetase: a new variant form of hereditary hypertyrosinemia. Pediatr Res 17: 92–96

    Article  PubMed  CAS  Google Scholar 

  32. Giardini O, Cantani A, Kennaway NG, D’Eufemia P (1983) Chronic tyrosinemia associated with 4-hydroxyphenylpyruvate dioxygenase deficiency with acute intermittent ataxia and without visceral and bone involvement. Pediatr Res 17: 25–29

    Article  PubMed  CAS  Google Scholar 

  33. Preece MA, Rylance GW, MacDonald A, Green A, Gray RGF (1996) A new case of tyrosinaemia type III detected by neonatal screening. J Inherit Metab Dis 19 [Suppl] 11: 32

    Google Scholar 

  34. Cerone R, Holme E, Schiaffino MC, Caruso U, Maritano L, Romano C (1997) Tyrosinemia type III: diagnosis and ten-year follow-up. Acta Paediatr 86: 1013–1015

    Article  PubMed  CAS  Google Scholar 

  35. Standing SJ, Dunger D, Ruetschi U, Holme E (1998) Tyrosinaemia type III detected by neonatal screening. J Inherit Metab Dis 21 [Suppl] 21: 25

    Google Scholar 

  36. Stenman G, Roijer E, Ruetschi U, Dellsen A, Rymo L, Lindstedt S (1995) Regional assignment of the human 4-hydroxyphenylpyruvate dioxygenase gene (HPD) to 12g24 -s qter by fluorescence in situ hybridization. Cytogenet Cell Genet 71: 374–376

    Article  PubMed  CAS  Google Scholar 

  37. Ruetschi U, Rymo L, Lindstedt S (1997) Human 4-hydroxyphenylpyruvate dioxygenase gene ( HPD ). Genomics 44: 292–299

    Google Scholar 

  38. Niederwieser A, Matasovic A, Tippett P, Danks DM (1977) A new sulfur amino acid, named Hawkinsin, identified in a baby with transient tyrosinemia and her mother. Clin Chim Acta 76: 345–356

    Article  PubMed  CAS  Google Scholar 

  39. Wilcken B, Hammond JW, Howard N et al. (1981) Hawkinsinuria: a dominantly inherited defect of tyrosine metabolism with severe effects in infancy. New Eng J Med 30 5: 865–869.

    Article  Google Scholar 

  40. Borden M, Holm J, Leslie J et al. (1992) Hawkinsinuria in two families. Am J Med Genet 44: 52–56

    Article  PubMed  CAS  Google Scholar 

  41. Nyhan WL (1984) Hawkinsinuria. Nyhan WL (ed) Abnormalities in amino acid Metabolism in Clinical Medicine, Norwalk, CT, Appleton-Century-Crofts, p 187–188

    Google Scholar 

  42. Osler W (1904) Ochronosis: the pigementation of cartilage, sclerotics, and skin in alkaptonuria. Lancet 1: 10

    Article  Google Scholar 

  43. Lichtenstein L, Kaplan L (1954) Hereditary ochronosis: Pathological changes observed in two necropsied cases. Am J Pathol 30: 99

    Google Scholar 

  44. Harrold AJ (1956) Alkaptonuric arthritis. J Bone Surg (Br) 38: 532

    Google Scholar 

  45. O’Brien WWM, La Due BN, Bunim JJJ (1963) Biochemical, patholgical and clinical aspects of alkaptonuria: ochronosis and ochronotic arthropathy. Am J Med 34: 813

    Article  Google Scholar 

  46. O’Brien WM, Bansfield WG, Sokoloff L (1961) Studies on the pathogenesis of ochronotic arthropathy. Artheritis Rheum 4: 137

    Article  Google Scholar 

  47. Pomeranz MM, Friedman LJ, Tunick IS (1941) Roentgen findings in alkaptonuric ochronosis. Radiology 37: 295

    Google Scholar 

  48. Vlay SC, Hartmann AR, Culliford AT (1986) Alkaptonuria and aortic stenosis. Ann Intern Med 10: 4–446

    Google Scholar 

  49. Garrod AE (1902) The insidence of alkaptonuria: a study in chemical individuality. Lancet 2: 1616

    Article  CAS  Google Scholar 

  50. Crissy RE, Day AJ (1950) Ochronosis: a case report. J Bone Joint Surg (Am) 32: 688

    Google Scholar 

  51. Dihlmann W, Greiling H, Kisters R, Stuhlsatz IW (1970) Biochemische and radiologische Untersuchungen zur Pathogenese der Alkaptonurie. Dtsch Med Wochenschr 95: 839

    Article  PubMed  CAS  Google Scholar 

  52. Murray JC, Lindberg KA, Pinnell SR (1977) In vitro inhibition of chick embryo lysyl hydroxylase by homogentisic acid. A proposed connective tissue defect in alkaptonuria. J Clin Invest 59: 1071–1079

    Google Scholar 

  53. Bory C, Boulieu R, Chantin C, Mathieu M (1990) Diagnosis of alcaptonuria: Rapid analysis of homogentisic acid by HPLC. Clin Chim Acta 189: 7

    Google Scholar 

  54. Fernandez-Canon JM, Penalva MA (1997) Spectrophotometric determination of homogentisate using Aspergillus nidulans homogentisate dioxygenase. Anal Biochem 245: 218–221

    Article  PubMed  CAS  Google Scholar 

  55. de Haas V, Carbasius Weber EC, de Klerk JB, Bakker HD, Smit GP, Huijbers WA, Duran M, Poll-The BT (1998) The success of dietary protein restriction in alkaptonuria patients is age-dependent. J Inherit Metab Dis 21: 791–798

    Article  PubMed  Google Scholar 

  56. Lustberg TJ, Schulman JD, Seegmiller JE (1970) Decreased binding of “C-homogentisic acid induced by ascorbic acid in connective tissue of rats with experimental alkaptonuria. Nature 228: 770

    Article  PubMed  CAS  Google Scholar 

  57. Wolff JA, Barshop B, Nyhan WL, Leslie J, Seegmiller JE, Gruber H, Garst M, Winter S, Michals K, Matalon R (1989) Effects of ascorbic acid in alkaptonuria: alterations in benzoquinone acetic acid and an ontogenic effect in infancy. Pediatr Res 26: 140–144

    Article  PubMed  CAS  Google Scholar 

  58. Beltran-Valero de Bernabe D, Granadino B, Chiarelli I, Porfirio B, Mayatepek E, Aquaron R, Moore MM, Festen JJ, Sanmarti R, Penalva MA, de Cordoba SR (1998) Mutation and polymorphism analysis of the human homogentisate 1, 2-dioxygenase gene in alkaptonuria patients. Am J Hum Genet 62: 776–784

    Article  Google Scholar 

  59. Gehrig A, Schmidt SR, Muller CR, Srsen S, Srsnova K, Kress W (1997) Molecular defects in alkaptonuria. Cytogenet Cell Genet 76: 14–16

    Article  PubMed  CAS  Google Scholar 

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Kvittingen, E.A., Holme, E. (2000). Disorders of Tyrosine Metabolism. In: Fernandes, J., Saudubray, JM., Van den Berghe, G. (eds) Inborn Metabolic Diseases. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-04285-4_15

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  • DOI: https://doi.org/10.1007/978-3-662-04285-4_15

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