Analysis of five cases of hypermethioninemia diagnosed by neonatal screening

J Pediatr Endocrinol Metab. 2020 Jan 28;33(1):47-52. doi: 10.1515/jpem-2019-0285.

Abstract

Background Hypermethioninemia is a group of diseases with elevated plasma methionine (Met) caused by hereditary and non-hereditary factors, although it could also be caused by administration of the amino acid Met. Among these, the disease caused by methionine adenosyltransferase (MAT) I/III deficiency is the most common, and is characterized by persistent, isolated hypermethioninemia as well as slightly elevated homocysteine. S-adenosylmethionine is the product of Met, which can be used as a direct methyl donor of many substances, such as choline and nucleotide, and essential in the development of the body. Among the patients, most have no symptoms, and a small number have central nervous system complications with high levels of plasma Met, including mental retardation, cognitive impairment and special breathing odor. Methods In this study, five cases of MAT I/III deficiency were diagnosed and retrospectively analyzed among 220,000 newborns. Patients with high Met levels received a Met-restricted diet treatment. Results and conclusions MAT I/III deficiency is a common reason for Met elevation in neonatal screening by tandem mass spectrometry (MS/MS), which needs long-term follow-up except for these patients with explicitly benign mutations.

Keywords: hypermethioninemia; methionine; methionine adenosyltransferase I/III deficiency; neonatal screening.

MeSH terms

  • Amino Acid Metabolism, Inborn Errors / diagnosis*
  • Amino Acid Metabolism, Inborn Errors / enzymology
  • Amino Acid Metabolism, Inborn Errors / genetics
  • Female
  • Gestational Age
  • Glycine N-Methyltransferase / deficiency*
  • Glycine N-Methyltransferase / genetics
  • Humans
  • Infant, Newborn
  • Male
  • Methionine / metabolism
  • Methionine Adenosyltransferase / genetics*
  • Mutation*
  • Neonatal Screening / methods*
  • Retrospective Studies

Substances

  • Methionine
  • Glycine N-Methyltransferase
  • Methionine Adenosyltransferase

Supplementary concepts

  • Hypermethioninemia