Prepair 500+
Gene: PDHA1
Onset in infancy or early childhood (OMIM).
Variants in this gene are known to have variable expressivity which has been detailed by PMID: 22142326.
- Neonatal lactic acidosis predominates in males, in whom the degree of residual pyruvate dehydrogenase complex (PDHC) activity depends on the PDHA1 mutation.
- Very severe mutations are not found in males, probably because they are embryonically lethal.
- In heterozygous females, the residual PDHC activity is related to both the mutation and the random pattern of X‐inactivation, with variable expression of the mutant and normal genes in different tissues.
- Females can also present a severe clinical picture, with early‐onset microcephaly, spastic quadriplegia, severe epilepsy, and cortical/subcortical atrophy.
- In the milder form, individuals may show intercurrent clinical and biochemical normalization, despite persistence of neuroradiological and electrophysiological findings. Some late‐onset childhood variants respond to thiamine supplementation.Created: 16 Jan 2025, 8:54 p.m. | Last Modified: 16 Jan 2025, 8:54 p.m.
Panel Version: 1.1064
Mode of inheritance
X-LINKED: hemizygous mutation in males, monoallelic mutations in females may cause disease (may be less severe, later onset than males)
Phenotypes
Pyruvate dehydrogenase E1-alpha deficiency MIM#312170
Publications
Reports of familial recurrence suggest that some females are mildly or not clinically affected and just have reproductive risk of severely affected males/females.Created: 17 Aug 2022, 6:40 a.m. | Last Modified: 17 Aug 2022, 6:40 a.m.
Panel Version: 0.131
Mode of inheritance
X-LINKED: hemizygous mutation in males, biallelic mutations in females
Phenotypes
Pyruvate dehydrogenase E1-alpha deficiency (MIM#312170)
Well-established gene disease association however condition shows XLD inheritance with a high proportion of females affected. Complete loss-of-function variants are embryonic lethal in males. Phenotype is highly variable
Does not fit with scope of testing (AR/XLR) - consider for exclusionCreated: 14 Jul 2022, 11:12 p.m. | Last Modified: 14 Jul 2022, 11:12 p.m.
Panel Version: 0.49
Mode of inheritance
X-LINKED: hemizygous mutation in males, monoallelic mutations in females may cause disease (may be less severe, later onset than males)
Phenotypes
Pyruvate dehydrogenase E1-alpha deficiency (MIM#312170)
Publications
gene: PDHA1 was added gene: PDHA1 was added to Prepair 500+. Sources: Mackenzie's Mission,Expert Review Green Mode of inheritance for gene: PDHA1 was set to X-LINKED: hemizygous mutation in males, biallelic mutations in females Publications for gene: PDHA1 were set to 28584645; 22142326 Phenotypes for gene: PDHA1 were set to Pyruvate dehydrogenase E1-alpha deficiency (MIM#312170)