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$Unique_ID{BRK03404}
$Pretitle{}
$Title{5-Oxoprolinuria}
$Subject{5-Oxoprolinuria Pyroglutamic Aciduria Pyroglutamicaciduria
Oxoprolinase Deficiency Glutathionuria (Gamma-Glutamyl Transpeptidase
Deficiency)}
$Volume{}
$Log{}
Copyright (C) 1988, 1989, 1990 National Organization for Rare Disorders,
Inc.
522:
5-Oxoprolinuria
** IMPORTANT **
It is possible the main title of the article (5-Oxoprolinuria) is not the
name you expected. Please check the SYNONYMS listing on the next page to
find alternate names and disorder subdivisions covered by this article.
Synonyms
Pyroglutamic Aciduria
Pyroglutamicaciduria
Information on the following disorder can be found in the Related Disorders
section of this report:
Oxoprolinase Deficiency
Glutathionuria (Gamma-Glutamyl Transpeptidase Deficiency)
General Discussion
** REMINDER **
The information contained in the Rare Disease Database is provided for
educational purposes only. It should not be used for diagnostic or treatment
purposes. If you wish to obtain more information about this disorder, please
contact your personal physician and/or the agencies listed in the "Resources"
section of this report.
5-Oxoprolinuria is a metabolic disorder caused by an inborn error of
glutathione metabolism. It is characterized by excretion of massive amounts
of 5-oxoproline (pyroglutamic acid) in the urine, and abnormally high levels
of this acid in the blood and cerebrospinal fluid. The disorder is caused by
a deficiency of the enzyme glutathione synthetase. Functioning of the
central nervous system is impaired. High acidity levels in the blood and
body tissues (metabolic acidosis) usually occur.
Symptoms
5-Oxoprolinuria is characterized by excretion of massive amounts of 5-
oxoproline (pyroglutamic acid) in the urine, and abnormally high levels of
this acid in the blood and cerebrospinal fluid. Without treatment, mental
retardation, impaired muscle coordination (cerebellar ataxia), and seizures
may occur.
Causes
5-Oxoprolinuria is inherited as an autosomal recessive trait. The disorder
is the result of a deficiency of the enzyme glutathione synthetase. (Human
traits including the classic genetic diseases, are the product of the
interaction of two genes for that condition, one received from the father and
one from the mother. In recessive disorders, the condition does not appear
unless a person inherits the same defective gene from each parent. If one
receives one normal gene and one gene for the disease, the person will be a
carrier for the disease, but usually will show no symptoms. The risk of
transmitting the disease to the children of a couple, both of whom are
carriers for a recessive disorder, is twenty-five percent. Fifty percent of
their children will be carriers, but healthy as described above. Twenty-five
percent of their children will receive both normal genes, one from each
parent and will be genetically normal.)
Affected Population
5-Oxoprolinuria can be present at birth. It is a very rare disorder
affecting males and females in equal numbers.
Related Disorders
Symptoms of the following disorders may be similar to those of 5-
Oxoprolinuria. Comparisons may be useful for a differential diagnosis:
5-Oxoprolinase Deficiency is characterized by an inborn deficiency of the
enzyme 5-oxoprolinase. A moderate amount of 5-oxoproline is excreted in the
urine and blood levels of this substance are higher than normal. Persons
with this disorder usually exhibit no other symptoms related to the enzyme
deficiency.
Glutathionuria (Gamma-Glutamyl Transpeptidase Deficiency) is a very rare,
possibly hereditary metabolic disorder. Concentrations of glutathione in
blood and urine are excessive. Patients with this disorder may be mildly
mentally retarded and/or suffer from behavioral problems.
Therapies: Standard
5-Oxoprolinuria is treated with bicarbonate of soda to compensate for
metabolic acidosis.
Genetic counseling is recommended for families of children with 5-
Oxoprolinuria.
Therapies: Investigational
This disease entry is based upon medical information available through April
1990. Since NORD's resources are limited, it is not possible to keep every
entry in the Rare Disease Database completely current and accurate. Please
check with the agencies listed in the Resources section for the most current
information about this disorder.
Resources
For more information on 5-Oxoprolinuria, please contact:
National Organization for Rare Disorders (NORD)
P.O. Box 8923
New Fairfield, CT 06812-1783
(203) 746-6518
NIH/National Institute of Neurological Disorders & Stroke (NINDS)
9000 Rockville Pike
Bethesda, MD 20892
(301) 496-5751
(800) 352-9424
Research Trust for Metabolic Diseases in Children
Golden Gates Lodge, Weston Rd.
Crewe CW1 1XN, England
Telephone: (0270) 250244
For genetic information and genetic counseling referrals, please contact:
March of Dimes Birth Defects Foundation
1275 Mamaroneck Avenue
White Plains, NY 10605
(914) 428-7100
Alliance of Genetic Support Groups
35 Wisconsin Circle, Suite 440
Chevy Chase, MD 20815
(800) 336-GENE
(301) 652-5553
References
METABOLIC BASIS OF INHERITED DISEASE, 5th ed.: John B. Stanbury, et al.,
eds; McGraw Hill, 1983. Pp. 348-357.
OPHTHALMOLOGICAL, PSYCHOMETRIC AND THERAPEUTIC INVESTIGATION IN TWO
SISTERS WITH HEREDITARY GLUTATHIONE SYNTHETASE DEFICIENCY (5-OXOPROLINURIA):
A. Larsson, et al.; Neuropediatrics (August 1985: issue 16(3)). Pp. 131-
136.
NEONATAL 5-OXOPROLINURIA: DIFFICULT-TO-DIAGNOSE?: I.S. Mendelson, et
al.; Journal Inherited Metab Dis (1983: issue 6(1)). Pp. 44-48.
THE CEREBRAL LESIONS IN A PATIENT WITH GENERALIZED GLUTATHIONE DEFICIENCY AND
PYROGLUTAMIC ACIDURIA (5-OXOPROLINURIA): K. Skullerud, et al.; Acta
Neuropathol (Berlin) (1980: issue 52(3)). Pp. 235-238.