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Arginase deficiency

Reviewed October 2006

What is arginase deficiency?

Arginase deficiency is an inherited disorder that causes the amino acid arginine (a building block of proteins) and ammonia to accumulate gradually in the blood. Ammonia, which is formed when proteins are broken down in the body, is toxic if levels become too high. The nervous system is especially sensitive to the effects of excess ammonia.

Arginase deficiency usually becomes evident by about the age of 3. It most often appears as stiffness, especially in the legs, caused by abnormal tensing of the muscles (spasticity). Other symptoms may include slower than normal growth, developmental delay and eventual loss of developmental milestones, intellectual disability, seizures, tremor, and difficulty with balance and coordination (ataxia). Occasionally, high protein meals or stress caused by illness or periods without food (fasting) may cause ammonia to accumulate more quickly in the blood. This rapid increase in ammonia may lead to episodes of irritability, refusal to eat, and vomiting.

In some affected individuals, signs and symptoms of arginase deficiency may be less severe, and may not appear until later in life.

How common is arginase deficiency?

Arginase deficiency is a very rare disorder; it has been estimated to occur once in every 300,000 to 1,000,000 individuals.

What genes are related to arginase deficiency?

Mutations in the ARG1 gene cause arginase deficiency.

Arginase deficiency belongs to a class of genetic diseases called urea cycle disorders. The urea cycle is a sequence of reactions that occurs in liver cells. This cycle processes excess nitrogen, generated when protein is used by the body, to make a compound called urea that is excreted by the kidneys.

The ARG1 gene provides instructions for making an enzyme called arginase. This enzyme controls the final step of the urea cycle, which produces urea by removing nitrogen from arginine. In people with arginase deficiency, arginase is damaged or missing, and arginine is not broken down properly. As a result, urea cannot be produced normally, and excess nitrogen accumulates in the blood in the form of ammonia. The accumulation of ammonia and arginine are believed to cause the neurological problems and other signs and symptoms of arginase deficiency.

Related Gene(s)

Changes in this gene are associated with arginase deficiency.

  • ARG1

How do people inherit arginase deficiency?

This condition is inherited in an autosomal recessive pattern, which means both copies of the gene in each cell have mutations. The parents of an individual with an autosomal recessive condition each carry one copy of the mutated gene, but they typically do not show signs and symptoms of the condition.

Where can I find information about diagnosis or management of arginase deficiency?

These resources address the diagnosis or management of arginase deficiency and may include treatment providers.

  • Gene Review: Arginase Deficiency (http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=gene&part=arg1)
  • Gene Review: Urea Cycle Disorders (http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=gene&part=ucd-overview)
  • Gene Tests: Arginase Deficiency (http://www.ncbi.nlm.nih.gov/sites/GeneTests/lab/clinical_disease_id/22236)
  • Genetic Alliance (http://www.geneticalliance.org/site-search/results/argininemia+taxonomy%3A13)
  • MedlinePlus Encyclopedia: Hereditary urea cycle abnormality (http://www.nlm.nih.gov/medlineplus/ency/article/000372.htm)

You might also find information on the diagnosis or management of arginase deficiency in Educational resources (http://ghr.nlm.nih.gov/condition/arginase-deficiency/show/Educational+resources) and Patient support (http://ghr.nlm.nih.gov/condition/arginase-deficiency/show/Patient+support).

To locate a healthcare provider, see How can I find a genetics professional in my area? (http://ghr.nlm.nih.gov/handbook/consult/findingprofessional) in the Handbook.

Where can I find additional information about arginase deficiency?

You may find the following resources about arginase deficiency helpful. These materials are written for the general public.

  • MedlinePlus - Health information

    • Encyclopedia: Hereditary urea cycle abnormality (http://www.nlm.nih.gov/medlineplus/ency/article/000372.htm)
    • Health Topic: Metabolic Disorders (http://www.nlm.nih.gov/medlineplus/metabolicdisorders.html)
    • Health Topic: Newborn Screening (http://www.nlm.nih.gov/medlineplus/newbornscreening.html)

  • Educational resources - Information pages

    • Cincinnati Children's Hospital (http://www.cincinnatichildrens.org/health/u/ucd/)
    • Connecticut Department of Public Health (http://www.ct.gov/dph/lib/dph/family_health/newborn_screening/pdf/argininemia_hp.pdf)
    • Iowa Department of Public Health (http://www.idph.state.ia.us/genetics/common/pdf/arg.pdf)
    • Madisons Foundation (http://www.madisonsfoundation.org/index.php?option=com_mpower&task=disease&diseaseID=388)
    • Orphanet (http://www.orpha.net/consor/cgi-bin/OC_Exp.php?Lng=EN&Expert=90)
    • Screening, Technology and Research in Genetics (http://www.newbornscreening.info/Parents/aminoaciddisorders/argininemia.html)

  • Patient support - For patients and families

    • Children Living with Inherited Metabolic Diseases (http://www.climb.org.uk/)
    • National Organization for Rare Disorders (http://www.rarediseases.org/rare-disease-information/rare-diseases/byID/312/viewAbstract)
    • National Urea Cycle Disorders Foundation (http://www.nucdf.org/)
    • Urea Cycle Disorders Consortium (http://rarediseasesnetwork.epi.usf.edu/ucdc/)

You may also be interested in these resources, which are designed for healthcare professionals and researchers.

