A deficiência de Carnitina Palmitoiltransferase II (CPT II) é uma doença metabólica hereditária que afeta a forma como as mitocôndrias (as "usinas de energia" das células) processam e transformam em energia certos tipos de gordura, chamados ácidos graxos de cadeia longa (AGCL). Existem três formas conhecidas da deficiência de CPT II: uma forma que afeta os músculos, uma forma grave que atinge bebês e uma forma que aparece em recém-nascidos.
Introdução
O que você precisa saber de cara
A deficiência de Carnitina Palmitoiltransferase II (CPT II) é uma doença metabólica hereditária que afeta a forma como as mitocôndrias (as "usinas de energia" das células) processam e transformam em energia certos tipos de gordura, chamados ácidos graxos de cadeia longa (AGCL). Existem três formas conhecidas da deficiência de CPT II: uma forma que afeta os músculos, uma forma grave que atinge bebês e uma forma que aparece em recém-nascidos.
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<1/50kMuito rara
1/20kRara
1/10kPouco freq.
1/5kIncomum
1/2k
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Sinais e sintomas
O que aparece no corpo e com que frequência cada sintoma acontece
Partes do corpo afetadas
+ 32 sintomas em outras categorias
Características mais comuns
Os sintomas variam de pessoa para pessoa. Abaixo estão as 116 características clínicas mais associadas, ordenadas por frequência.
Linha do tempo da pesquisa
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Genética e causas
O que está alterado no DNA e como passa nas famílias
Genes associados
1 gene identificado com associação a esta condição. Padrão de herança: Autosomal recessive.
Involved in the intramitochondrial synthesis of acylcarnitines from accumulated acyl-CoA metabolites (PubMed:20538056, PubMed:24780397). Reconverts acylcarnitines back into the respective acyl-CoA esters that can then undergo beta-oxidation, an essential step for the mitochondrial uptake of long-chain fatty acids and their subsequent beta-oxidation in the mitochondrion. Active with medium (C8-C12) and long-chain (C14-C18) acyl-CoA esters (PubMed:20538056)
Mitochondrion inner membrane
Carnitine palmitoyltransferase 2 deficiency, myopathic, stress-induced
An autosomal recessive disorder of mitochondrial long-chain fatty acid oxidation, characterized by recurrent myoglobinuria, episodes of muscle pain, stiffness, and rhabdomyolysis. These symptoms are exacerbated by prolonged exercise, fasting, cold, or viral infection. CPT2DM affects most frequently children or young adults, and severity of attacks is highly variable. Myoglobinuria can cause kidney failure and death.
Medicamentos e terapias
Mecanismo: Peroxisome proliferator-activated receptor agonist
Variantes genéticas (ClinVar)
308 variantes patogênicas registradas no ClinVar.
Classificação de variantes (ClinVar)
Distribuição de 994 variantes classificadas pelo ClinVar.
Vias biológicas (Reactome)
2 vias biológicas associadas aos genes desta condição.
Diagnóstico
Os sinais que médicos procuram e os exames que confirmam
Tratamento e manejo
Remédios, cuidados de apoio e o que precisa acompanhar
Onde tratar no SUS
Hospitais de referência no Brasil e o protocolo oficial do SUS (PCDT)
🇧🇷 Atendimento SUS — Deficiência de carnitina palmitoiltransferase 2
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Outros ensaios clínicos
13 ensaios clínicos encontrados, 1 ativos.
Publicações mais relevantes
Metabolic Myopathies and HyperCKemia in Adulthood: A Clinical Approach to Diagnosis and Management.
