[Cerebral creatine transporter deficiency: an infradiagnosed neurometabolic disease].

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Campistol J, Arias-Dimas A, Poo P, Pineda M, Hoffman M, Vilaseca MA, Artuch R, Ribes A

[Cerebral creatine transporter deficiency: an infradiagnosed neurometabolic disease].

Rev Neurol. 2007 Mar 16-31;44(6):343-7.

PubMed ID

17385170 [ View in PubMed

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Abstract

INTRODUCTION: Brain creatine deficiencies are a group of inborn errors of metabolism recently recognized which are caused by arginine: glycine amidinotransferase (AGAT) deficiency, guanidinoacetate metiltransferase (GAMT) deficiency and defects in creatine transporter (CRTR). Although all of them are characterized by a brain creatine deficiency, clinical and biochemical features are different. CASE REPORTS: We present a retrospective study about four patients of masculine sex affected of creatine transporter defects who were recently diagnosed in our centre. We describe the clinical presentation features, the different tests that we used in the diagnosis process (brain magnetic resonance spectroscopy, biochemical analysis of guanidinoacetate and creatine/creatinine ratio in urine), evolution aspects and the response to treatment. The most significative clinical feature was developmental delay mainly in expressive speech, they also presented epilepsy (three cases), autism (three cases), hypotonia (one case) and microcephalia (one case). Brain magnetic resonance spectroscopy showed a low (three cases) or an absence (one case) of creatine level. To confirm the defect we studied the creatine uptake in fibroblasts and molecular analysis of the SLC6A8/creatine transporter gene. Patients with creatine transporter deficiency are being treated with arginine, because a lack of response to creatine. CONCLUSION: Cerebral creatine transporter deficiency can present with different neurological symptoms but developmental and language delay and epilepsy are the most significative; diagnosis is easy and there are some therapeutical options.

DrugBank Data that Cites this Article

Drug Targets

Drug	Target	Kind	Organism	Pharmacological Action	Actions
Creatine	Sodium- and chloride-dependent creatine transporter 1	Protein	Humans	Yes	Not Available	Details
Phosphocreatine	Sodium- and chloride-dependent creatine transporter 1	Protein	Humans	Yes	Not Available	Details