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5-Oxoprolinase deficiency(OPLAHD)

MedGen UID:
82814
Concept ID:
C0268525
Disease or Syndrome
Synonyms: 5-alpha-oxoprolinase deficiency; OPLAHD; Oxoprolinuria due to 5-oxoprolinase deficiency
SNOMED CT: 5-Oxoprolinase deficiency (26132002); Pyroglutamate hydrolase deficiency (26132002)
Modes of inheritance:
Autosomal recessive inheritance
MedGen UID:
141025
Concept ID:
C0441748
Intellectual Product
Source: Orphanet
A mode of inheritance that is observed for traits related to a gene encoded on one of the autosomes (i.e., the human chromosomes 1-22) in which a trait manifests in individuals with two pathogenic alleles, either homozygotes (two copies of the same mutant allele) or compound heterozygotes (whereby each copy of a gene has a distinct mutant allele).
 
Gene (location): OPLAH (8q24.3)
 
HPO: HP:0040142
Monarch Initiative: MONDO:0009825
OMIM®: 260005
Orphanet: ORPHA33572

Definition

5-Oxoprolinuria can be caused by genetic defects in either of 2 enzymes involved in the gamma-glutamyl cycle of glutathione metabolism: glutathione synthetase (GSS; 601002) or 5-oxoprolinase (OPLAH; 614243). GSS deficiency (266130) is best characterized as an inborn error of glutathione metabolism, but there is debate as to whether OPLAH deficiency represents a disorder or simply a biochemical condition with no adverse clinical effects because patients lack a consistent clinical picture apart from 5-oxoprolinuria (summary by Calpena et al., 2013). [from OMIM]

Clinical features

From HPO
Abdominal pain
MedGen UID:
7803
Concept ID:
C0000737
Sign or Symptom
An unpleasant sensation characterized by physical discomfort (such as pricking, throbbing, or aching) and perceived to originate in the abdomen.
Prolinuria
MedGen UID:
78685
Concept ID:
C0268534
Disease or Syndrome
Level of proline in the urine anove the upper limit of normal.
Nephrolithiasis, calcium oxalate
MedGen UID:
318935
Concept ID:
C1833683
Disease or Syndrome
Kleta (2006) reviewed aspects of renal stone disease. Nephrolithiasis and urolithiasis remain major public health problems of largely unknown cause. While disorders such as cystinuria (220100) and primary hyperoxaluria (see 259900) that have nephrolithiasis as a major feature have advanced understanding of the metabolic and physiologic processes of stone formation in general, they have not addressed the etiology of calcium oxalate stone formation, responsible for approximately 75% of urolithiasis cases in humans. Men are affected twice as often as women, but children show no such gender bias. The recurrence rate is also high. In populations of European ancestry, 5 to 10% of adults experience the painful precipitation of calcium oxalate in their urinary tracts. Thorleifsson et al. (2009) noted that between 35 and 65% of hypercalciuric stone formers and up to 70% of subjects with hypercalciuria have relatives with nephrolithiasis, and twin studies have estimated the heritability of kidney stones to be 56%. Genetic Heterogeneity of Calcium Oxalate Nephrolithiasis See also CAON2 (620374), caused by mutation in the OXGR1 gene (606922) on chromosome 13q32.
Increased level of L-pyroglutamic acid in urine
MedGen UID:
1641941
Concept ID:
C4703642
Finding
An increase in the level of L-pyroglutamic acid in the urine.
Diarrhea
MedGen UID:
8360
Concept ID:
C0011991
Sign or Symptom
Abnormally increased frequency (usually defined as three or more) loose or watery bowel movements a day.
Enterocolitis
MedGen UID:
4966
Concept ID:
C0014356
Disease or Syndrome
An inflammation of the colon and small intestine. However, most conditions are either categorized as Enteritis (inflammation of the small intestine) or Colitis (inflammation of the large intestine).
Vomiting
MedGen UID:
12124
Concept ID:
C0042963
Sign or Symptom
Forceful ejection of the contents of the stomach through the mouth by means of a series of involuntary spasmic contractions.
5-Oxoprolinase deficiency
MedGen UID:
82814
Concept ID:
C0268525
Disease or Syndrome
5-Oxoprolinuria can be caused by genetic defects in either of 2 enzymes involved in the gamma-glutamyl cycle of glutathione metabolism: glutathione synthetase (GSS; 601002) or 5-oxoprolinase (OPLAH; 614243). GSS deficiency (266130) is best characterized as an inborn error of glutathione metabolism, but there is debate as to whether OPLAH deficiency represents a disorder or simply a biochemical condition with no adverse clinical effects because patients lack a consistent clinical picture apart from 5-oxoprolinuria (summary by Calpena et al., 2013).

