COVID-19 triggered encephalopathic crisis in a patient with glutaric aciduria type 1

Author:

Zubarioglu Tanyel1,Ahmadzada Saffa1,Yalcinkaya Cengiz2,Kiykim Ertugrul1,Aktuglu-Zeybek Cigdem1

Affiliation:

1. Cerrahpasa Medical Faculty, Department of Pediatrics, Division of Nutrition and Metabolism , Istanbul University-Cerrahpasa , Istanbul , Turkey

2. Cerrahpasa Medical Faculty, Department of Neurology, Division of Pediatric Neurology , Istanbul University-Cerrahpasa , Istanbul , Turkey

Abstract

Abstract Objectives The impact of coronavirus disease-19 (COVID-19) on metabolic outcome in patients with inborn errors of metabolism has rarely been discussed. Herein, we report a case with an acute encephalopathic crisis at the course of COVID-19 disease as the first sign of glutaric aciduria type 1 (GA-1). Case presentation A 9-month-old patient was admitted with encephalopathy and acute loss of acquired motor skills during the course of COVID-19 disease. She had lethargy, hypotonia, and choreoathetoid movements. In terms of COVID-19 encephalopathy, the reverse transcription-polymerase chain reaction assay test for COVID-19 was negative in cerebral spinal fluid. Brain imaging showed frontotemporal atrophy, bilateral subcortical and periventricular white matter, basal ganglia, and thalamic involvement. Elevated glutarylcarnitine in plasma and urinary excretion of glutaric and 3-OH-glutaric acids was noted. A homozygote mutation in the glutaryl-CoA dehydrogenase gene led to the diagnosis of GA-1. Conclusions With this report, neurological damage associated with COVID-19 has been reported in GA-1 patients for the first time in literature.

Publisher

Walter de Gruyter GmbH

Subject

Endocrinology,Endocrinology, Diabetes and Metabolism,Pediatrics, Perinatology, and Child Health

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