nih-gov/www.ncbi.nlm.nih.gov/omim/614482

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<title>
Entry
- #614482 - HUPPKE-BRENDEL SYNDROME; HPBDS
- OMIM
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<span class="h4">#614482</span>
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<strong>Table of Contents</strong>
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<a href="#title"><strong>Title</strong></a>
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<a href="#phenotypeMap"><strong>Phenotype-Gene Relationships</strong></a>
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<a href="/clinicalSynopsis/614482"><strong>Clinical Synopsis</strong></a>
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<a href="#text"><strong>Text</strong></a>
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<a href="#description">Description</a>
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<li role="presentation" style="margin-left: 1em">
<a href="#clinicalFeatures">Clinical Features</a>
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<li role="presentation" style="margin-left: 1em">
<a href="#inheritance">Inheritance</a>
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<li role="presentation" style="margin-left: 1em">
<a href="#molecularGenetics">Molecular Genetics</a>
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<li role="presentation">
<a href="#references"><strong>References</strong></a>
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<li role="presentation">
<a href="#contributors"><strong>Contributors</strong></a>
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<li role="presentation">
<a href="#creationDate"><strong>Creation Date</strong></a>
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<div><a href="https://clinicaltrials.gov/search?cond=HUPPKE-BRENDEL SYNDROME" class="mim-tip-hint" title="A registry of federally and privately supported clinical trials conducted in the United States and around the world." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'Clinical Trials', 'domain': 'clinicaltrials.gov'})">Clinical Trials</a></div>
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<div class="col-lg-8 col-lg-pull-2 col-md-8 col-md-pull-2 col-sm-8 col-sm-pull-2 col-xs-12">
<div>
<a id="title" class="mim-anchor"></a>
<div>
<a id="number" class="mim-anchor"></a>
<div class="text-right">
<a href="#" class="mim-tip-icd" qtip_title="<strong>ICD+</strong>" qtip_text="
<strong>SNOMEDCT:</strong> 773648002<br />
<strong>ORPHA:</strong> 300313<br />
">ICD+</a>
</div>
<div>
<span class="h3">
<span class="mim-font mim-tip-hint" title="Phenotype description, molecular basis known">
<span class="text-danger"><strong>#</strong></span>
614482
</span>
</span>
</div>
</div>
<div>
<a id="preferredTitle" class="mim-anchor"></a>
<h3>
<span class="mim-font">
HUPPKE-BRENDEL SYNDROME; HPBDS
</span>
</h3>
</div>
<div>
<br />
</div>
<div>
<a id="alternativeTitles" class="mim-anchor"></a>
<div>
<p>
<span class="mim-font">
<em>Alternative titles; symbols</em>
</span>
</p>
</div>
<div>
<h4>
<span class="mim-font">
CONGENITAL CATARACTS, HEARING LOSS, AND NEURODEGENERATION; CCHLND<br />
ACETYL-CoA TRANSPORTER DEFICIENCY
</span>
</h4>
</div>
</div>
<div>
<br />
</div>
</div>
<div>
<a id="phenotypeMap" class="mim-anchor"></a>
<h4>
<span class="mim-font">
<strong>Phenotype-Gene Relationships</strong>
</span>
</h4>
<div>
<table class="table table-bordered table-condensed table-hover small mim-table-padding">
<thead>
<tr class="active">
<th>
Location
</th>
<th>
Phenotype
</th>
<th>
Phenotype <br /> MIM number
</th>
<th>
Inheritance
</th>
<th>
Phenotype <br /> mapping key
</th>
<th>
Gene/Locus
</th>
<th>
Gene/Locus <br /> MIM number
</th>
</tr>
</thead>
<tbody>
<tr>
<td>
<span class="mim-font">
<a href="/geneMap/3/803?start=-3&limit=10&highlight=803">
3q25.31
</a>
</span>
</td>
<td>
<span class="mim-font">
Huppke-Brendel syndrome
</span>
</td>
<td>
<span class="mim-font">
<a href="/entry/614482"> 614482 </a>
</span>
</td>
<td>
<span class="mim-font">
<abbr class="mim-tip-hint" title="Autosomal recessive">AR</abbr>
</span>
</td>
<td>
<span class="mim-font">
<abbr class="mim-tip-hint" title="3 - The molecular basis of the disorder is known"> 3 </abbr>
</span>
</td>
<td>
<span class="mim-font">
SLC33A1
</span>
</td>
<td>
<span class="mim-font">
<a href="/entry/603690"> 603690 </a>
</span>
</td>
</tr>
</tbody>
</table>
</div>
</div>
<div>
<div class="btn-group ">
<a href="/clinicalSynopsis/614482" class="btn btn-warning" role="button"> Clinical Synopsis </a>
<button type="button" id="mimPhenotypicSeriesToggle" class="btn btn-warning dropdown-toggle mimSingletonFoldToggle" data-toggle="collapse" href="#mimClinicalSynopsisFold" onclick="ga('send', 'event', 'Unfurl', 'ClinicalSynopsis', 'omim.org')">
<span class="caret"></span>
<span class="sr-only">Toggle Dropdown</span>
</button>
</div>
&nbsp;
<div class="btn-group">
<button type="button" class="btn btn-success dropdown-toggle" data-toggle="dropdown" aria-haspopup="true" aria-expanded="false">
PheneGene Graphics <span class="caret"></span>
</button>
<ul class="dropdown-menu" style="width: 17em;">
<li><a href="/graph/linear/614482" target="_blank" onclick="gtag('event', 'mim_graph', {'destination': 'Linear'})"> Linear </a></li>
<li><a href="/graph/radial/614482" target="_blank" onclick="gtag('event', 'mim_graph', {'destination': 'Radial'})"> Radial </a></li>
</ul>
</div>
<span class="glyphicon glyphicon-question-sign mim-tip-hint" title="OMIM PheneGene graphics depict relationships between phenotypes, groups of related phenotypes (Phenotypic Series), and genes.<br /><a href='/static/omim/pdf/OMIM_Graphics.pdf' target='_blank'>A quick reference overview and guide (PDF)</a>"></span>
<div>
<p />
</div>
<div id="mimClinicalSynopsisFold" class="well well-sm collapse mimSingletonToggleFold">
<div class="small" style="margin: 5px">
<div>
<div>
<span class="h5 mim-font">
<strong> INHERITANCE </strong>
</span>
</div>
<div style="margin-left: 2em;">
<div>
<span class="mim-font">
