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- $Unique_ID{BRK03567}
- $Pretitle{}
- $Title{Carnitine Palmityltransferase Deficiency}
- $Subject{Carnitine Palmityltransferase Deficiency CPTD CPT Deficiency Myopathy
- with Deficiency of Carnitine Palmityltransferase Myopathy-Metabolic Carnitine
- Palmityltransferase Deficiency Eaton-Lambert Syndrome Myopathy Scapuloperoneal
- Fibromyalgia LCAD Deficiency}
- $Volume{}
- $Log{}
-
- Copyright (C) 1992 National Organization for Rare Disorders, Inc.
-
- 915:
- Carnitine Palmityltransferase Deficiency
-
- ** IMPORTANT **
- It is possible that the main title of the article (Carnitine
- Palmityltransferase Deficiency) is not the name you expected. Please check
- the SYNONYM listing to find the alternate names and disorder subdivisions
- covered by this article.
-
- Synonyms
-
- CPTD
- CPT Deficiency
- Myopathy with Deficiency of Carnitine Palmityltransferase
- Myopathy-Metabolic, Carnitine Palmityltransferase Deficiency
-
- Information on the following diseases can be found in the Related
- Disorders section of this report:
-
- Eaton-Lambert Syndrome
- Myopathy, Scapuloperoneal
- Fibromyalgia
- LCAD 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.
-
- Carnitine Palmityltransferase Deficiency is a metabolic disorder that
- affects the muscle's ability to function properly. It is a very rare genetic
- disorder. CPT Deficiency is a disease of muscle fat (lipid) metabolism.
- Strenuous exercise triggers the symptoms which leads to breakdown of muscle
- tissue and appearance of muscle hemoglobin in the urine. Major symptoms may
- include muscle pain, fatigue and passing of dark red-brown urine
- (myoglobinuria) after strenuous exercise.
-
- Symptoms
-
- Carnitine Palmityltransferase Deficiency is a very rare metabolic disease.
- It is characterized by easy fatigue during prolonged exercise, disabling
- muscle pain that sometimes lasts for days and fat (lipid) levels in the
- muscles that usually remain the same or increase only slightly. Destruction
- of skeletal muscles (rhabdomyolysis) is sometimes followed by passage of red-
- brown urine (myoglobinuria). The combination of these conditions may
- sometimes become life-threatening.
-
- CPT Deficiency is more apparent in diabetics and cases of malnutrition.
- The disorder usually becomes noticeable during adulthood but may affect
- children in a more serious form. Life-threatening rhabdomyolysis and
- myoglobinuria may follow prolonged exercise, viral illness, sleep and food
- deprivation and over-exposure to cold, especially in diabetic patients or
- persons on a high fat diet. As a precaution, siblings of CPT patients should
- be tested for the disorder to help prevent possible development of the
- symptoms.
-
- Causes
-
- Carnitine Palmityltransferase Deficiency is thought to be caused by an
- autosomal recessive mode of inheritance. Human traits, including the classic
- genetic diseases, are the product of the interaction of two genes, one
- received from the father and one from the mother. In autosomal recessive
- disorders the condition does not appear unless a person inherits the same
- defective gene from the same trait 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 not show 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.
-
- CPT Deficiency usually affects adults. However, a more serious form of
- the disorder sometimes affects children. Symptoms can occur as a response to
- extreme stress, over-exercise, malnutrition and cold, especially in diabetic
- persons with the disorder. Muscle fat levels usually remain the same or are
- only slightly elevated during attacks, and there are usually no symptoms
- between attacks.
-
- The gene responsible for the disorder is assigned to chromosome 1 in the
- region of 1q12-1pter.
-
- Affected Population
-
- Carnitine Palmityltransferase Deficiency is a very rare disorder that is
- discovered in males more often than females. It usually becomes apparent in
- adulthood. However, a more serious form may affect children. When this
- disorder is diagnosed in a family each child of that couple should be checked
- to determine whether others are affected by CPT Deficiency so precautions can
- be taken to avoid the symptoms of the illness.
-
- Related Disorders
-
- Symptoms of the following disorders can be similar to those of Carnitine
- Palmityltransferase Deficiency. Comparisons may be useful for a differential
- diagnosis:
-
- Eaton-Lambert Syndrome is a neuromuscular disorder that includes muscle
- weakness and fatigue especially of the pelvic and thigh muscles. Patients
- may not have deep tendon reflexes and lower limbs are affected more often
- than upper limbs. (For more information on this disorder, choose "Eaton-
- Lambert" as your search term in the Rare Disease Database).
