Evolución de un caso de tirosinemia crónica tipo I tratado con NTBC
Evolution of a case of tyrosinemia type i treated with NTBC
J. Ros Viladomsa,
, M.aA. Vilaseca Buscàb, N. Lambruschini Ferric, A. Mas Comasd, E. González Pascuala, E. Holmee
Autor para correspondencia
rjimenez@hsjdbcn.org
Correspondencia: Servicio de Pediatría. Unidad Integrada Hospital Sant Joan de Déu-Hospital Clínic. P.° Sant Joan de Déu, 2. Esplugues de Llobregat. 08950 Barcelona.
Correspondencia: Servicio de Pediatría. Unidad Integrada Hospital Sant Joan de Déu-Hospital Clínic. P.° Sant Joan de Déu, 2. Esplugues de Llobregat. 08950 Barcelona.
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Esplugues de Llobregat. 08950 Barcelona." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Evolution of a case of tyrosinemia type i treated with NTBC" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2000-05-31" "fechaAceptado" => "2000-10-31" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec186599" "palabras" => array:4 [ 0 => "Hepatocarcinoma" 1 => "Error innato del metabolismo" 2 => "Osteoporosis" 3 => "Tirosina" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec186600" "palabras" => array:4 [ 0 => "Hepatocarcinoma" 1 => "Inborn error of metabolism" 2 => "Osteoporosis" 3 => "Tyrosine" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">La tirosinemia tipo I es una enfermedad hereditaria autosómica recesiva causada por la actividad deficiente de la enzima fumarilacetoacetasa. El tratamiento con 2-(2-nitro- 4-trifluorometilbenzoil)-1,3-ciclohexadiona (NTBC), un inhibidor del 4-hidroxifenilpiruvato dioxigenasa, ha sido usado con éxito en los últimos años. Se ha evaluado la respuesta clínica y bioquímica al tratamiento con NTBC en un paciente de 18 años con una forma crónica de tirosinemia tipo I, con hallazgos clínicos de raquitismo por vitamina D resistente junto con osteoporosis y múltiples fracturas y deformidades esqueléticas. Con el tratamiento los metabolitos tóxicos llegaron a ser indetectables con actividad enzimática de la porfobilinógeno sintetasa normalizada. La función renal mejoró, la hemoglobina se normalizó y la concentración de alfafetoproteína disminuyó. Su estado general mejoró de manera espectacular. Sin embargo, durante el segundo año de tratamiento, la concentración de alfafetoproteína aumentó considerablemente y el paciente desarrolló un carcinoma hepatocelular. El tratamiento con NTBC debe considerarse, incluso en casos de tirosinemia tipo I avanzados, como terapia paliativa.