- Autosomal recessive <span class="mim-feature-ids hidden">[SNOMEDCT: <a href="https://purl.bioontology.org/ontology/SNOMEDCT/258211005" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'SNOMEDCT\', \'domain\': \'bioontology.org\'})">258211005</a>]</span> <span class="mim-feature-ids hidden">[UMLS: <a href="https://bioportal.bioontology.org/search?q=C0441748&searchproperties=true" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'UMLS\', \'domain\': \'bioontology.org\'})">C0441748</a> HPO: <a href="https://hpo.jax.org/app/browse/term/HP:0000007" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'HPO\', \'domain\': \'hpo.jax.org\'})">HP:0000007</a>]</span> <span class="mim-feature-ids hidden">[HPO: <a href="https://hpo.jax.org/app/browse/term/HP:0000007" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'HPO\', \'domain\': \'hpo.jax.org\'})">HP:0000007</a>]</span><br />
</span>
</div>
</div>
</div>
<div>
<div>
<span class="h5 mim-font">
<strong> HEAD & NECK </strong>
</span>
</div>
<div style="margin-left: 2em;">
<div>
<div>
<span class="h5 mim-font">
<em> Head </em>
</span>
</div>
<div style="margin-left: 2em;">
<span class="mim-font">
- Microcephaly <span class="mim-feature-ids hidden">[SNOMEDCT: <a href="https://purl.bioontology.org/ontology/SNOMEDCT/1148757008" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'SNOMEDCT\', \'domain\': \'bioontology.org\'})">1148757008</a>]</span> <span class="mim-feature-ids hidden">[ICD10CM: <a href="https://purl.bioontology.org/ontology/ICD10CM/Q02" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'ICD10CM\', \'domain\': \'bioontology.org\'})">Q02</a>]</span> <span class="mim-feature-ids hidden">[ICD9CM: <a href="https://purl.bioontology.org/ontology/ICD9CM/742.1" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'ICD9CM\', \'domain\': \'bioontology.org\'})">742.1</a>]</span> <span class="mim-feature-ids hidden">[UMLS: <a href="https://bioportal.bioontology.org/search?q=C4551563&searchproperties=true" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'UMLS\', \'domain\': \'bioontology.org\'})">C4551563</a>, <a href="https://bioportal.bioontology.org/search?q=C0025958&searchproperties=true" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'UMLS\', \'domain\': \'bioontology.org\'})">C0025958</a> HPO: <a href="https://hpo.jax.org/app/browse/term/HP:0000252" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'HPO\', \'domain\': \'hpo.jax.org\'})">HP:0000252</a>]</span> <span class="mim-feature-ids hidden">[HPO: <a href="https://hpo.jax.org/app/browse/term/HP:0000252" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'HPO\', \'domain\': \'hpo.jax.org\'})">HP:0000252</a>]</span> <a href="https://elementsofmorphology.nih.gov/index.cgi?tid=0584d323b99dcd7001cc50e224947aca" target="_blank" class="small mim-tip-eom" title="&lt;img src=&quot;https://elementsofmorphology.nih.gov/images/terms/Microcephaly-small.jpg&quot;&gt; &lt;br/&gt;Further Information: &lt;a href=&quot;https://elementsofmorphology.nih.gov/index.cgi?tid=0584d323b99dcd7001cc50e224947aca&quot target=&quot;_blank&quot onclick=&quot;gtag(\'event\', \'mim_outbound\', {\'name\': \'EOM\', \'domain\': \'elementsofmorphology.nih.gov\'})&quot;&gt;Elements of Morphology&lt;/a&gt;"><span class="glyphicon glyphicon-user" aria-hidden="true"></span></a><br />
</span>
</div>
</div>
<div>
<div>
<span class="h5 mim-font">
<em> Ears </em>
</span>
</div>
<div style="margin-left: 2em;">
<span class="mim-font">
- Hearing loss <span class="mim-feature-ids hidden">[SNOMEDCT: <a href="https://purl.bioontology.org/ontology/SNOMEDCT/103276001" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'SNOMEDCT\', \'domain\': \'bioontology.org\'})">103276001</a>, <a href="https://purl.bioontology.org/ontology/SNOMEDCT/343087000" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'SNOMEDCT\', \'domain\': \'bioontology.org\'})">343087000</a>, <a href="https://purl.bioontology.org/ontology/SNOMEDCT/15188001" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'SNOMEDCT\', \'domain\': \'bioontology.org\'})">15188001</a>]</span> <span class="mim-feature-ids hidden">[ICD10CM: <a href="https://purl.bioontology.org/ontology/ICD10CM/H91.9" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'ICD10CM\', \'domain\': \'bioontology.org\'})">H91.9</a>]</span> <span class="mim-feature-ids hidden">[ICD9CM: <a href="https://purl.bioontology.org/ontology/ICD9CM/389.9" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'ICD9CM\', \'domain\': \'bioontology.org\'})">389.9</a>, <a href="https://purl.bioontology.org/ontology/ICD9CM/389" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'ICD9CM\', \'domain\': \'bioontology.org\'})">389</a>]</span> <span class="mim-feature-ids hidden">[UMLS: <a href="https://bioportal.bioontology.org/search?q=C0011053&searchproperties=true" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'UMLS\', \'domain\': \'bioontology.org\'})">C0011053</a>, <a href="https://bioportal.bioontology.org/search?q=C0018772&searchproperties=true" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'UMLS\', \'domain\': \'bioontology.org\'})">C0018772</a>, <a href="https://bioportal.bioontology.org/search?q=C1384666&searchproperties=true" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'UMLS\', \'domain\': \'bioontology.org\'})">C1384666</a>, <a href="https://bioportal.bioontology.org/search?q=C3887873&searchproperties=true" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'UMLS\', \'domain\': \'bioontology.org\'})">C3887873</a>, <a href="https://bioportal.bioontology.org/search?q=C2029884&searchproperties=true" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'UMLS\', \'domain\': \'bioontology.org\'})">C2029884</a> HPO: <a href="https://hpo.jax.org/app/browse/term/HP:0000365" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'HPO\', \'domain\': \'hpo.jax.org\'})">HP:0000365</a>]</span> <span class="mim-feature-ids hidden">[HPO: <a href="https://hpo.jax.org/app/browse/term/HP:0000365" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'HPO\', \'domain\': \'hpo.jax.org\'})">HP:0000365</a>]</span><br />
</span>
</div>
</div>
<div>
<div>
<span class="h5 mim-font">
<em> Eyes </em>
</span>
</div>
<div style="margin-left: 2em;">
<span class="mim-font">
