Phenotype of patients with peroxisomal disorders subdivided into sixteen complementation groups

• Published in: The Journal of pediatrics 1995-07, Vol.127 (1), p.13-22
• Main Authors: Moser, Ann B., Rasmussen, Magnhild, Naidu, Sakkubai, Watkins, Paul A., McGuinness, Martina, Hajra, Amiya K., Chen, Grace, Raymond, Gerald, Liu, Angela, Gordon, Donald, Garnaas, Karen, Walton, David S., Skjeldal, Ola H., Guggenheim, Mary Anne, Jackson, Laird G., Elias, Ellen Roy, Moser, Hugo W.
• Format: Article
• Language: English
• Subjects: Acyltransferases - deficiency; Adrenoleukodystrophy - blood; Adrenoleukodystrophy - enzymology; Adrenoleukodystrophy - genetics; Adult; Biological and medical sciences; Cells, Cultured; Child; Errors of metabolism; Fatty Acids; Female; Genetic Complementation Test; Genotype; Humans; Male; Medical sciences; Metabolic diseases; Microbodies - genetics; Middle Aged; Miscellaneous hereditary metabolic disorders; Phenotype; Refsum Disease - blood; Refsum Disease - enzymology; Refsum Disease - genetics; Zellweger Syndrome - blood; Zellweger Syndrome - enzymology; Zellweger Syndrome - genetics
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/S0022-3476(95)70250-4

Objective: To use the technique of complementation analysis to help define genotype and classify patients with clinical manifestations consistent with those of the disorders of peroxisome assembly, namely the Zellweger syndrome (ZS), neonatal adrenoleukodystrophy (NALD), infantile Refsum disease (IRD), and rhizomelic chondrodysplasia punctata (RCDP). Study design: Clinical findings, peroxisomal function, and complementation groups were examined in 173 patients with the clinical manifestations of these disorders. Results: In 37 patients (21%), peroxisome assembly was intact and isolated deficiencies of one of five peroxisomal enzymes involved in the β-oxidation of fatty acids or plasmalogen biosynthesis were demonstrated. Ten complementation groups were identified among 93 patients (54%) with impaired peroxisome assembly and one of three phenotypes (ZS, NALD, or IRD) without correlation between complementation group and phenotype. Forty-three patients (25%) had impaired peroxisome assembly associated with the RCDP phenotype and belonged to a single complementation group. Of the 173 patients, 10 had unusually mild clinical manifestations, including survival to the fifth decade or deficits limited to congenital cataracts. Conclusions: At least 16 complementation groups, and hence genotypes, are associated with clinical manifestations of disorders of peroxisome assembly. The range of phenotype is wide, and some patients have mild involvement. (J P EDIATR 1995;127:13-22)