However, there are not enough studies in the literature about application and efficacy of this treatment. Link to citation list in Scopus. Data from this investigation support the use of psychological tests to evaluate cognitive and neuropsychological deficits that vary with metabolic changes associated with MSUD. On 28th hour of hemodialysis, patient had a fever and he had infection criteria but infection focus could not be detected. Confirmatory testing done with plasma amino acid levels collected at 8 days of life showed elevated levels of leucine.

In 1-year follow-up, branched-chain amino acid levels of the patient were within normal range Table 1. In a 5-person group of both classic and late-onset MSUD cases, patients were given NaPB for treatment and 3 out of 5 showed a significant decrease in branched-chain amino acid levels independent of residual BCKDH activity [ 6 ]. A 2-week-old male infant was born at term after an uneventful pregnancy and a normal vaginal delivery. I feel that the option of BCKD supplementation in conjunction with dietary regulation should be considered over a liver transplant. The condition shows in five different clinical phenotypes as classic, intermediate, intermittent, thiamine-responsive and E3 deficiency type [ 3 ]. Selected tests of neuropsychological and cognitive functioning, administered before dietary treatment and immediately following metabolic stabilization and at 5-week follow-up, indicated considerable clinical improvement.

Outcome of maple syrup urine disease. Exclusive breast feeding may delay stud onset to the second week of life. However, patient showed no response to thiamine treatment.

Maple Syrup Urine Disease Case Study – Philip’s Portfolio

Stdy has an annual incidence of 1 inlive births worldwide. The case we discussed here in our paper could be possibly interpreted as the first example of an alternative attack management method in situations where extracorporeal procedures are not available due to technical reasons. Neuropsychiatry, Neuropsychology and Behavioral NeurologyVol. Link to citation list in Scopus.


Access to Document Link to publication in Scopus. These abnormalities resolve promptly after treatment. A case study of maple syrup urine disease, dietary treatment and neuropsychological performance.

No attacks were seen. He has been treated by high-dextrose fluid and intralipids glucose: Following the path of these studies, new studies about using nitrogen scavenging agents in MSUD patients to reduce branched-chain amino acid levels are also in progress [ 6 ]. Eight Fr double-lumen hemodialysis catheter was placed into femoral vein and continuous venovenous hemodialysis CVVHD was started.

The patient had deep metabolic acidosis and his msudd amino acid levels were leu: Conflicts of interest There are no conflicts of interest.

Case Reports in Pediatrics

There had been no problems through pregnancy and birth, but once Matthew was born, he had failed to thrive. Diagnosis and treatment of maple syrup disease: Maple syrup urine disease. Chuang D, Shih V. If untreated, the disease progresses to cause seizures, coma, and eventually, death.

msud case study

Despite this diet, he still suffered from chronic and severe metabolic crises. KathaitPaulo Puacand Mauricio Castillo. Heterozygous carriers are not affected by MSUD, but only have one functional allele.


A 2-day-old male infant was hospitalized in pediatric intensive care unit with encephalopathy findings of repetitive myoclonic convulsions, hypertonicity, and pedaling. Disorders of branched-chain studdy acid and studdy acid metabolism. Global known incidence rate of this condition is 1 in [ 1 ]. A homozygous dominant individual should have normal amino acid blood levels because they have to functional alleles in their genome.

It is characterized by an enzymatic deficiency of branched-chain alpha-ketoacid dehydrogenase complex leading to accumulation of BCAAs leucine, isoleucine, and valineand their toxic by-products keto acids in blood and urine. Noncontrast-enhanced computed tomography of the brain shows diffuse bilaterally symmetrical hypodensity within the aforementioned structures but lacks the specificity and sensitivity offered by MRI.

Maple syrup urine disease: report of two cases.

His physical examination during initial admission showed moderate dehydration and lethargy. However, there are not enough studies in the literature about application and efficacy of this treatment. Each of them can be distinguished from the other based on age of onset, severity of clinical symptoms, and response to thiamine. View at Google Scholar L. In 1-year follow-up, branched-chain amino acid levels of the patient were within normal range Table 1.

msud case study

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