- Cataracts, congenital <span class="mim-feature-ids hidden">[SNOMEDCT: <a href="https://purl.bioontology.org/ontology/SNOMEDCT/79410001" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'SNOMEDCT\', \'domain\': \'bioontology.org\'})">79410001</a>]</span> <span class="mim-feature-ids hidden">[ICD10CM: <a href="https://purl.bioontology.org/ontology/ICD10CM/Q12.0" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'ICD10CM\', \'domain\': \'bioontology.org\'})">Q12.0</a>]</span> <span class="mim-feature-ids hidden">[ICD9CM: <a href="https://purl.bioontology.org/ontology/ICD9CM/743.30" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'ICD9CM\', \'domain\': \'bioontology.org\'})">743.30</a>]</span> <span class="mim-feature-ids hidden">[UMLS: <a href="https://bioportal.bioontology.org/search?q=C0009691&searchproperties=true" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'UMLS\', \'domain\': \'bioontology.org\'})">C0009691</a> HPO: <a href="https://hpo.jax.org/app/browse/term/HP:0000519" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'HPO\', \'domain\': \'hpo.jax.org\'})">HP:0000519</a>]</span><br /> -
Nystagmus <span class="mim-feature-ids hidden">[SNOMEDCT: <a href="https://purl.bioontology.org/ontology/SNOMEDCT/563001" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'SNOMEDCT\', \'domain\': \'bioontology.org\'})">563001</a>]</span> <span class="mim-feature-ids hidden">[ICD10CM: <a href="https://purl.bioontology.org/ontology/ICD10CM/H55.0" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'ICD10CM\', \'domain\': \'bioontology.org\'})">H55.0</a>, <a href="https://purl.bioontology.org/ontology/ICD10CM/H55.00" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'ICD10CM\', \'domain\': \'bioontology.org\'})">H55.00</a>]</span> <span class="mim-feature-ids hidden">[ICD9CM: <a href="https://purl.bioontology.org/ontology/ICD9CM/379.50" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'ICD9CM\', \'domain\': \'bioontology.org\'})">379.50</a>]</span> <span class="mim-feature-ids hidden">[UMLS: <a href="https://bioportal.bioontology.org/search?q=C0028738&searchproperties=true" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'UMLS\', \'domain\': \'bioontology.org\'})">C0028738</a> HPO: <a href="https://hpo.jax.org/app/browse/term/HP:0000639" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'HPO\', \'domain\': \'hpo.jax.org\'})">HP:0000639</a>]</span> <span class="mim-feature-ids hidden">[HPO: <a href="https://hpo.jax.org/app/browse/term/HP:0000639" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'HPO\', \'domain\': \'hpo.jax.org\'})">HP:0000639</a>]</span><br />
</span>
</div>
</div>
</div>
</div>
<div>
<div>
<span class="h5 mim-font">
<strong> GENITOURINARY </strong>
</span>
</div>
<div style="margin-left: 2em;">
<div>
<div>
<span class="h5 mim-font">
<em> External Genitalia (Male) </em>
</span>
</div>
<div style="margin-left: 2em;">
<span class="mim-font">
- Micropenis <span class="mim-feature-ids hidden">[SNOMEDCT: <a href="https://purl.bioontology.org/ontology/SNOMEDCT/34911001" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'SNOMEDCT\', \'domain\': \'bioontology.org\'})">34911001</a>]</span> <span class="mim-feature-ids hidden">[ICD10CM: <a href="https://purl.bioontology.org/ontology/ICD10CM/Q55.62" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'ICD10CM\', \'domain\': \'bioontology.org\'})">Q55.62</a>]</span> <span class="mim-feature-ids hidden">[ICD9CM: <a href="https://purl.bioontology.org/ontology/ICD9CM/752.64" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'ICD9CM\', \'domain\': \'bioontology.org\'})">752.64</a>]</span> <span class="mim-feature-ids hidden">[UMLS: <a href="https://bioportal.bioontology.org/search?q=C0266435&searchproperties=true" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'UMLS\', \'domain\': \'bioontology.org\'})">C0266435</a>, <a href="https://bioportal.bioontology.org/search?q=C4551492&searchproperties=true" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'UMLS\', \'domain\': \'bioontology.org\'})">C4551492</a>, <a href="https://bioportal.bioontology.org/search?q=C1387005&searchproperties=true" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'UMLS\', \'domain\': \'bioontology.org\'})">C1387005</a> HPO: <a href="https://hpo.jax.org/app/browse/term/HP:0008736" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'HPO\', \'domain\': \'hpo.jax.org\'})">HP:0008736</a>, <a href="https://hpo.jax.org/app/browse/term/HP:0000054" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'HPO\', \'domain\': \'hpo.jax.org\'})">HP:0000054</a>]</span> <span class="mim-feature-ids hidden">[HPO: <a href="https://hpo.jax.org/app/browse/term/HP:0000054" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'HPO\', \'domain\': \'hpo.jax.org\'})">HP:0000054</a>]</span><br />
</span>
</div>
</div>
</div>
</div>
<div>
<div>
<span class="h5 mim-font">
<strong> SKELETAL </strong>
</span>
</div>
<div style="margin-left: 2em;">
<div>
<span class="mim-font">
- Fracture without trauma (in 1 patient) <span class="mim-feature-ids hidden">[UMLS: <a href="https://bioportal.bioontology.org/search?q=C5936342&searchproperties=true" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'UMLS\', \'domain\': \'bioontology.org\'})">C5936342</a>]</span><br />
</span>
</div>
</div>
</div>
<div>
<div>
<span class="h5 mim-font">
<strong> SKIN, NAILS, & HAIR </strong>
</span>
</div>
<div style="margin-left: 2em;">
<div>
<div>
<span class="h5 mim-font">
<em> Skin </em>
</span>
</div>
<div style="margin-left: 2em;">
<span class="mim-font">
- Hypopigmented skin <span class="mim-feature-ids hidden">[SNOMEDCT: <a href="https://purl.bioontology.org/ontology/SNOMEDCT/18655006" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'SNOMEDCT\', \'domain\': \'bioontology.org\'})">18655006</a>, <a href="https://purl.bioontology.org/ontology/SNOMEDCT/23006000" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'SNOMEDCT\', \'domain\': \'bioontology.org\'})">23006000</a>, <a href="https://purl.bioontology.org/ontology/SNOMEDCT/89031001" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'SNOMEDCT\', \'domain\': \'bioontology.org\'})">89031001</a>]</span> <span class="mim-feature-ids hidden">[UMLS: <a href="https://bioportal.bioontology.org/search?q=C0162835&searchproperties=true" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'UMLS\', \'domain\': \'bioontology.org\'})">C0162835</a> HPO: <a href="https://hpo.jax.org/app/browse/term/HP:0001010" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'HPO\', \'domain\': \'hpo.jax.org\'})">HP:0001010</a>]</span> <span class="mim-feature-ids hidden">[HPO: <a href="https://hpo.jax.org/app/browse/term/HP:0001010" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'HPO\', \'domain\': \'hpo.jax.org\'})">HP:0001010</a>]</span><br />
</span>
</div>
</div>
<div>