HyperCKemia, defined as elevated serum creatine kinase, commonly reflects muscle injury but may also indicate underlying metabolic disease. Metabolic aetiologies, including glycogen storage disorders, fatty acid oxidation defects, mitochondrial cytopathies, and purine metabolism disorders, are clinically important owing to diagnostic complexity, therapeutic implications, and potential reversibility. To summarise current evidence on metabolic causes of hyperCKemia in adults, with emphasis on disorders of carbohydrate, lipid, and purine metabolism and mitochondrial disease. Semi-systematic narrative review of pathophysiology, clinical features, diagnostic approaches, and management of metabolic disorders associated with hyperCKemia. Metabolic myopathies often present with nonspecific or exercise-related symptoms, with creatine kinase levels ranging from mild-to-severe elevations. Conditions such as McArdle disease, carnitine palmitoyltransferase II deficiency, and mitochondrial cytopathies demonstrate characteristic metabolic vulnerabilities leading to episodic or persistent hyperCKemia. Medications, including statins and antiretrovirals, may precipitate symptoms in predisposed individuals. Diagnosis requires a structured, multidisciplinary approach incorporating biochemical testing, genetic analysis, functional studies, and muscle biopsy. Many causes are amenable to targeted therapy, including dietary modification, endocrine correction, and medication withdrawal. Metabolic causes of hyperCKemia are under-recognised but clinically significant. Early identification allows targeted treatment and prevention of complications.
[Carnitine palmitoyltransferase II deficiency: Impaired fatty acid oxidation].
Migratory and intermittent polyarthritis as an atypical presentation of carnitine palmitoyltransferase II deficiency with positive response to treatment with Interleukin-1 receptor antagonist: a case presentation and case-based review.
Carnitine palmitoyltransferase 2 (CPT2) deficiency is an autosomal recessive disorder affecting fatty-acid metabolism that manifests in three phenotypes: lethal neonatal, infantile and adult. In the adult population, CPT2 deficiency is characterized as the commonest cause of recurrent episodes of rhabdomyolysis. Although inflammatory arthritis has not been previously associated with CPT2 deficiency, existing literature suggests a potential mechanism involving synovial inflammation secondary to the accumulation of fatty acids and acylcarnitine. Attacks are most commonly triggered by infections, strenuous exercise, fasting and consumption of a fat-rich meal. Management in typically conservative, involving dietary modification (high-carbohydrate, low-fat diet) and personalized exercise regimens. The following article describes the case of 43-year old male patient with chronic, intermittent arthritis who was diagnosed with CPT2 deficiency and is currently receiving treatment with interleukin 1 receptor antagonist (IL-1Ra). In addition, a case-based review was conducted to evaluate the possible, underlying mechanisms of inflammatory arthritis in patients with CPT2 deficiency, along with any nuances in the treatment strategy. The presented case, along with the associated case-based literature review, highlight the inflammatory changes taking place in the synovial cells upon accumulation of fatty acids and acylcarnitine molecules that release IL-1β. Finally, the report explores potential future therapeutic strategies.
Severe rhabdomyolysis in an infant due to fatty acid oxidation disorder: a case report.
Rhabdomyolysis can develop from numerous etiologies, both acquired and hereditary. Consequences of rhabdomyolysis may be grave, therefore identifying and treating the etiology is crucial. We herein report the occurrence of severe rhabdomyolysis in a previously healthy 14-month-old infant presenting to the emergency department with fever, hypotonia, and generalized discomfort. Analysis revealed extremely high creatine phosphokinase levels (> 100,000 UI/L). Metabolic myopathy was suspected, however, primary metabolic analyses were normal. Carnitine palmitoyltransferase II deficiency was diagnosed following genetic analysis, identifying a homozygous NM_000098.3, c.338C > T, p.[Ser113Leu] missense variant. Prophylactic measures were established to prevent relapse and genetic counseling provided for the sibship. This case highlights the difficulty of diagnosing carnitine palmitoyltransferase II deficiency in an infant and the importance of genetic analysis to establish the diagnosis, despite a normal acylcarnitine profile.
Battling Recurrent Rhabdomyolysis in Carnitine Palmitoyltransferase II Deficiency.