-
- Scapuloperoneal Myopathy is a genetic disorder characterized by a
- weakness and wasting of muscles. Symptoms are usually limited to the
- shoulder blade area and the smaller of the two leg muscle groups below the
- knee. The disorder may begin in childhood or adulthood. (For more
- information on this disorder, choose "Scaploperoneal Myopathy" as your search
- term in the Rare Disease Database).
-
- Fibromyalgia is a chronic disorder characterized by pain throughout much
- of the body. The pain may begin gradually or have a sudden onset. Other
- symptoms are muscle spasms, fatigue, muscle tissue stiffness and non-
- restorative sleep. The exact cause of this disorder is unknown. (For more
- information on this disorder, choose "Fibromyalgia" as your search term in
- the Rare Disease Database).
-
- LCAD Deficiency is a secondary Carnitine deficiency resulting in low
- blood sugar, abnormal liver function, abnormally low ketones in the blood and
- acidosis. Poor muscle tone, fatigue and vomiting occur after a viral
- illness. This disorder can occur in any age group from the prenatal stage
- into adulthood. Left untreated it can result in physical and mental
- retardation and may become life threatening.
-
- Therapies: Standard
-
- Carnitine Palmityltransferase Deficiency can be diagnosed by enzymatic
- studies and muscle biopsy. It is important for persons with this metabolic
- problem to first be aware of the limitations of the disorder, especially if
- the person is diabetic. Patients should exercise in moderation, eat adequate
- amounts of food, avoid stress and high fat foods, and keep warm.
- Supplementing carnitine in the diet is not helpful in CP Deficiency.
-
- Genetic counseling may be of benefit for patients and their families.
- Other treatment is symptomatic and supportive.
-
- Therapies: Investigational
-
- Research on inborn errors of metabolism is ongoing. Scientists are studying
- the causes of these disorders and trying to design enzyme replacement
- therapies that will return a missing enzyme to the body.
-
- The National Institutes of Health (NIH) is sponsoring the Human Genome
- Project which is aimed at mapping every gene in the human body and learning
- why they sometimes malfunction. It is hoped that this new knowledge will
- lead to prevention and treatment of genetic disorders in the future.
-
- This disease entry is based upon medical information available through
- May 1992. 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 Carnitine Palmityltransferase Deficiency, please
- contact:
-
- National Organization for Rare Disorders (NORD)
- P.O. Box 8923
- New Fairfield, CT 06812-1783
- (203) 746-6518
-
- NIH/National Institute of Diabetes, Digestive & Kidney Diseases
- 9000 Rockville Pike
- Bethesda, MD 20892
- (301) 496-3583
-
- Research Trust for Metabolic Diseases in Children
- Golden Gates Lodge, Weston Road
- Crewe CW1 1XN, England
- (0270) 250244
-
- For Genetic Information and Genetic Counseling Referrals:
-
- 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
-
- MENDELIAN INHERITANCE IN MAN, 9th Ed.: Victor A. McKusick, Editor: Johns
- Hopkins University Press, 1990. P. 1365.
-
- THE METABOLIC BASIS OF INHERITED DISEASE, 6th Ed.: Charles R. Scriver, et
- al., Editors; McGraw Hill, 1989. Pp. 388, 889, 911.
-
- BIRTH DEFECTS ENCYCLOPEDIA, Mary Louise Buyse, M.D., Editor-In-Chief;
- Blackwell Scientific Publications, 1990. Pp. 1200-1201.
-
- REGULATION OF CARNITINE PALMITYLTRANSFERASE IN VIVO BY GLUCAGON AND
- INSULIN. Brady, P.S. et al.; Biochem J, March 15, 1989, (issue 258 (3)).
- Pp. 677-682.
-
- CARNITINE PALMITYLTRANSFERASE IN HUMAN ERYTHROCYTE MEMBRANE. PROPERTIES
- AND MALONYL-CoA SENSITIVITY. Ramsay, R.R., et al,; Biochem J, May 1, 1991,
- (issue 275 (pt. 3)). Pp. 685-688.
-
- CHRONIC MYOPATHY WITH A PARTIAL DEFICIENCY OF THE CARNITINE
- PALMITYLTRANSFERASE ENZYME., Kieval, R.I., et al.; Arch Neurol, May, 1989,
- (issue 46 (5)). Pp. 575-576.
-
- FATAL RHABDOMYOLYSIS FOLLOWING INFLUENZA INFECTION IN A GIRL WITY
- FAMILIAL CARNITINE PALMITYLTRANSFERASE DEFICIENCY., Kelly, K.J., et al.;
- Pediatrics, August, 1989, (issue 84 (2)). Pp. 312-316.
-
-