<div>
<span class="h5 mim-font">
<em> Hair </em>
</span>
</div>
<div style="margin-left: 2em;">
<span class="mim-font">
- Hypopigmented hair <span class="mim-feature-ids hidden">[UMLS: <a href="https://bioportal.bioontology.org/search?q=C4231619&searchproperties=true" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'UMLS\', \'domain\': \'bioontology.org\'})">C4231619</a>]</span><br /> -
Sparse hair <span class="mim-feature-ids hidden">[SNOMEDCT: <a href="https://purl.bioontology.org/ontology/SNOMEDCT/1162675003" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'SNOMEDCT\', \'domain\': \'bioontology.org\'})">1162675003</a>]</span> <span class="mim-feature-ids hidden">[UMLS: <a href="https://bioportal.bioontology.org/search?q=C5551005&searchproperties=true" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'UMLS\', \'domain\': \'bioontology.org\'})">C5551005</a> HPO: <a href="https://hpo.jax.org/app/browse/term/HP:0008070" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'HPO\', \'domain\': \'hpo.jax.org\'})">HP:0008070</a>]</span> <span class="mim-feature-ids hidden">[HPO: <a href="https://hpo.jax.org/app/browse/term/HP:0008070" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'HPO\', \'domain\': \'hpo.jax.org\'})">HP:0008070</a>]</span><br /> -
Kinky hair <span class="mim-feature-ids hidden">[UMLS: <a href="https://bioportal.bioontology.org/search?q=C1860857&searchproperties=true" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'UMLS\', \'domain\': \'bioontology.org\'})">C1860857</a>]</span><br />
</span>
</div>
</div>
</div>
</div>
<div>
<div>
<span class="h5 mim-font">
<strong> MUSCLE, SOFT TISSUES </strong>
</span>
</div>
<div style="margin-left: 2em;">
<div>
<span class="mim-font">
- Hypotonia <span class="mim-feature-ids hidden">[SNOMEDCT: <a href="https://purl.bioontology.org/ontology/SNOMEDCT/398151007" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'SNOMEDCT\', \'domain\': \'bioontology.org\'})">398151007</a>, <a href="https://purl.bioontology.org/ontology/SNOMEDCT/398152000" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'SNOMEDCT\', \'domain\': \'bioontology.org\'})">398152000</a>]</span> <span class="mim-feature-ids hidden">[UMLS: <a href="https://bioportal.bioontology.org/search?q=C0026827&searchproperties=true" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'UMLS\', \'domain\': \'bioontology.org\'})">C0026827</a>, <a href="https://bioportal.bioontology.org/search?q=C1858120&searchproperties=true" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'UMLS\', \'domain\': \'bioontology.org\'})">C1858120</a> HPO: <a href="https://hpo.jax.org/app/browse/term/HP:0001290" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'HPO\', \'domain\': \'hpo.jax.org\'})">HP:0001290</a>, <a href="https://hpo.jax.org/app/browse/term/HP:0001252" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'HPO\', \'domain\': \'hpo.jax.org\'})">HP:0001252</a>]</span> <span class="mim-feature-ids hidden">[HPO: <a href="https://hpo.jax.org/app/browse/term/HP:0001252" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'HPO\', \'domain\': \'hpo.jax.org\'})">HP:0001252</a>]</span><br />
</span>
</div>
</div>
</div>
<div>
<div>
<span class="h5 mim-font">
<strong> NEUROLOGIC </strong>
</span>
</div>
<div style="margin-left: 2em;">
<div>
<div>
<span class="h5 mim-font">
<em> Central Nervous System </em>
</span>
</div>
<div style="margin-left: 2em;">
<span class="mim-font">
- Psychomotor retardation, severe <span class="mim-feature-ids hidden">[UMLS: <a href="https://bioportal.bioontology.org/search?q=C1854919&searchproperties=true" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'UMLS\', \'domain\': \'bioontology.org\'})">C1854919</a> HPO: <a href="https://hpo.jax.org/app/browse/term/HP:0011344" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'HPO\', \'domain\': \'hpo.jax.org\'})">HP:0011344</a>]</span> <span class="mim-feature-ids hidden">[SNOMEDCT: <a href="https://purl.bioontology.org/ontology/SNOMEDCT/398991009" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'SNOMEDCT\', \'domain\': \'bioontology.org\'})">398991009</a>, <a href="https://purl.bioontology.org/ontology/SNOMEDCT/1144814003" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'SNOMEDCT\', \'domain\': \'bioontology.org\'})">1144814003</a>]</span><br /> -
Inability to sit or walk independently <span class="mim-feature-ids hidden">[UMLS: <a href="https://bioportal.bioontology.org/search?q=C3280966&searchproperties=true" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'UMLS\', \'domain\': \'bioontology.org\'})">C3280966</a>]</span><br /> -
Spastic ataxia (in 1 patient) <span class="mim-feature-ids hidden">[UMLS: <a href="https://bioportal.bioontology.org/search?q=C1849156&searchproperties=true" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'UMLS\', \'domain\': \'bioontology.org\'})">C1849156</a> HPO: <a href="https://hpo.jax.org/app/browse/term/HP:0002497" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'HPO\', \'domain\': \'hpo.jax.org\'})">HP:0002497</a>]</span> <span class="mim-feature-ids hidden">[HPO: <a href="https://hpo.jax.org/app/browse/term/HP:0002497" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'HPO\', \'domain\': \'hpo.jax.org\'})">HP:0002497</a>]</span><br /> -
Parkinsonian tremor (in 1 patient) <span class="mim-feature-ids hidden">[SNOMEDCT: <a href="https://purl.bioontology.org/ontology/SNOMEDCT/308909003" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'SNOMEDCT\', \'domain\': \'bioontology.org\'})">308909003</a>]</span> <span class="mim-feature-ids hidden">[UMLS: <a href="https://bioportal.bioontology.org/search?q=C0586392&searchproperties=true" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'UMLS\', \'domain\': \'bioontology.org\'})">C0586392</a> HPO: <a href="https://hpo.jax.org/app/browse/term/HP:0002322" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'HPO\', \'domain\': \'hpo.jax.org\'})">HP:0002322</a>]</span> <span class="mim-feature-ids hidden">[HPO: <a href="https://hpo.jax.org/app/browse/term/HP:0002322" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'HPO\', \'domain\': \'hpo.jax.org\'})">HP:0002322</a>]</span><br /> -
