A case of using specialized medical nutrition product containing anhydrous betaine in patient with homocystinuria

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Abstract

BACKGROUND: Although homocystinuria is a rare disorder, its management remains an important issue in modern pediatrics. Diet therapy is the main pathogenetic treatment for patients with homocystinuria. The use of betaine as part of combination therapy helps reduce plasma homocysteine concentrations, particularly in patients who do not respond to other treatment approaches.

A CASE REPORT: A 12-year-old child with genetically confirmed pyridoxine-responsive homocystinuria underwent substitution of an imported preparation containing anhydrous betaine with a specialized medical nutrition product, Amino Acid Module Betaine (ORPHANIC® trademark). The previously effective combination therapy regimen remained unchanged.

CONCLUSION: Replacement of anhydrous betaine within the previously established treatment regimen, followed by 30 days of administration of the medical nutrition product Amino Acid Module Betaine (ORPHANIC® trademark) containing betaine anhydrous, demonstrated a good safety profile. This substitution did not significantly affect the patient’s general condition, disease course, or key parameters of sulfur-containing amino acid metabolism.

Prescription of the medical nutrition product Amino Acid Module Betaine (ORPHANIC® trademark) containing anhydrous betaine, or transition of a patient to this product, requires monitoring of the patient’s general condition and regular determination of sulfur-containing amino acid metabolism parameters. This study represents the first clinical evaluation of anhydrous betaine produced in Russia. The obtained results indicate its efficacy and safety in the treatment of a patient with homocystinuria.

About the authors

Anna A. Agafonova

Tomsk National Research Medical Center

Author for correspondence.
Email: anna.agafonova@medgenetics.ru
ORCID iD: 0009-0001-2797-2737
SPIN-code: 8596-9192

MD

Russian Federation, 3 Moskovsky Trakt, Tomsk, 634050

Svetlana V. Mikhaylova

Russian Children’s Clinical Hospital

Email: svetychvital@mail.ru
ORCID iD: 0000-0002-2115-985X

MD, Dr. Sci. (Medicine)

Russian Federation, Moscow

Natalya A. Votyakova

Russian Children’s Clinical Hospital

Email: voina-86@mail.ru
ORCID iD: 0009-0007-4734-6526

MD

Russian Federation, Moscow

Mayya V. Zazhivikhina

Russian Children’s Clinical Hospital

Email: maya2690@gmail.com
ORCID iD: 0000-0002-7595-9860

MD

Russian Federation, Moscow

Larisa I. Minaycheva

Tomsk National Research Medical Center

Email: larisa.minaycheva@medgenetics.ru
ORCID iD: 0000-0002-1752-2521
SPIN-code: 4638-7372

MD, Dr. Sci. (Medicine)

Russian Federation, Tomsk

Gulnara N. Seitova

Russian Children’s Clinical Hospital

Email: gulnara.seitova@medgenetics.ru
ORCID iD: 0000-0001-7525-0176
SPIN-code: 7393-7228

MD, Cand. Sci. (Medicine)

Russian Federation, Tomsk

References

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  2. Moiseev S, Chebotareva N, Bulanov N, et al. Classic homocystinuria: etiology, natural history and treatment. Klinicheskaya farmakologiya i terapiya = Clin Pharmacol Ther. 2022;31(3):30-37. doi: 10.32756/0869-54902022-3-30-37 EDN: HIZDWX
  3. Buchinskaya NV, Isupova EA, Kostik MM. Homocystinuria: literature review and clinical case description. Current Pediatrics. 2019;18(3):187-195. doi: 10.15690/vsp.v18i3.2036 EDN: NHOTMD
  4. Hoss GRW, Poloni S, Blom HJ, Schwartz IVD. Three main causes of homocystinuria: CBS, cblC and MTHFR deficiency. What do they have in common? JIEMS. 2019;7. doi: 10.1590/2326-4594-jiems-2019-0007
  5. Morris AAM, Kožich V, Santra S, et al. Guidelines for the diagnosis and management of cystathionine beta-synthase deficiency. J. Inherited Metab. Dis. 2017;40(1):49-74. doi: 10.1007/s10545-016-9979-0
  6. Gan-Schreier H, Kebbewar M, Fang-Hoffmann J, et al. Newborn population screening for classic homocystinuria by determination of total homocysteine from guthrie cards. J. Pediatr. 2010;156(3):427–32. doi: 10.1016/j.jpeds.2009.09.054

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