</p>" ] "en" => array:1 [ "resumen" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Tyrosinemia type I is an autosomal recessive inherited disorder caused by deficient fumarylacetoacetase activity. Treatment with 2-(2-nitro-4-trifluoro-methylbenzoyl)- 1,3-cyclohexanedione (NTBC), an inhibitor of 4-hydroxyphenylpyruvate dioxygenase, has successfully been applied for the last few years. Our aim was to evaluate the clinical and biochemical response to treatment with NTBC of a 18-year-old patient with a chronic form of tyrosinemia type I, whose main clinical feature was vitamin D-resistant rickets leading to severe osteoporosis with multiple bone fractures and skeletal deformities. After treatment, toxic metabolites became undetectable and porphobilinogen synthase activity returned to normal. Renal function improved, blood hemoglobin returned to normal and alfa-fetoprotein decreased. The patient's general condition greatly improved. However, the alfa-fetoprotein concentration slowly increased during the second year of NTBC treatment and hepatocellular carcinoma developed. NTBC treatment should be considered even in advanced cases of tyrosinemia type I, although only as a palliative therapy.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:19 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "On the enzymic defects in hereditary tyrosinemia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "B. Lindblad" 1 => "S. Lindstedt" 2 => "G. 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 6 | 12 | 18 |
| 2024 Octubre | 39 | 47 | 86 |
| 2024 Septiembre | 39 | 43 | 82 |
| 2024 Agosto | 55 | 96 | 151 |
| 2024 Julio | 29 | 53 | 82 |
| 2024 Junio | 41 | 62 | 103 |
| 2024 Mayo | 31 | 50 | 81 |
| 2024 Abril | 36 | 51 | 87 |
| 2024 Marzo | 39 | 57 | 96 |
| 2024 Febrero | 50 | 50 | 100 |
| 2024 Enero | 30 | 45 | 75 |
| 2023 Diciembre | 39 | 39 | 78 |
| 2023 Noviembre | 30 | 34 | 64 |
| 2023 Octubre | 39 | 41 | 80 |
| 2023 Septiembre | 25 | 39 | 64 |
| 2023 Agosto | 28 | 25 | 53 |
| 2023 Julio | 23 | 40 | 63 |
| 2023 Junio | 33 | 46 | 79 |
| 2023 Mayo | 41 | 48 | 89 |
| 2023 Abril | 31 | 36 | 67 |
| 2023 Marzo | 33 | 44 | 77 |
| 2023 Febrero | 11 | 39 | 50 |
| 2023 Enero | 18 | 36 | 54 |
| 2022 Diciembre | 32 | 30 | 62 |
| 2022 Noviembre | 45 | 55 | 100 |
| 2022 Octubre | 36 | 52 | 88 |
| 2022 Septiembre | 31 | 25 | 56 |
| 2022 Agosto | 38 | 39 | 77 |
| 2022 Julio | 25 | 36 | 61 |
| 2022 Junio | 24 | 40 | 64 |
| 2022 Mayo | 22 | 48 | 70 |
| 2022 Abril | 34 | 56 | 90 |
| 2022 Marzo | 41 | 43 | 84 |
| 2022 Febrero | 34 | 32 | 66 |
| 2022 Enero | 34 | 71 | 105 |
| 2021 Diciembre | 34 | 70 | 104 |
| 2021 Noviembre | 32 | 60 | 92 |
| 2021 Octubre | 35 | 65 | 100 |
| 2021 Septiembre | 27 | 43 | 70 |
| 2021 Agosto | 29 | 32 | 61 |
| 2021 Julio | 35 | 39 | 74 |
| 2021 Junio | 32 | 34 | 66 |
| 2021 Mayo | 37 | 28 | 65 |
| 2021 Abril | 80 | 53 | 133 |
| 2021 Marzo | 83 | 24 | 107 |
| 2021 Febrero | 93 | 18 | 111 |
| 2021 Enero | 57 | 24 | 81 |
| 2020 Diciembre | 34 | 26 | 60 |
| 2020 Noviembre | 26 | 15 | 41 |
| 2020 Octubre | 18 | 10 | 28 |
| 2020 Septiembre | 14 | 9 | 23 |
| 2020 Agosto | 16 | 11 | 27 |
| 2020 Julio | 49 | 19 | 68 |
| 2020 Junio | 17 | 22 | 39 |