Seizures <span class="mim-feature-ids hidden">[SNOMEDCT: <a href="https://purl.bioontology.org/ontology/SNOMEDCT/91175000" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'SNOMEDCT\', \'domain\': \'bioontology.org\'})">91175000</a>]</span> <span class="mim-feature-ids hidden">[UMLS: <a href="https://bioportal.bioontology.org/search?q=C0036572&searchproperties=true" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'UMLS\', \'domain\': \'bioontology.org\'})">C0036572</a> HPO: <a href="https://hpo.jax.org/app/browse/term/HP:0001250" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'HPO\', \'domain\': \'hpo.jax.org\'})">HP:0001250</a>]</span> <span class="mim-feature-ids hidden">[HPO: <a href="https://hpo.jax.org/app/browse/term/HP:0001250" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'HPO\', \'domain\': \'hpo.jax.org\'})">HP:0001250</a>]</span><br /> -
Lack of speech <span class="mim-feature-ids hidden">[UMLS: <a href="https://bioportal.bioontology.org/search?q=C1854882&searchproperties=true" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'UMLS\', \'domain\': \'bioontology.org\'})">C1854882</a> HPO: <a href="https://hpo.jax.org/app/browse/term/HP:0001344" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'HPO\', \'domain\': \'hpo.jax.org\'})">HP:0001344</a>]</span> <span class="mim-feature-ids hidden">[HPO: <a href="https://hpo.jax.org/app/browse/term/HP:0001344" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'HPO\', \'domain\': \'hpo.jax.org\'})">HP:0001344</a>]</span><br /> -
Cerebral atrophy <span class="mim-feature-ids hidden">[SNOMEDCT: <a href="https://purl.bioontology.org/ontology/SNOMEDCT/278849000" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'SNOMEDCT\', \'domain\': \'bioontology.org\'})">278849000</a>]</span> <span class="mim-feature-ids hidden">[UMLS: <a href="https://bioportal.bioontology.org/search?q=C0235946&searchproperties=true" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'UMLS\', \'domain\': \'bioontology.org\'})">C0235946</a> HPO: <a href="https://hpo.jax.org/app/browse/term/HP:0002059" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'HPO\', \'domain\': \'hpo.jax.org\'})">HP:0002059</a>]</span> <span class="mim-feature-ids hidden">[HPO: <a href="https://hpo.jax.org/app/browse/term/HP:0002059" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'HPO\', \'domain\': \'hpo.jax.org\'})">HP:0002059</a>]</span><br /> -
Cerebellar atrophy <span class="mim-feature-ids hidden">[UMLS: <a href="https://bioportal.bioontology.org/search?q=C0740279&searchproperties=true" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'UMLS\', \'domain\': \'bioontology.org\'})">C0740279</a> HPO: <a href="https://hpo.jax.org/app/browse/term/HP:0001272" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'HPO\', \'domain\': \'hpo.jax.org\'})">HP:0001272</a>]</span> <span class="mim-feature-ids hidden">[HPO: <a href="https://hpo.jax.org/app/browse/term/HP:0001272" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'HPO\', \'domain\': \'hpo.jax.org\'})">HP:0001272</a>]</span><br /> -
Hypomyelination <span class="mim-feature-ids hidden">[SNOMEDCT: <a href="https://purl.bioontology.org/ontology/SNOMEDCT/111007000" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'SNOMEDCT\', \'domain\': \'bioontology.org\'})">111007000</a>]</span> <span class="mim-feature-ids hidden">[UMLS: <a href="https://bioportal.bioontology.org/search?q=C0544820&searchproperties=true" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'UMLS\', \'domain\': \'bioontology.org\'})">C0544820</a>]</span><br /> -
Wide subarachnoid spaces <span class="mim-feature-ids hidden">[UMLS: <a href="https://bioportal.bioontology.org/search?q=C3280967&searchproperties=true" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'UMLS\', \'domain\': \'bioontology.org\'})">C3280967</a>]</span><br />
</span>
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<div>
<div>
<span class="h5 mim-font">
<strong> LABORATORY ABNORMALITIES </strong>
</span>
</div>
<div style="margin-left: 2em;">
<div>
<span class="mim-font">
- Decreased serum copper <span class="mim-feature-ids hidden">[UMLS: <a href="https://bioportal.bioontology.org/search?q=C0859988&searchproperties=true" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'UMLS\', \'domain\': \'bioontology.org\'})">C0859988</a>]</span><br /> -
Decreased serum ceruloplasmin <span class="mim-feature-ids hidden">[UMLS: <a href="https://bioportal.bioontology.org/search?q=C0240997&searchproperties=true" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'UMLS\', \'domain\': \'bioontology.org\'})">C0240997</a> HPO: <a href="https://hpo.jax.org/app/browse/term/HP:0010837" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'HPO\', \'domain\': \'hpo.jax.org\'})">HP:0010837</a>]</span> <span class="mim-feature-ids hidden">[HPO: <a href="https://hpo.jax.org/app/browse/term/HP:0010837" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'HPO\', \'domain\': \'hpo.jax.org\'})">HP:0010837</a>]</span><br />
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<div>
<div>
<span class="h5 mim-font">
<strong> MISCELLANEOUS </strong>
</span>
</div>
<div style="margin-left: 2em;">
<div>
<span class="mim-font">
- Onset in infancy <span class="mim-feature-ids hidden">[UMLS: <a href="https://bioportal.bioontology.org/search?q=C1848924&searchproperties=true" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'UMLS\', \'domain\': \'bioontology.org\'})">C1848924</a> HPO: <a href="https://hpo.jax.org/app/browse/term/HP:0003593" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'HPO\', \'domain\': \'hpo.jax.org\'})">HP:0003593</a>]</span> <span class="mim-feature-ids hidden">[HPO: <a href="https://hpo.jax.org/app/browse/term/HP:0003593" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'HPO\', \'domain\': \'hpo.jax.org\'})">HP:0003593</a>]</span><br /> -
Progressive disorder <span class="mim-feature-ids hidden">[UMLS: <a href="https://bioportal.bioontology.org/search?q=C1864985&searchproperties=true" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'UMLS\', \'domain\': \'bioontology.org\'})">C1864985</a> HPO: <a href="https://hpo.jax.org/app/browse/term/HP:0003676" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'HPO\', \'domain\': \'hpo.jax.org\'})">HP:0003676</a>]</span> <span class="mim-feature-ids hidden">[HPO: <a href="https://hpo.jax.org/app/browse/term/HP:0003676" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'HPO\', \'domain\': \'hpo.jax.org\'})">HP:0003676</a>]</span><br /> -
