Journal
TWIN RESEARCH AND HUMAN GENETICS
Volume 16, Issue 6, Pages 1117-1120Publisher
CAMBRIDGE UNIV PRESS
DOI: 10.1017/thg.2013.72
Keywords
fumarase deficiency; Krebs tricarboxylic acid cycle; dichorionic diamniotic; leiomyomatosis; renal cell carcinoma; hepatomegaly
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Fumarase deficiency is a rare autosomal recessive inborn error of metabolism of the Krebs Tricarboxylic Acid cycle. A heavy neurological disease burden is imparted by fumarase deficiency, commonly manifesting as microcephaly, dystonia, global developmental delay, seizures, and lethality in the infantile period. Heterozygous carriers also carry an increased risk of developing hereditary leiomyomatosis and renal cell carcinoma. We describe a non-consanguineous family in whom a dichorionic diamniotic twin pregnancy resulted in twin boys with fumarase deficiency proven at the biochemical, enzymatic, and molecular levels. Their clinical phenotype included hepatic involvement. A novel mutation in the fumarate hydratase gene was identified in this family.
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