Carnitine palmitoyltransferase II (CPT II) deficiency is an inherited metabolic disorder that impairs the mitochondrial oxidation of long-chain fatty acids, leading to decreased utilization of these fatty acids. The adult form of this condition is characterized by recurrent rhabdomyolysis, often exacerbated by exercise, fasting, extremes of temperature, and infections. This case study details a severe episode of rhabdomyolysis triggered by a chest infection in a patient with CPT II deficiency. It discusses the management strategies for such acute episodes, emphasizing the importance of immediate intervention and avoiding potential triggers to prevent severe complications. The findings highlight the necessity of proactive management and preventive measures to mitigate risks in affected individuals.
Publicações recentes
Carnitine Palmitoyltransferase II Deficiency.
Metabolic Myopathies and HyperCKemia in Adulthood: A Clinical Approach to Diagnosis and Management.
📖 Revisão[Carnitine palmitoyltransferase II deficiency: Impaired fatty acid oxidation].
🥇 Meta-análiseMigratory and intermittent polyarthritis as an atypical presentation of carnitine palmitoyltransferase II deficiency with positive response to treatment with Interleukin-1 receptor antagonist: a case presentation and case-based review.
🥇 Revisão sistemáticaSevere rhabdomyolysis in an infant due to fatty acid oxidation disorder: a case report.
📚 EuropePMC104 artigos no totalmostrando 56
Metabolic Myopathies and HyperCKemia in Adulthood: A Clinical Approach to Diagnosis and Management.
Journal of clinical medicine[Carnitine palmitoyltransferase II deficiency: Impaired fatty acid oxidation].
MMW Fortschritte der MedizinMigratory and intermittent polyarthritis as an atypical presentation of carnitine palmitoyltransferase II deficiency with positive response to treatment with Interleukin-1 receptor antagonist: a case presentation and case-based review.
Rheumatology internationalSevere rhabdomyolysis in an infant due to fatty acid oxidation disorder: a case report.
Journal of medical case reportsBattling Recurrent Rhabdomyolysis in Carnitine Palmitoyltransferase II Deficiency.
CureusRecurrent rhabdomyolysis caused by palmitoyltransferase II (CPT-2) deficiency but complete normal acylcarnitine profile: A patient presentation and review of the literature.
Molecular genetics and metabolism reportsDiagnostic Challenges in the Myopathic Variant of Carnitine Palmitoyltransferase II Deficiency: A Case Report.
CureusThiopentone-based total intravenous anaesthesia for a patient with carnitine palmitoyltransferase II deficiency and malignant hyperthermia susceptibility.
Anaesthesia reportsExpanded Newborn Screening for Inborn Errors of Metabolism in Hong Kong: Results and Outcome of a 7 Year Journey.
International journal of neonatal screeningMyopathy due to carnitine palmitoyltransferase II deficiency: updating genetic aspects of the first publication in Brazil.
Arquivos de neuro-psiquiatriaLow C0 and normal C16 and C18:1 masking the diagnosis of carnitine palmitoyltransferase II deficiency including a novel CPT2 variant: A case report.
Archives de pediatrie : organe officiel de la Societe francaise de pediatrieNewborn Screening with (C16 + C18:1)/C2 and C14/C3 for Carnitine Palmitoyltransferase II Deficiency throughout Japan Has Revealed C12/C0 as an Index of Higher Sensitivity and Specificity.
International journal of neonatal screeningExperience with carnitine palmitoyltransferase II deficiency: diagnostic challenges in the myopathic form.
Journal of pediatric endocrinology & metabolism : JPEMDoes SARS-Cov-2 Trigger Rhabdomyolysis in Carnitine-Palmitoyltransferase-II Deficiency?
Prilozi (Makedonska akademija na naukite i umetnostite. Oddelenie za medicinski nauki)Adult-onset carnitine palmitoyl transferase II (CPT II) deficiency presenting with rhabdomyolysis and acute kidney injury.