Death in childhood may occur <span class="mim-feature-ids hidden">[UMLS: <a href="https://bioportal.bioontology.org/search?q=C1843392&searchproperties=true" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'UMLS\', \'domain\': \'bioontology.org\'})">C1843392</a> HPO: <a href="https://hpo.jax.org/app/browse/term/HP:0003819" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'HPO\', \'domain\': \'hpo.jax.org\'})">HP:0003819</a>]</span> <span class="mim-feature-ids hidden">[HPO: <a href="https://hpo.jax.org/app/browse/term/HP:0003819" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'HPO\', \'domain\': \'hpo.jax.org\'})">HP:0003819</a>]</span><br />
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<span class="h5 mim-font">
<strong> MOLECULAR BASIS </strong>
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<div style="margin-left: 2em;">
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<span class="mim-font">
- Caused by mutation in the solute carrier family 33 (acetyl-CoA transporter), member 1 gene (SLC33A1, <a href="/entry/603690#0002">603690.0002</a>)<br />
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<p>A number sign (#) is used with this entry because of evidence that Huppke-Brendel syndrome (HPBDS) is caused by homozygous or compound heterozygous mutation in the SLC33A1 gene (<a href="/entry/603690">603690</a>) on chromosome 3q25.</p>
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<p>Huppke-Brendel syndrome (HPBDS) is an autosomal recessive disorder characterized by congenital cataracts, severe psychomotor retardation, and hearing loss associated with decreased serum ceruloplasmin and copper. Brain MRI shows cerebral and cerebellar atrophy and hypomyelination (summary by <a href="#3" class="mim-tip-reference" title="Huppke, P., Brendel, C., Kalscheuer, V., Korenke, G. C., Marquardt, I., Freisinger, P., Christodoulou, J., Hillebrand, M., Pitelet, G., Wilson, C., Gruber-Sedlmayr, U., Ullmann, R., Haas, S., Elpeleg, O., Nurnberg, G., Nurnberg, P., Dad, S., Moller, L. B., Kaler, S. G., Gartner, J. &lt;strong&gt;Mutations in SLC33A1 cause a lethal autosomal-recessive disorder with congenital cataracts, hearing loss, and low serum copper and ceruloplasmin.&lt;/strong&gt; Am. J. Hum. Genet. 90: 61-68, 2012. Note: Erratum: Am. J. Hum. Genet. 90: 378 only, 2012.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/22243965/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;22243965&lt;/a&gt;, &lt;a href=&quot;https://www.ncbi.nlm.nih.gov/pmc/?term=22243965[PMID]&amp;report=imagesdocsum&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed Image&#x27;, &#x27;domain&#x27;: &#x27;ncbi.nlm.nih.gov&#x27;})&quot;&gt;images&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1016/j.ajhg.2011.11.030&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="22243965">Huppke et al., 2012</a>). <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=22243965" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p>
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<strong>Clinical Features</strong>
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<p><a href="#2" class="mim-tip-reference" title="Horvath, R., Freisinger, P., Rubio, R., Merl, T., Bax, R., Mayr, J. A., Shawan, Muller-Hocker, J., Pongratz, D., Moller, L. B., Horn, N., Jaksch, M. &lt;strong&gt;Congenital cataract, muscular hypotonia, developmental delay and sensorineural hearing loss associated with a defect in copper metabolism.&lt;/strong&gt; J. Inherit. Metab. Dis. 28: 479-492, 2005.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/15902551/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;15902551&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1007/s10545-005-0479-x&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="15902551">Horvath et al. (2005)</a> reported a boy, born of consanguineous Arab parents, who presented in the first weeks of life with severe hypotonia, weakness of the neck muscles, and bilateral congenital cataracts. Examination at age 4 months showed delayed psychomotor development, severe hypotonia, inability to fix gaze, and rotary nystagmus. Laboratory studies showed low serum copper and ceruloplasmin, and neutropenia. Skeletal muscle biopsy showed some enlarged and abnormal mitochondria and decreased cytochrome c oxidase activity. Brain MRI at age 5 months revealed Dandy-Walker malformation, hypoplasia of the cerebellar vermis, and hypoplasia of the temporal lobes. Treatment with copper histidinate supplementation resulted in marked clinical improvement by ages 8 and 13 months: hypotonia was less severe, and there was complete restoration of cytochrome c oxidase activity in skeletal muscle, although serum copper levels did not increase significantly. At age 13 months, he was noted to have bilateral hearing impairment. Patient fibroblasts showed an increased copper uptake with normal retention. Immunoblot analysis excluded deficiencies of ATP7A (<a href="/entry/300011">300011</a>), which causes Menkes disease (<a href="/entry/309400">309400</a>), and ATP7B (<a href="/entry/606882">606882</a>), which causes Wilson disease (<a href="/entry/277900">277900</a>), 2 disorders of copper metabolism. <a href="#3" class="mim-tip-reference" title="Huppke, P., Brendel, C., Kalscheuer, V., Korenke, G. C., Marquardt, I., Freisinger, P., Christodoulou, J., Hillebrand, M., Pitelet, G., Wilson, C., Gruber-Sedlmayr, U., Ullmann, R., Haas, S., Elpeleg, O., Nurnberg, G., Nurnberg, P., Dad, S., Moller, L. B., Kaler, S. G., Gartner, J. &lt;strong&gt;Mutations in SLC33A1 cause a lethal autosomal-recessive disorder with congenital cataracts, hearing loss, and low serum copper and ceruloplasmin.&lt;/strong&gt; Am. J. Hum. Genet. 90: 61-68, 2012. Note: Erratum: Am. J. Hum. Genet. 90: 378 only, 2012.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/22243965/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;22243965&lt;/a&gt;, &lt;a href=&quot;https://www.ncbi.nlm.nih.gov/pmc/?term=22243965[PMID]&amp;report=imagesdocsum&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed Image&#x27;, &#x27;domain&#x27;: &#x27;ncbi.nlm.nih.gov&#x27;})&quot;&gt;images&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1016/j.ajhg.2011.11.030&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="22243965">Huppke et al. (2012)</a> provided follow-up of the patient reported by <a href="#2" class="mim-tip-reference" title="Horvath, R., Freisinger, P., Rubio, R., Merl, T., Bax, R., Mayr, J. A., Shawan, Muller-Hocker, J., Pongratz, D., Moller, L. B., Horn, N., Jaksch, M. &lt;strong&gt;Congenital cataract, muscular hypotonia, developmental delay and sensorineural hearing loss associated with a defect in copper metabolism.