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Severe neurological crisis in adult patients with Tyrosinemia type 1

Dawson, Charlotte; Ramachandran, Radha; Safdar, Samreen; Murphy, Elaine; Swayne, Orlando; Katz, Jonathan; Newsome, Philip N; (2020) Severe neurological crisis in adult patients with Tyrosinemia type 1. Annals of Clinical and Translational Neurology , 7 (9) pp. 1732-1737. 10.1002/acn3.51160. Green open access

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Abstract

We report six adult patients with Tyrosinaemia type 1 (HT-1) who presented with recurrent porphyria-like neurological crises after discontinuation/interruption of 2-(2-nitro-4-trifluoro-methylbenzyol)-1,3 cyclohexanedione (NTBC) treatment. The crises were life-threatening for some of the patients, with respiratory muscle paralysis requiring ventilatory support, hemodynamic disturbance due to autonomic changes requiring resuscitation, acute progressive ascending motor neuropathy causing profound impairment, recurrent seizures, and neuropathic pain. Our patients’ porphyria-like presentations were variably misdiagnosed, with delay to diagnosis resulting in more severe recurrent attacks. We report the first series of neurological crises in adult patients with HT-1. These crises, which may be fatal, can be prevented and treated effectively with neurologist/physician awareness and patient education.

Type: Article
Title: Severe neurological crisis in adult patients with Tyrosinemia type 1
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1002/acn3.51160
Publisher version: https://doi.org/10.1002/acn3.51160
Language: English
Additional information: © The Author(s), 2020. Annals of Clinical and Translational Neurology published by Wiley Periodicals LLC on behalf of American Neurological Association This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. https://creativecommons.org/licenses/by/4.0/
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Brain Repair and Rehabilitation
URI: https://discovery.ucl.ac.uk/id/eprint/10203588
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