CEN case reportsFrom recurrent rhabdomyolysis in a young adult to carnitine palmitoyltransferase II deficiency.
Archive of clinical casesDo renal and cardiac malformations in the fetus signal carnitine palmitoyltransferase II deficiency? A rare lethal fatty acid oxidation defect.
BMJ case reportsA rare presentation of Carnitine palmitoyltransferase II (CPT-2) deficiency with normal acylcarnitine profile in a 10-year-old boy with muscle weakness and bilateral hearing loss; a case report.
Iranian journal of child neurologyRhabdomyolysis Associated with Recent SARS-COV-2 Infection in a Patient with Carnitine Palmitoyltransferase II Deficiency.
Prilozi (Makedonska akademija na naukite i umetnostite. Oddelenie za medicinski nauki)A Case of Carnitine Palmitoyltransferase II Deficiency in Bahrain With a Novel Mutation.
CureusHypercholesterolaemia treatment in a patient with family hypercholesterolaemia and myopathy due to carnitine palmitoyltransferase II deficiency with PCSK9 inhibitors.
NeurologiaDetection of Early Onset Carnitine Palmitoyltransferase II Deficiency by Newborn Screening: Should CPT II Deficiency Be a Primary Disease Target?
International journal of neonatal screeningClinical Reasoning: A 2-Day-Old Boy With Sudden Cardiac Arrest and Encephalopathy.
NeurologyCarnitine palmitoyltransferase-II deficiency: case presentation and review of the literature.
Romanian journal of internal medicine = Revue roumaine de medecine interneHypercholesterolemia treatment in a patient with family hypercholesterolemia and myopathy due to carnitine palmitoyltransferase II deficiency with PCSK9 inhibitors.
NeurologiaCause of recurrent rhabdomyolysis, carnitine palmitoyltransferase II deficiency and novel pathogenic mutation.
Ideggyogyaszati szemleCarnitine palmitoyltransferase II deficiency and post-COVID vaccination rhabdomyolysis.
QJM : monthly journal of the Association of PhysiciansSchizophrenic Psychosis Symptoms in a Background of Mild-To-Moderate Carnitine Palmitoyltransferase II Deficiency: A Case Report.
Reports (MDPI)Severe rhabdomyolysis in homozygote carnitine palmitoyltransferase II deficiency.
EXCLI journalNeed for strict clinical management of patients with carnitine palmitoyltransferase II deficiency: Experience with two cases detected by expanded newborn screening.
Molecular genetics and metabolism reportsSubclinical effects of long-chain fatty acid β-oxidation deficiency on the adult heart: A case-control magnetic resonance study.
Journal of inherited metabolic diseaseCase 1: Lethal Pulmonary Hemorrhage in a 3-day-old Term Infant.
NeoReviews[Tandem mass spectrometry analysis and genetic diagnosis of neonates with fatty acid oxidation disorders in central and northern regions of Guangxi].
Zhonghua yi xue yi chuan xue za zhi = Zhonghua yixue yichuanxue zazhi = Chinese journal of medical geneticsCarnitine palmitoyltransferase II deficiency in a prenatal case with polycystic kidney disease-like phenotype.
Congenital anomaliesRecurrent Myalgia since Early Infancy-Misleading Clinical Course in a Child with Carnitine Palmitoyltransferase-II Deficiency.
NeuropediatricsStatin use in carnitine palmitoyltransferase II deficiency.
Journal of clinical lipidologyUnrecognized High Occurrence of Genetically Confirmed Hereditary Carnitine Palmitoyltransferase II Deficiency in an Austrian Family Points to the Ongoing Underdiagnosis of the Disease.
Frontiers in geneticsExome-Based Rare-Variant Analyses in CKD.
Journal of the American Society of Nephrology : JASNNormal FGF-21-Serum Levels in Patients with Carnitine Palmitoyltransferase II (CPT II) Deficiency.
International journal of molecular sciencesCarnitine palmitoyltransferase II deficiency with a focus on newborn screening.