&lt;/strong&gt; J. Inherit. Metab. Dis. 28: 479-492, 2005.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/15902551/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;15902551&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1007/s10545-005-0479-x&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="15902551">Horvath et al. (2005)</a>, who died at age 4 years. <a href="https://pubmed.ncbi.nlm.nih.gov/?term=15902551+22243965" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p><p><a href="#3" class="mim-tip-reference" title="Huppke, P., Brendel, C., Kalscheuer, V., Korenke, G. C., Marquardt, I., Freisinger, P., Christodoulou, J., Hillebrand, M., Pitelet, G., Wilson, C., Gruber-Sedlmayr, U., Ullmann, R., Haas, S., Elpeleg, O., Nurnberg, G., Nurnberg, P., Dad, S., Moller, L. B., Kaler, S. G., Gartner, J. &lt;strong&gt;Mutations in SLC33A1 cause a lethal autosomal-recessive disorder with congenital cataracts, hearing loss, and low serum copper and ceruloplasmin.&lt;/strong&gt; Am. J. Hum. Genet. 90: 61-68, 2012. Note: Erratum: Am. J. Hum. Genet. 90: 378 only, 2012.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/22243965/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;22243965&lt;/a&gt;, &lt;a href=&quot;https://www.ncbi.nlm.nih.gov/pmc/?term=22243965[PMID]&amp;report=imagesdocsum&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed Image&#x27;, &#x27;domain&#x27;: &#x27;ncbi.nlm.nih.gov&#x27;})&quot;&gt;images&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1016/j.ajhg.2011.11.030&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="22243965">Huppke et al. (2012)</a> reported 4 patients from 3 families with a phenotype similar to that reported in the patient by <a href="#2" class="mim-tip-reference" title="Horvath, R., Freisinger, P., Rubio, R., Merl, T., Bax, R., Mayr, J. A., Shawan, Muller-Hocker, J., Pongratz, D., Moller, L. B., Horn, N., Jaksch, M. &lt;strong&gt;Congenital cataract, muscular hypotonia, developmental delay and sensorineural hearing loss associated with a defect in copper metabolism.&lt;/strong&gt; J. Inherit. Metab. Dis. 28: 479-492, 2005.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/15902551/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;15902551&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1007/s10545-005-0479-x&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="15902551">Horvath et al. (2005)</a>. All had severe psychomotor retardation, with inability to sit or walk independently and lack of speech, as well as congenital cataracts and hearing loss. Additional, more variable neurologic features included nystagmus (3) and seizures (2). Brain MRI showed cerebral and cerebellar atrophy, wide subarachnoid spaces, and hypomyelination. Serum copper was low (10 to 20% of normal), and ceruloplasmin was very low. All patients died between ages 22 months and 6 years, from various causes. Two patients treated with copper supplementation showed no clinical improvement. The patients did not show evidence of total body copper deficiency or copper toxicity. <a href="https://pubmed.ncbi.nlm.nih.gov/?term=15902551+22243965" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p><p><a href="#1" class="mim-tip-reference" title="Chiplunkar, S., Bindu, P. S., Nagappa, M., Bineesh, C., Govindaraj, P., Gayathri, N., Bharath, M. M., Arvinda, H. R., Mathuranath, P. S., Sinha, S., Taly, A. B. &lt;strong&gt;Huppke-Brendel syndrome in a seven months old boy with a novel 2-bp deletion in SLC33A1.&lt;/strong&gt; Metab. Brain Dis. 31: 1195-1198, 2016.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/27306358/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;27306358&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1007/s11011-016-9854-6&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="27306358">Chiplunkar et al. (2016)</a> reported a 7-month-old boy, born to first-cousin parents from India, with Huppke-Brendel syndrome. The patient had hypopigmented hair and bilateral congenital cataracts at birth. He underwent surgery for cataracts at 2 months of age. At 7 months of age, he was noted to have a full face with hypopigmented hair and skin and small male genitalia. His weight was at the 75th centile for age, while head circumference was less than the 3rd centile. He had nystagmus and significant developmental delay. Serum copper and ceruloplasmin levels were low. MRI of the brain showed hypomyelination and cerebellar hypoplasia. He died at age 10 months. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=27306358" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p><p><a href="#6" class="mim-tip-reference" title="Monastiri, K., Chioukh, F. Z., Besbes, H., Ben Hmida, H. &lt;strong&gt;Huppke-Brendel syndrome: two new Tunisian cases. (Abstract)&lt;/strong&gt; J. Inher. Metab. Dis. 44: 335 only, 2021."None>Monastiri et al. (2021)</a> reported 2 brothers, born of consanguineous Tunisian parents, with Huppke-Brendel syndrome. The 1-year-old brother had cutis marmorata, recurrent pneumonia, neurologic regression, and seizures with onset at 7 months of age. Brain MRI showed cerebral atrophy, mega cisterna magna, and suspected Leigh syndrome. Serum copper was slightly elevated and plasma ceruloplasmin was low. He died at the age of 16 months. In the 5-month-old brother, mild hypotonia, horizontal nystagmus, and bilateral cataracts were noted. He had neurodevelopmental regression with recurrent aspiration pneumonia. Both serum copper and plasma ceruloplasmin were low. He was treated with enteral copper without improvement.</p><p><a href="#7" class="mim-tip-reference" title="Sikic, K., Peters, T. M. A., Marusic, E., Cagalj, I. C., Ramadza, D. P., Zigman, T., Fumic, K., Fernandez, E., Gevaert, K., Debeljak, Z., Wevers, R. A., Baric, I. &lt;strong&gt;Abnormal concentrations of acetylated amino acids in cerebrospinal fluid in acetyl-CoA transporter deficiency.&lt;/strong&gt; J. Inherit. Metab. Dis. 45: 1048-1058, 2022.