2-Hydroxyglutaric aciduria

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2-Hydroxyglutaric aciduria
Classification and external resources
Alpha-hydroxyglutaric acid.png
OMIM 600721 236792613657615182
DiseasesDB 34515 34514

2-hydroxyglutaric aciduria is a group of rare neurometabolic disorders characterized by the significant elevation of urinary levels of hydroxyglutaric acid. It is either autosomal recessive or autosomal dominant.


Most forms of 2-Hydroxyglutaric aciduria have an autosomal recessive pattern of inheritance.

2-hydroxyglutaric aciduria is an organic aciduria, and because of the stereoisomeric property of 2-hydroxyglutarate different variants of this disorder are distinguished:

L-2-hydroxyglutaric aciduria[edit]

The L-2 form is more common, severe, and mainly affects the central nervous system. The basal ganglia are affected, and cystic cavitations in the white matter of the brain are common, beginning in infancy. This form is chronic, with early symptoms such as hypotonia, tremors, and epilepsy declining into spongiform leukoencephalopathy, muscular choreodystonia, mental retardation, and psychomotor regression.[1]

It is associated with L2HGDH.[2]

D-2-hydroxyglutaric aciduria[edit]

The D2 form is rare, with symptoms including macrocephaly, cardiomyopathy, mental retardation, hypotonia, and cortical blindness.[3]

It is caused by recessive mutations in D2HGDH[4] (type I) or by dominant gain-of-function mutations in IDH2[5] (type II).

Combined D-2- and L-2-hydroxyglutaric aciduria[edit]

The combined form is characterized by severe early-onset epileptic encephalopathy and absence of developmental progress.[6] It is caused by recessive mutations in SLC25A1 encoding the mitochondrial citrate carrier. [7]

See also[edit]


  1. ^ Seijo-Martinez M, Navarro C, Castro del Rio M, Vila O, Puig M, Ribes A, Butron M (2005). "L-2-hydroxyglutaric aciduria: clinical, neuroimaging, and neuropathological findings". Arch Neurol. 62 (4): 666–670. doi:10.1001/archneur.62.4.666. PMID 15824270. 
  2. ^ Topçu M, Jobard F, Halliez S, et al. (November 2004). "L-2-Hydroxyglutaric aciduria: identification of a mutant gene C14orf160, localized on chromosome 14q22.1". Hum. Mol. Genet. 13 (22): 2803–11. doi:10.1093/hmg/ddh300. PMID 15385440. 
  3. ^ Nyhan WL, Shelton GD, Jakobs C, Holmes B, Bowe C, Curry CJ, Vance C, Duran M, Sweetman L (1995). "D-2-hydroxyglutaric aciduria". J Child Neurol. 10 (2): 137–142. doi:10.1177/088307389501000216. PMID 7782605. 
  4. ^ Struys EA, Salomons GS, Achouri Y, Van Schaftingen E, Grosso S, Craigen WJ, Verhoeven NM, Jakobs C (Jan 2005). "Mutations in the D-2-hydroxyglutarate dehydrogenase gene cause D-2-hydroxyglutaric aciduria". Am J Hum Genet 76 (2): 358–60. doi:10.1086/427890. PMC 1196381. PMID 15609246. 
  5. ^ Kranendijk M, Struys EA, van Schaftingen E, et al. (2010). "IDH2 mutations in patients with D-2-hydroxyglutaric aciduria". Science 330 (6002): 336. doi:10.1126/science.1192632. PMID 20847235. 
  6. ^ Muntau A, Röschinger W, Merkenschlager A, van der Knaap MS,et al. (2000). "Combined D-2- and L-2-hydroxyglutaric aciduria with neonatal onset encephalopathy: a third biochemical variant of 2-hydroxyglutaric aciduria?". Neuropediatrics 31 (3): 137–40. doi:10.1055/s-2000-7497. PMID 10963100. 
  7. ^ Nota B, et al. (2013). "Deficiency in SLC25A1, Encoding the Mitochondrial Citrate Carrier, Causes Combined D-2- and L-2-Hydroxyglutaric Aciduria.". The American Journal of Human Genetics 92 (4): 627–631. doi:10.1016/j.ajhg.2013.03.009. PMID 23561848.