Clinical and genetic analysis of 26 Chinese patients with neonatal intrahepatic cholestasis due to citrin deficiency

Clin Chim Acta. 2024 Jan 1:552:117617. doi: 10.1016/j.cca.2023.117617. Epub 2023 Oct 27.

Abstract

Background: Neonatal intrahepatic cholestasis due to citrin deficiency (NICCD) is an autosomal recessive disorder caused by SLC25A13 genetic mutations. We retrospectively analyzed 26 Chinese infants with NICCD (years 2014-2022) in Quanzhou City.

Methods: The plasma citrulline (CIT) concentration analyzed by tandem mass spectrometry (MS/MS), biochemical parameters and molecular analysis results are presented.

Results: Twelve genotypes were discovered. The relationship between the CIT concentration and genotype is uncertain. In total, 8 mutations were detected, with 4 variations, c.851_854delGTAT, c.615 + 5G > A, c.1638_1660dup and IVS16ins3kb, constituting the high-frequency mutations. Specifically, we demonstrated 2 patients with NICCD combined with another inborn errors of metabolism (IEM). Patient No. 22 possessed compound heterozygous mutations of c.615 + 5G > A and c.790G > A in the SLC25A13 gene accompanied by compound heterozygous variations of c.C259T and c.A155G in the PTS gene. Additionally, Patient No. 26 carried c.51C > G and c.760C > T in the SLC22A5 gene as well as c.615 + 5G > A and IVS16ins3kb in the SLC25A13 gene.

Conclusions: We report a case of the simultaneous occurrence of primary carnitine deficiency (PCD) and NICCD.

Keywords: Neonatal intrahepatic cholestasis due to citrin deficiency; Newborn screening program; PTS; SLC25A13; Tetrahydrobiopterin deficiency.

MeSH terms

  • Calcium-Binding Proteins / genetics
  • China
  • Cholestasis*
  • Cholestasis, Intrahepatic* / genetics
  • Citrullinemia* / genetics
  • Humans
  • Infant
  • Infant, Newborn
  • Infant, Newborn, Diseases*
  • Mitochondrial Membrane Transport Proteins / genetics
  • Mutation
  • Organic Anion Transporters* / genetics
  • Retrospective Studies
  • Solute Carrier Family 22 Member 5 / genetics
  • Tandem Mass Spectrometry

Substances

  • Calcium-Binding Proteins
  • Mitochondrial Membrane Transport Proteins
  • Organic Anion Transporters
  • SLC22A5 protein, human
  • SLC25A13 protein, human
  • Solute Carrier Family 22 Member 5
  • citrin

Supplementary concepts

  • Neonatal-onset citrullinemia type 2