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Table 1 Outcome in EE patients treated by liver transplantation compared to medical therapies (follow-up ≥ 1 year)

From: Ethylmalonic encephalopathy and liver transplantation: long-term outcome of the first treated patient

Reference

Genotype

Age at onset

Phenotype

Age at last follow-up

Liver Transplant age

Low protein diet start–end

NAC therapy start–end

MTZ Therapy start–end

EMA baseline/follow-up

Reported outcome at follow-up

Present Case

c.131_132delAG/131_132delAG

7 m

Severe

7 y

9 m

 

7 m–ongoing

7 m–21 m

205/40

Disease stabilization, achievement of cognitive and social skills (says few words, sits unaided), persistence of diarrhea and skin signs, MRI improvement of atrophy

[28]

del exon 4/del exon 4

NBS

Severe

2.3 y

19 m

 

13 m–ongoing

13 m–ongoing

 

Improvement of social and language skills, sits unaided, babbling

[28]

c.487C>T/c.487C>T

NBS

Severe

2.9 y

13 m

 

2 m–ongoing

2 m–ongoing

153/31

Seven months after transplant episode of metabolic decompensation, then slow improvements in motor, verbal and social skills (sit unaided, says few simple words)

[29]

c.375 + 5G>A/c.462 T>A

1 m

Severe

3.2 y

18 m

15 m–18 m

 

15–20 m

179/70.7

No remarkable general amelioration, disease stabilization, quadriplegia, achievement of few words, head control, persistence of skin signs and diarrhea, MRI stabilization

[11]

c.131_132delAG/c.566delG

NBS

Severe

2.1 y

 

8 m–ongoing

1.5 m–ongoing

1.5 m–ongoing

617.7/383.9

Slow developments in motor and verbal skills, sits unaided, says few words, mild skin signs, no diarrhea

[32]

c.448G>A/c.448G>A

10 m

Severe

2.5 y

 

15 m–ongoing

15 m–ongoing

15 m–ongoing

 

Disease stabilization, psychomotor achievements, says simple words, walks with aid

[11]

c.505 + 1G>A/c.505 + 1G>A

NBS

Severe

2.1 y

  

2 m–ongoing

2 m–ongoing

586/352.2

Sits unaided, poor growth, diffuse skin signs, non-verbal achievement, good visual attention, no diarrhea

[15]

c.79C>A/c.79C>A

10 y

Mild

19 y

  

16 y–ongoing

16 y–ongoing

72/74

Improvement of mobility and speech, at 17 years episode of acute decompensation with seizures followed by regain of functionalities

[31]

c.3G>T/c.3G>T

5 y

Mild

15 y

  

11 y–ongoing

11 y–ongoing

46/24

Improved diarrhea and QoL, worsening of paraparesis, normal IQ, normal MRI

  1. EMA Ethylmalonic acid, mean values expressed as mmol/mol creatinine, MTZ metronidazole, NAC N-acetylcysteine, NBS newborn screening, QoL quality of life