| 2020 Mayo | 32 | 21 | 53 |
| 2020 Abril | 29 | 20 | 49 |
| 2020 Marzo | 23 | 17 | 40 |
| 2020 Febrero | 25 | 16 | 41 |
| 2020 Enero | 32 | 26 | 58 |
| 2019 Diciembre | 51 | 36 | 87 |
| 2019 Noviembre | 19 | 27 | 46 |
| 2019 Octubre | 12 | 36 | 48 |
| 2019 Septiembre | 18 | 48 | 66 |
| 2019 Agosto | 26 | 21 | 47 |
| 2019 Julio | 31 | 27 | 58 |
| 2019 Junio | 21 | 43 | 64 |
| 2019 Mayo | 43 | 57 | 100 |
| 2019 Abril | 33 | 55 | 88 |
| 2019 Marzo | 15 | 23 | 38 |
| 2019 Febrero | 16 | 17 | 33 |
| 2019 Enero | 12 | 28 | 40 |
| 2018 Diciembre | 22 | 14 | 36 |
| 2018 Noviembre | 24 | 18 | 42 |
| 2018 Octubre | 44 | 15 | 59 |
| 2018 Septiembre | 16 | 7 | 23 |
| 2018 Agosto | 4 | 0 | 4 |
| 2018 Junio | 1 | 0 | 1 |
| 2018 Mayo | 3 | 0 | 3 |
| 2018 Abril | 7 | 0 | 7 |
| 2018 Marzo | 8 | 0 | 8 |
| 2018 Febrero | 9 | 0 | 9 |
| 2018 Enero | 7 | 0 | 7 |
| 2017 Diciembre | 6 | 0 | 6 |
| 2017 Noviembre | 7 | 0 | 7 |
| 2017 Octubre | 9 | 0 | 9 |
| 2017 Septiembre | 10 | 2 | 12 |
| 2017 Agosto | 4 | 0 | 4 |
| 2017 Julio | 12 | 0 | 12 |
| 2017 Junio | 21 | 30 | 51 |
| 2017 Mayo | 13 | 23 | 36 |
| 2017 Abril | 12 | 12 | 24 |
| 2017 Marzo | 22 | 32 | 54 |
| 2017 Febrero | 4 | 24 | 28 |
| 2017 Enero | 7 | 6 | 13 |
| 2016 Diciembre | 19 | 17 | 36 |
| 2016 Noviembre | 34 | 15 | 49 |
| 2016 Octubre | 42 | 34 | 76 |
| 2016 Septiembre | 30 | 30 | 60 |
| 2016 Agosto | 31 | 11 | 42 |
| 2016 Julio | 18 | 23 | 41 |
| 2016 Junio | 3 | 15 | 18 |
| 2016 Mayo | 3 | 12 | 15 |
| 2016 Abril | 2 | 0 | 2 |
| 2016 Marzo | 5 | 0 | 5 |
| 2016 Febrero | 5 | 0 | 5 |
| 2016 Enero | 3 | 0 | 3 |
| 2015 Diciembre | 4 | 0 | 4 |
| 2015 Noviembre | 3 | 0 | 3 |
| 2015 Octubre | 3 | 0 | 3 |
| 2015 Septiembre | 2 | 0 | 2 |
| 2015 Agosto | 3 | 0 | 3 |
| 2015 Julio | 9 | 0 | 9 |
| 2015 Junio | 5 | 7 | 12 |
| 2015 Mayo | 8 | 0 | 8 |
| 2015 Abril | 10 | 16 | 26 |
| 2015 Marzo | 12 | 8 | 20 |
| 2015 Febrero | 10 | 7 | 17 |
| 2015 Enero | 10 | 5 | 15 |
| 2014 Diciembre | 20 | 4 | 24 |
| 2014 Noviembre | 11 | 1 | 12 |
| 2014 Octubre | 21 | 1 | 22 |
| 2014 Septiembre | 17 | 2 | 19 |
| 2014 Agosto | 21 | 1 | 22 |
| 2014 Julio | 18 | 1 | 19 |
| 2014 Junio | 51 | 1 | 52 |
| 2014 Mayo | 54 | 2 | 56 |
| 2014 Abril | 53 | 3 | 56 |
| 2014 Marzo | 45 | 8 | 53 |
| 2014 Febrero | 43 | 10 | 53 |
| 2014 Enero | 35 | 9 | 44 |
| 2013 Diciembre | 50 | 13 | 63 |
| 2013 Noviembre | 43 | 4 | 47 |
| 2013 Octubre | 42 | 8 | 50 |
| 2013 Septiembre | 20 | 8 | 28 |
| 2013 Agosto | 33 | 9 | 42 |
| 2013 Julio | 24 | 3 | 27 |
| 2013 Junio | 2 | 2 | 4 |
| 2013 Mayo | 3 | 2 | 5 |
| 2013 Abril | 2 | 1 | 3 |
| 2013 Marzo | 5 | 2 | 7 |
| 2013 Febrero | 17 | 2 | 19 |
| 2013 Enero | 11 | 2 | 13 |
| 2012 Diciembre | 6 | 1 | 7 |
| 2012 Noviembre | 5 | 4 | 9 |
| 2012 Octubre | 1 | 0 | 1 |
| 2012 Agosto | 1 | 1 | 2 |
| 2001 Marzo | 3249 | 0 | 3249 |
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