  • Gene Reviews - Clinical summary

    • Gene Review: Arginase Deficiency (http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=gene&part=arg1)
    • Gene Review: Urea Cycle Disorders (http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=gene&part=ucd-overview)
  • Gene Tests - DNA tests ordered by healthcare professionals (http://www.ncbi.nlm.nih.gov/sites/GeneTests/lab/clinical_disease_id/22236)

  • ACT Sheets - Newborn screening follow up

    • Increased Arginine (http://www.acmg.net/StaticContent/ACT/Arginine.pdf)
  • ClinicalTrials.gov - Linking patients to medical research (http://clinicaltrials.gov/ct2/results?cond=%22arginase%20deficiency%22%20OR%20%22Hyperargininemia%22)
  • PubMed - Recent literature (http://www.ncbi.nlm.nih.gov/pubmed?term=(arginase%20deficiency%5BTIAB%5D)%20AND%20english%5Bla%5D%20AND%20human%5Bmh%5D%20AND%20%22last%203600%20days%22%5Bdp%5D)
  • Online Books - Medical and science texts
    Scriver's Online Metabolic and Molecular Bases of Inherited Disease (OMMBID): Urea Cycle Enzymes (http://books.mcgraw-hill.com/getommbid.php?isbn=0071459960&template=ommbid&c=85)
  • OMIM - Genetic disorder catalog (http://omim.org/entry/207800)

What other names do people use for arginase deficiency?

  • ARG1 deficiency
  • Arginase Deficiency Disease
  • Argininemia
  • Hyperargininemia

For more information about naming genetic conditions, see the Genetics Home Reference Condition Naming Guidelines (http://ghr.nlm.nih.gov/ConditionNameGuide) and How are genetic conditions and genes named? (http://ghr.nlm.nih.gov/handbook/mutationsanddisorders/naming) in the Handbook.

What if I still have specific questions about arginase deficiency?

Ask the Genetic and Rare Diseases Information Center (http://rarediseases.info.nih.gov/GARD/).

What glossary definitions help with understanding arginase deficiency?

acids ; amino acid ; ammonia ; ataxia ; autosomal ; autosomal recessive ; cell ; class ; compound ; deficiency ; developmental delay ; enzyme ; fasting ; gene ; hyperammonemia ; kidney ; mutation ; nervous system ; neurological ; newborn screening ; protein ; recessive ; screening ; seizure ; sign ; spasticity ; stress ; symptom ; toxic ; tremor ; urea

You may find definitions for these and many other terms in the Genetics Home Reference Glossary (http://ghr.nlm.nih.gov/glossary).

References

  • Crombez EA, Cederbaum SD. Hyperargininemia due to liver arginase deficiency. Mol Genet Metab. 2005 Mar;84(3):243-51. Epub 2004 Dec 19. Review. (http://www.ncbi.nlm.nih.gov/pubmed/15694174?dopt=Abstract)
  • Endo F, Matsuura T, Yanagita K, Matsuda I. Clinical manifestations of inborn errors of the urea cycle and related metabolic disorders during childhood. J Nutr. 2004 Jun;134(6 Suppl):1605S-1609S; discussion 1630S-1632S, 1667S-1672S. Review. (http://www.ncbi.nlm.nih.gov/pubmed/15173438?dopt=Abstract)
  • Gene Review: Arginase Deficiency (http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=gene&part=arg1)
  • Gene Review: Urea Cycle Disorders (http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=gene&part=ucd-overview)
  • OMIM: ARGININEMIA (http://omim.org/entry/207800)
  • Scaglia F, Brunetti-Pierri N, Kleppe S, Marini J, Carter S, Garlick P, Jahoor F, O'Brien W, Lee B. Clinical consequences of urea cycle enzyme deficiencies and potential links to arginine and nitric oxide metabolism. J Nutr. 2004 Oct;134(10 Suppl):2775S-2782S; discussion 2796S-2797S. Review. (http://www.ncbi.nlm.nih.gov/pubmed/15465784?dopt=Abstract)
  • Scriver's Online Metabolic and Molecular Bases of Inherited Disease (OMMBID): Urea Cycle Enzymes (http://books.mcgraw-hill.com/getommbid.php?isbn=0071459960&template=ommbid&c=85)

 

The resources on this site should not be used as a substitute for professional medical care or advice. Users seeking information about a personal genetic disease, syndrome, or condition should consult with a qualified healthcare professional. See How can I find a genetics professional in my area? (http://ghr.nlm.nih.gov/handbook/consult/findingprofessional) in the Handbook.

 
Reviewed: October 2006
Published: May 14, 2012