Alpha-methylacyl-CoA racemase deficiency (AMACR)

Evidence-based neurology checklist on alpha-methylacyl-coa racemase deficiency (amacr): Pathology This is a peroxisomal enzyme deficiency It is caused by mutations in the AMACR gene The transmission is autosomal recessive There is accumulation of toxic bile acid intermediates The onset age is…

Pathology

  • This is a peroxisomal enzyme deficiency
  • It is caused by mutations in the AMACR gene
  • The transmission is autosomal recessive
  • There is accumulation of toxic bile acid intermediates
  • The onset age is bimodal: in infancy and early adulthood

Neurological features

Systemic features

Differential diagnosis

Magnetic resonance imaging (MRI) brain: lesion sites

Magnetic resonance imaging (MRI) brain: other features

Other investigations

Treatment

References

  1. Klouwer FCC, Roosendaal SD, Hollak CEM, et al. Redefining the phenotype of alpha-methylacyl-CoA racemase (AMACR) deficiency. Orphanet J Rare Dis 2024; 19:350. 
  2. Dick D, Horvath R, Chinnery PF. AMACR mutations cause late-onset autosomal recessive cerebellar ataxia. Neurology. 2011; 76:1768-1770.
  3. Alsalamah AK, Khan AO. Asymptomatic retinal dysfunction in alpha-methylacyl-CoA racemase deficiency. Mol Vis 2021; 27:396-402.
  4. Haugarvoll K, Johansson S, Tzoulis C, et al. MRI characterisation of adult onset alpha-methylacyl-coA racemase deficiency diagnosed by exome sequencing. Orphanet J Rare Dis 2013; 8:1.
  5. Thompson SA, Calvin J, Hogg S, Ferdinandusse S, Wanders RJ, Barker RA. Relapsing encephalopathy in a patient with α-methylacyl-CoA racemase deficiency. BMJ Case Rep 2009; 2009:bcr08.2008.0814.
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