The first case, T. O., was 10 year old girl whose parents were consanguineous. Clinical findings of T. O. revealed the following: bilateral dislocated lenses without cataracts, fine hair, myopia, poordevelopmental milestones, mental retardation, pes valgus and abnormal EEG patterns.
The second case, S. M., 6 year old boy, showed developmental retardation, fine hair, myopia, ectopialentis and hypertension.
Routine laboratory studies disclosed no abnormality of urinalysis, hematologic findings and bloodchemistry. Renal function test was abnormal.
Cyanide-nitroprussid tests on their urine were positive. Patient T. O. and S. M. found to excrete37.9mg/d
l and 10.7 to 16.4mg/d
l of homocystine in urine by the estimation with use of an automaticamino acid analyzer. Their serum levels of homocystine and methionine were elevated whereas thoseof cystine were diminished.
We made methionine loading experiments on two affected sibs, their families and two unrelatedadult males. The results were shown in Fig. 3 & 4.
By the administration of Vitamin B6 500mg per day, both serum and urinary homocystine levels ofthe patient S. M. decreased remarkably. Methionine level in serum also diminished. In the case of T. O., Vitamin B
6 showed no influence on homocystine concentration in blood and urine.
A diet low in methonine or a lowmethionine diet to which high cystine was added was effectivefor keeping serum homocystine in low level.
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