Maple syrup urine disease

Case contributed by Utkarsh Kabra
Diagnosis certain

Presentation

Poor feeding, hypoglycemia.

Patient Data

Age: 10 days
Gender: Male
mri

Nearly symmetrical areas of diffusion restriction involving centrum semiovale, perirolandic white matter, posterior limbs of both internal capsules, bilateral thalami, brainstem and bilateral cerebellar white matter.

Possible microhemorrhages in bilateral cerebellar hemispheres.

Case Discussion

Findings are consistent with maple syrup urine disease. The child had an elder sibling who passed away due to the same inborn error of metabolism.

Toxic metabolic screen was suggestive of the same and genetic exome sequencing confirmed the diagnosis.

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