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PNDDB - AADC deficiency
OMIM 608643
Gene: DDC
Enzyme: Aromatic amino acid decarboxylase (EC 4.1.1.28)
Reaction: L-Dopa > (B6) > Dopamine; 5-OH-Trp > (B6) > Serotonin
DD:
Diagnosis: CSF; Urine, Blood; DNA CSF: 5HIAA (low); HVA (low), MHPG (low), 3OMD (high), L-Dopa (high), 5HTPH (high) Urine: Vanillactic acid (high) Plasma: Prolactin (high), AADC activity (low) DNA: see PNDDB
Clinical signs & symptoms: Oculogyric crises Truncal hypotonia Limb hypertonia Chorea/athetosis Ptosis Sweeating Temperature instability Hypersalivation
Treatment: Bromocriptine 0.25-0.5 mg/kg/d - 1-2 doses/day Pergolide 4 mg/d - 2 doses/day Trihexyphenidyl <10 mg/kg/d - 3 doses/day Tranylcypromine 8 mg/d - 2 doses/day
Alternative treatment: L-Dopa <60 mg/kg/d - 3 doses/day Pyridoxine <200 mg/kg/d - 3 doses/day