Tyrosinemia type 1 and irreversible neurologic crisis after one month discontinuation of nitisone

• Published in: Metabolic brain disease Vol. 31; no. 5; pp. 1181 - 1183
• Main Authors: Önenli Mungan, Neslihan, Yıldızdaş, Dinçer, Kör, Deniz, Horoz, Özden Özgür, İncecik, Faruk, Öktem, Murat, Sander, Johannes
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-10-2016; Springer Nature B.V
• Subjects: Biochemistry; Biomedical and Life Sciences; Biomedicine; Cyclohexanones - administration & dosage; Fatal Outcome; Humans; Infant; Male; Metabolic Diseases; Nervous System Diseases - blood; Nervous System Diseases - diagnosis; Neurology; Neurosciences; Nitrobenzoates - administration & dosage; Oncology; Short Communication; Time Factors; Tyrosine - blood; Tyrosinemias - blood; Tyrosinemias - diagnosis; Tyrosinemias - drug therapy; Nitisone; Tyrosinemia type I; Polyneuropathy; Neurologic crisis
• ISSN: 0885-7490; 1573-7365
• DOI: 10.1007/s11011-016-9833-y

Tyrosinemia type I is an autosomal recessively inherited metabolic disease of tyrosine metabolism due to the deficiency of fumarylacetoacetate hydrolase. Clinical manifestations include hepatic failure, cirrhosis, hepatocellular carcinoma, renal fanconi syndrome, and neurologic crisis. With the introduction of 2-(2-nitro-4-trifluoro-methylbenzyol)-1,3 cyclohexanedione treatment the prognosis improved with reduced rate of complications. “Neurologic crisis” of tyrosinemia type I is a rare complication seen after discontinuation of treatment characterized with anorexia, vomiting, and hyponatremia in the initial phase continuing with paresthesia and paralysis of the extremities and the diaphragm. Here, we report a tyrosinemia type I patient who admitted to the hospital with nonspecific symptoms such as vomiting, anorexia, weakness, and restlessness only after one month discontinuation of nitisone and diagnosed as neurological crisis.