Journal of human geneticsRhabdomyolysis-Associated Acute Kidney Injury.
American journal of kidney diseases : the official journal of the National Kidney FoundationRecurrent rhabdomyolysis caused by carnitine palmitoyltransferase II deficiency, common but under-recognised: Lessons to be learnt.
Molecular genetics and metabolism reportsCarnitine Palmitoyltransferase II Deficiency (CPT II) Followed By Rhabdomyolysis and Acute Kidney Injury.
Open access Macedonian journal of medical sciencesRhabdomyolysis with different etiologies in childhood.
World journal of clinical pediatricsNewborn screening for carnitine palmitoyltransferase II deficiency using (C16+C18:1)/C2: Evaluation of additional indices for adequate sensitivity and lower false-positivity.
Molecular genetics and metabolismA surviving 24-month-old patient with neonatal-onset carnitine palmitoyltransferase II deficiency.
Molecular genetics and metabolism reportsA newborn case with carnitine palmitoyltransferase II deficiency initially judged as unaffected by acylcarnitine analysis soon after birth.
Molecular genetics and metabolism reportsDisorders of fatty acid oxidation and autosomal recessive polycystic kidney disease-different clinical entities and comparable perinatal renal abnormalities.
Pediatric nephrology (Berlin, Germany)Muscle Carnitine Palmitoyltransferase II Deficiency: A Review of Enzymatic Controversy and Clinical Features.
International journal of molecular sciences[CPT2 gene mutation analysis and prenatal diagnosis in a family with carnitine palmitoyltransferase II deficiency].
Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatricsFirst Japanese Case of Carnitine Palmitoyltransferase II Deficiency with the Homozygous Point Mutation S113L.
Internal medicine (Tokyo, Japan)Substrate kinetics in patients with disorders of skeletal muscle metabolism.
Danish medical journalMissed Newborn Screening Case of Carnitine Palmitoyltransferase-II Deficiency.
JIMD reportsNeonatal Carnitine Palmitoyltransferase II Deficiency: A Lethal Entity.
Journal of clinical and diagnostic research : JCDRMetabolic autopsy with next generation sequencing in sudden unexpected death in infancy: Postmortem diagnosis of fatty acid oxidation disorders.
Molecular genetics and metabolism reportsThe role of mitochondria in statin-induced myopathy.
European journal of clinical investigationAssociações
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Referências e fontes
Bases de dados externas citadas neste artigo
Publicações científicas
Artigos indexados no PubMed ligados a esta doença no grafo RarasNet — título, periódico e PMID direto da fonte, sem intermediação de IA.
- Metabolic Myopathies and HyperCKemia in Adulthood: A Clinical Approach to Diagnosis and Management.
- [Carnitine palmitoyltransferase II deficiency: Impaired fatty acid oxidation].
- Migratory and intermittent polyarthritis as an atypical presentation of carnitine palmitoyltransferase II deficiency with positive response to treatment with Interleukin-1 receptor antagonist: a case presentation and case-based review.
- Severe rhabdomyolysis in an infant due to fatty acid oxidation disorder: a case report.
- Battling Recurrent Rhabdomyolysis in Carnitine Palmitoyltransferase II Deficiency.
- Carnitine Palmitoyltransferase II Deficiency.
Bases de dados e fontes oficiais
Identificadores e referências canônicas usadas para montar este verbete.
- ORPHA:157(Orphanet)
- MONDO:0015515(MONDO)
- GARD:1121(GARD (NIH))
- Variantes catalogadas(ClinVar)
- Busca completa no PubMed(PubMed)
- Q2033861(Wikidata)
Dados compilados pelo RarasNet a partir de fontes abertas (Orphanet, OMIM, MONDO, PubMed/EuropePMC, ClinicalTrials.gov, DATASUS, PCDT/MS). Este conteúdo é informativo e não substitui avaliação médica.
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