A case report on primary hyperoxaluria type 1 in an infant

Authors

  • Jaladhi V. Bhatt Department of Paediatrics, Narendra Modi Medical College, Ahmedabad, Gujarat, India
  • Kanisha S. Shah Department of Paediatrics, Narendra Modi Medical College, Ahmedabad, Gujarat, India
  • Pankti Desai Department of Paediatrics, Narendra Modi Medical College, Ahmedabad, Gujarat, India
  • Parag Paliya Department of Paediatrics, Narendra Modi Medical College, Ahmedabad, Gujarat, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20242674

Keywords:

Primary hyperoxaluria, Infant presentation, Metabolic acidosis, Genetic diagnosis

Abstract

An alanine-glyoxylate aminotransferase (AGT) deficiency causes elevated oxalate levels in primary hyperoxaluria type 1 (PH1), a rare genetic disorder that can cause renal complications. We report the case of a 3-month-old male infant with respiratory distress, decreased urine output, and metabolic acidosis who was born to consanguineous parents. Bilateral nephrocalcinosis and severe metabolic disturbances were found during further examinations. Prompt identification and genetic validation for therapeutic interventions guided by PH1, such as peritoneal dialysis. The severity of PH1 was highlighted by difficulties maintaining renal function even after an initial improvement. To lessen the severe effects of PH1, this case highlights the significance of early diagnosis, genetic evaluation, and multidisciplinary management.

References

Groothoff JW, Metry E, Deesker L, Garrelfs S, Acquaviva C, Almardini R, et al. Clinical practice recommendations for primary hyperoxaluria: an expert consensus statement from ERKNet and OxalEurope. Nat Rev Nephrol. 2023;193:194-211.

Fargue S, Acquaviva Bourdain C. Primary hyperoxaluria type 1: pathophysiology and genetics. Clin Kidney J. 2022;15:i4.

Devriendt A, Damry N, Hall M, Mesquita M, Avni F. A rare case of primary hyperoxaluria type 1 co-existing with autosomal-dominant polycystic kidney disease in a newborn. Pediatr Radiol. 2011;41:107-9.

Krishnamurthy S, Kartha GB, Venkateswaran VS, Prasannakumar M, Mahadevan S, Gowda M, et al. Primary Hyperoxaluria Type 1 with Homozygosity for a Double-mutated AGXT Allele in a 2-year-old Child. Indian J Nephrol. 2017;27:402-5.

Williams EL, Bagg EAL, Mueller M, Vandrovcova J, Aitman TJ, Rumsby G. Performance evaluation of Sanger sequencing for the diagnosis of primary hyperoxaluria and comparison with targeted next generation sequencing. Mol Genet Genomic Med. 2015;3:69-78.

Wang X, Danese D, Brown T, Baldwin J, Sajeev G, Cook EE, et al. Primary Hyperoxaluria Type 1 Disease Manifestations and Healthcare Utilization: A Multi-Country, Online, Chart Review Study. Front Med. 2021;8:703305.

Ben-Shalom E, Garrelfs SF, Groothoff JW. Primary hyperoxaluria: the pediatric nephrologist’s point of view. Clin Kidney J. 2022;15:i23-8.

Takada Y, Kaneko N, Esumi H, Purdue PE, Danpure CJ. Human peroxisomal L-alanine:glyoxylate aminotransferase. Evolutionary loss of a mitochondrial targeting signal by point mutation of the initiation codon. Biochem J. 1990;268:517-20.

National Organization for Rare Disorders. Primary Hyperoxaluria - Symptoms, Causes, Treatment. Available at: https://rarediseases.org/rare-diseases/ primary-hyperoxaluria/. Accessed on 01 May 2024.

Hoppe B. An update on primary hyperoxaluria. Nat Rev Nephrol. 2012;8:467-75.

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Published

2024-09-13

Issue

Section

Case Reports