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGV5-Oxoprolinase deficiency
Follow this link to review classifications for 5-Oxoprolinase deficiency in Orphanet.

Conditions with this feature

5-Oxoprolinase deficiency
MedGen UID:
82814
Concept ID:
C0268525
Disease or Syndrome
5-Oxoprolinuria can be caused by genetic defects in either of 2 enzymes involved in the gamma-glutamyl cycle of glutathione metabolism: glutathione synthetase (GSS; 601002) or 5-oxoprolinase (OPLAH; 614243). GSS deficiency (266130) is best characterized as an inborn error of glutathione metabolism, but there is debate as to whether OPLAH deficiency represents a disorder or simply a biochemical condition with no adverse clinical effects because patients lack a consistent clinical picture apart from 5-oxoprolinuria (summary by Calpena et al., 2013).

Recent clinical studies

Etiology

Luyasu S, Wamelink MM, Galanti L, Dive A
Acta Clin Belg 2014 Jun;69(3):221-3. Epub 2014 Apr 2 doi: 10.1179/2295333714Y.0000000022. PMID: 24694265

Diagnosis

Sass JO, Gemperle-Britschgi C, Tarailo-Graovac M, Patel N, Walter M, Jordanova A, Alfadhel M, Barić I, Çoker M, Damli-Huber A, Faqeih EA, García Segarra N, Geraghty MT, Jåtun BM, Kalkan Uçar S, Kriewitz M, Rauchenzauner M, Bilić K, Tournev I, Till C, Sayson B, Beumer D, Ye CX, Zhang LH, Vallance H, Alkuraya FS, van Karnebeek CD
Mol Genet Metab 2016 Sep;119(1-2):44-9. Epub 2016 Jul 22 doi: 10.1016/j.ymgme.2016.07.008. PMID: 27477828
Li X, Ding Y, Liu Y, Ma Y, Song J, Wang Q, Yang Y
Brain Dev 2015 Nov;37(10):952-9. Epub 2015 Apr 4 doi: 10.1016/j.braindev.2015.03.005. PMID: 25851806
Almaghlouth IA, Mohamed JY, Al-Amoudi M, Al-Ahaidib L, Al-Odaib A, Alkuraya FS
Clin Genet 2012 Aug;82(2):193-6. Epub 2011 Jun 30 doi: 10.1111/j.1399-0004.2011.01728.x. PMID: 21651516
Ristoff E, Larsson A
Orphanet J Rare Dis 2007 Mar 30;2:16. doi: 10.1186/1750-1172-2-16. PMID: 17397529Free PMC Article
Ristoff E, Larsson A
Chem Biol Interact 1998 Apr 24;111-112:113-21. doi: 10.1016/s0009-2797(97)00155-5. PMID: 9679548

Therapy

Luyasu S, Wamelink MM, Galanti L, Dive A
Acta Clin Belg 2014 Jun;69(3):221-3. Epub 2014 Apr 2 doi: 10.1179/2295333714Y.0000000022. PMID: 24694265
Kanji HD, Mithani S, Boucher P, Dias VC, Yarema MC
J Popul Ther Clin Pharmacol 2013;20(3):e207-11. Epub 2013 Sep 6 PMID: 24077426

Prognosis

Xia H, Ye J, Wang L, Zhu J, He Z
Braz J Med Biol Res 2018 Jan 11;51(3):e6853. doi: 10.1590/1414-431X20176853. PMID: 29340523Free PMC Article
Almaghlouth IA, Mohamed JY, Al-Amoudi M, Al-Ahaidib L, Al-Odaib A, Alkuraya FS
Clin Genet 2012 Aug;82(2):193-6. Epub 2011 Jun 30 doi: 10.1111/j.1399-0004.2011.01728.x. PMID: 21651516
Ristoff E, Larsson A
Orphanet J Rare Dis 2007 Mar 30;2:16. doi: 10.1186/1750-1172-2-16. PMID: 17397529Free PMC Article
Yapicioğlu H, Satar M, Tutak E, Narli N, Topaloğlu AK
Turk J Pediatr 2004 Jan-Mar;46(1):72-5. PMID: 15074378

Clinical prediction guides

Ristoff E, Larsson A
Orphanet J Rare Dis 2007 Mar 30;2:16. doi: 10.1186/1750-1172-2-16. PMID: 17397529Free PMC Article

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