Resumen
Se exponen dos casos de tirosinemia tipo I con presentación atÃpica. El primero se inicia con crisis convulsivas secundarias a hipoglucemias graves. En el estudio metabólico para el diagnóstico de las hipoglucemias se detecta un perfil tÃpico de tirosinemia tipo I en sangre y orina. El segundo caso fue un hallazgo casual en el contexto de un ingreso por bronquitis. Ambos casos siguen tratamiento con 2-(2-nitro-4-trifluorometilbenzoil)-1-3-ciclohexanediona (NTBC) en combinación con dieta con bajo contenido en proteÃnas naturales suplementada con fórmula especial sin tirosina ni fenilalanina. En la actua¬lidad no presentan alteraciones clÃnico-analÃticas ni compli¬caciones.
Abstract
The authors describe two cases of tyrosinemia type I with atypical clinical presentation. The first patient presented with refractory seizures secondary to hypoglycemic episodes. The metabolic study for the differential diagnosis of hypoglycemia, revealed a pattern suggestive of tyrosinemia type I. In the second patient, the presence of tyrosinemia was detected during a hospital stay owing to bronchitis. In both cases, treatment with 2-(2-nitro-4-trifluoromethylbenzoyl)-1,3-cyclohexanedione (NTBC) combined with a low protein diet supplemented with a tyrosine- and phenylalanine-free formula was prescribed. There have been no complications during the follow-up period in either case and, at the present time, the clinical and analytical findings are normal.