Pyruvate kinase deficiency

Pyruvate kinase deficiency

Infobox_Disease
Name = PAGENAME


Caption = Phosphoenolpyruvate
DiseasesDB = 11090
ICD10 = ICD10|D|55|2|d|55
ICD9 = ICD9|282.3
ICDO =
OMIM = 266200
MedlinePlus = 001197
eMedicineSubj = med
eMedicineTopic = 1980
MeshID =

Pyruvate kinase deficiency, also called erythrocyte piruvate kinase deficiency, [OMIM|266200] is an inherited metabolic disorder of the enzyme pyruvate kinase which affects the survival of red blood cells.

Both autosomal dominant [cite journal |pmid=6475936 |year=1984 |month=Oct |author=Etiemble, J; Picat, C; Dhermy, D; Buc, Ha; Morin, M; Boivin, P |title=Erythrocytic pyruvate kinase deficiency and hemolytic anemia inherited as a dominant trait |volume=17 |issue=3 |pages=251–60 |issn=0361-8609 |journal=American journal of hematology] and recessive [cite journal |pmid=11186276 |year=2000 |month=Dec |author=Carey, Pj; Chandler, J; Hendrick, A; Reid, Mm; Saunders, Pw; Tinegate, H; Taylor, Pr; West, N |title=Prevalence of pyruvate kinase deficiency in northern European population in the north of England. Northern Region Haematologists Group |volume=96 |issue=12 |pages=4005–6 |issn=0006-4971 |journal=Blood |url=http://www.bloodjournal.org/cgi/pmidlookup?view=long&pmid=11186276 |format=Free full text] inheritance have been observed with thedisorder.

Pyruvate kinase deficiency is the second most common cause of enzyme-deficient hemolytic anemia, following G6PD deficiency.

Causes

A variety of mutations can lead to lowered production, activity, or stability of pyruvate kinase, an enzyme essential to glycolysis. A total lack of this enzyme's activity will be lethal.

Pathophysiology

Because the ability of erythrocytes to manufacture ATP depends on glycolysis, the cells become deficient in energy and unable to maintain the activity of the basolateral Na+/K+-ATPase. This will result in an increase in intracellular [Na+] which will cause water to diffuse passively into the red blood cell (RBC) and will lead to swelling. This swelling will lead to lysis of the RBCs and an increase in plasma bilirubin. The increase in plasma bilirubin will lead to jaundice and the lysis of the RBCs will lead to hemolytic anemia. The buildup of reaction intermediates can also increase the level of 2,3-bisphosphoglycerate (2,3 BPG) in the cells and affect tissue oxygenation. This will cause a "right shift" in the hemoglobin oxygen saturation curve, implying a decreased oxygen affinity for the hemoglobin and earlier oxygen unloading than under normal conditions.

Red blood cells use glycolysis as their sole energy source. In pyruvate kinase deficiency, the last step (phosphoenolpyruvate converted to pyruvate) of glycolsis is unable to occur. A discrepancy between red blood cell energy requirements and ATP generating capacity produces irreversible membrane injury resulting in cellular distortion, rigidity, and lysis. This leads to premature erythrocyte destruction by the spleen and liver.

Treatment

Most affected individuals do not require treatment. Individuals who are most severely affected may die in utero of anemia or may require blood transfusions or splenectomy, but most of the symptomatology is limited to early life and times of physiologic stress or infection.

Treatment can include a blood transfusion or removal of the spleen. Treatment is usually effective in reducing the severity of the symptoms.

References


Wikimedia Foundation. 2010.

Игры ⚽ Поможем написать реферат

Look at other dictionaries:

  • Pyruvate carboxylase deficiency — Classification and external resources Oxaloacetate is the product of pyruvate carboxylase ICD 10 E …   Wikipedia

  • Pyruvate kinase — is an enzyme involved in glycolysis. It catalyzes the transfer of a phosphate group from phosphoenolpyruvate (PEP) to ADP, yielding one molecule of pyruvate and one molecule of ATP. ReactionThe reaction with pyruvate kinase: pyruvate kinase PEP > …   Wikipedia

  • pyruvate kinase — n an enzyme that functions in glycolysis by catalyzing esp. the transfer of phosphate from phosphoenolpyruvate to ADP forming pyruvate and ATP * * * py·ru·vate ki·nase (PK) (piґroo vāt kiґnās) [EC 2.7.1.40] an enzyme of the transferase… …   Medical dictionary

  • pyruvate kinase (PK) deficiency — py·ru·vate ki·nase (PK) de·fi·cien·cy (piґroo vāt kiґnās) an autosomal recessive disorder caused by mutation in the PKLR gene (locus: 1q21), which encodes the liver and erythrocyte isozymes of pyruvate kinase. It is the most common… …   Medical dictionary

  • Deficit en pyruvate kinase — Déficit en pyruvate kinase Le déficit en pyruvate kinase est une maladie (orpheline) à transmission autosomale récessive, c est à dire que les patients sont le plus souvent, en l absence de consanguinité, des hétérozygotes composites (les parents …   Wikipédia en Français

  • Déficit En Pyruvate Kinase — Le déficit en pyruvate kinase est une maladie (orpheline) à transmission autosomale récessive, c est à dire que les patients sont le plus souvent, en l absence de consanguinité, des hétérozygotes composites (les parents sont hétérozygotes et… …   Wikipédia en Français

  • Déficit en pyruvate kinase — Le déficit en pyruvate kinase est une maladie (orpheline) à transmission autosomale récessive, c est à dire que les patients sont le plus souvent, en l absence de consanguinité, des hétérozygotes composites (les parents sont hétérozygotes et… …   Wikipédia en Français

  • Pyruvate dehydrogenase complex — (PDC) is a complex of three enzymes that transform pyruvate into acetyl CoA by a process called pyruvate decarboxylation. Acetyl CoA may then be used in the citric acid cycle to carry out cellular respiration, and this complex links the… …   Wikipedia

  • Pyruvate dehydrogenase — Crystallographic structure of pyruvate dehydrogenase (PDH). PH is a six domain dimer with α (blue), α’ (yellow), β (red), and β’ (teal) regions denoted by the different colors. Thiamine pyrophosphate (TPP) is shown in grey ball and stick form,… …   Wikipedia

  • deficiency — An insufficient quantity of some substance (as in dietary d. or hemoglobin d. in marrow aplasia); organization (as in mental d.); activity (as in enzyme d. or reduced oxygen carrying capacity of the blood), etc., of which the amount present is of …   Medical dictionary

Share the article and excerpts

Direct link
Do a right-click on the link above
and select “Copy Link”