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/35999711/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;35999711&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1002/jimd.12549&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="35999711">Sikic et al. (2022)</a> reported a 3-year-old girl, born to nonconsanguineous Croatian parents, with Huppke-Brendel syndrome She had mild hypotonia and bilateral cataracts in the newborn period. At 5 months, deterioration in her development was noted, with improvement after 6 months of intensive therapies. Clinical deterioration was again noted at 14 months, when she was hospitalized due to meningitis and urosepsis. She was noted to have significant dyskinesia of the arms, head and trunk and uncoordinated eye movements. She had nystagmus. Joints were hypermobile, and facial features included hypotelorism, thin upper lip, and micrognathia. Recurrent seizures developed, leading to initiation of antiepileptic therapy. A brain MRI showed bilateral frontal subdural hygromas, cystic formation in the posterior cranial fossa, and diffuse hypomyelination and cerebellar hypoplasia. Bilateral hearing loss was identified. She had low serum copper and ceruloplasmin concentrations. Subcutaneous copper histidinate therapy was started at age 18 months with no clinical improvement, although an increase in serum copper and ceruloplasmin was noted. She was noted to have a distal femur fracture at age 3 years without preceding trauma. At her last evaluation at age 3 years and 4 months, she was microcephalic (head circumference less than 1st centile) and had pale skin and white sparse kinky hair. She had severe psychomotor disability: she was bedridden, somnolent with no visual contact, responded only to painful stimuli, was tube-fed, and used tracheostomy with noninvasive ventilation as breathing support. She continued to have daily seizures despite treatment with 3 antiepileptic medications, and an EEG shows burst suppression elements. Levels of ceruloplasmin and copper were low, despite continuous copper histidinate therapy. Although N-terminal protein acetylation and acetyl-CoA levels in fibroblasts appeared normal, the authors found decreased levels of many N-acetylated amino acids in the cerebrospinal fluid and suggested that these could be potential biomarkers for the condition. <a href="#7" class="mim-tip-reference" title="Sikic, K., Peters, T. M. A., Marusic, E., Cagalj, I. C., Ramadza, D. P., Zigman, T., Fumic, K., Fernandez, E., Gevaert, K., Debeljak, Z., Wevers, R. A., Baric, I. &lt;strong&gt;Abnormal concentrations of acetylated amino acids in cerebrospinal fluid in acetyl-CoA transporter deficiency.&lt;/strong&gt; J. Inherit. Metab. Dis. 45: 1048-1058, 2022.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/35999711/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;35999711&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1002/jimd.12549&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="35999711">Sikic et al. (2022)</a> also reviewed phenotype and genotype of previously reported patients with Huppke-Brendel syndrome. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=35999711" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p><p><a href="#5" class="mim-tip-reference" title="Kirk, F. T., Munk, D. E., Ek, J., Birk Moller, L., Bendixen Thorup, M., Hvid Danielsen, E., Vilstrup, H., Ott, P., Damgaard Sandahl, T. &lt;strong&gt;Case report: Huppke-Brendel syndrome in an adult, mistaken for and treated as Wilson disease for 25 years.&lt;/strong&gt; Front. Neurol. 13: 957794, 2022.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/36119696/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;36119696&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.3389/fneur.2022.957794&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="36119696">Kirk et al. (2022)</a> reported a 53-year-old Danish woman with a mild form of Huppke-Brendel syndrome who had previously been diagnosed with Wilson disease (<a href="/entry/277900">277900</a>) because of elevated urinary copper and low ceruloplasmin levels. The patient initially presented in childhood with developmental delay and partial hearing loss. At age 29 years, she had moderately impaired intellectual development, partial hearing loss, spastic ataxia, hypotonia, and a unilateral tremor of parkinsonian type. She had low serum ceruloplasmin and serum copper levels, and urinary excretion of copper was moderately elevated, and Wilson disease was diagnosed. Zinc therapy was initiated, and she remained stable, without progression of her neurologic symptoms. At 49 years of age, she developed severe dysphagia and experienced a loss of mobility and bladder and bowel control. Penicillamine was added and her antipsychotic and antiepileptic medications were adjusted, with improvement in her dysphagia and mobility. Brain MRI showed no changes consistent with Wilson disease but showed global atrophy including cerebellar atrophy. These findings, along with genetic analysis finding no variants in the ATP7B (<a href="/entry/606882">606882</a>) gene and identifying variants in the SLC33A1 gene, led to a diagnosis of Huppke-Brendel syndrome. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=36119696" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p>
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<p>The transmission pattern of Huppke-Brendel syndrome in the families reported by <a href="#3" class="mim-tip-reference" title="Huppke, P., Brendel, C., Kalscheuer, V., Korenke, G. C., Marquardt, I., Freisinger, P., Christodoulou, J., Hillebrand, M., Pitelet, G., Wilson, C., Gruber-Sedlmayr, U., Ullmann, R., Haas, S., Elpeleg, O., Nurnberg, G., Nurnberg, P., Dad, S., Moller, L. B., Kaler, S. G., Gartner, J. &lt;strong&gt;Mutations in SLC33A1 cause a lethal autosomal-recessive disorder with congenital cataracts, hearing loss, and low serum copper and ceruloplasmin.&lt;/strong&gt; Am. J. Hum. Genet. 90: 61-68, 2012. Note: Erratum: Am. J. Hum. Genet. 90: 378 only, 2012.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/22243965/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;22243965&lt;/a&gt;, &lt;a href=&quot;https://www.ncbi.nlm.nih.gov/pmc/?term=22243965[PMID]&amp;report=imagesdocsum&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed Image&#x27;, &#x27;domain&#x27;: &#x27;ncbi.nlm.nih.gov&#x27;})&quot;&gt;images&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1016/j.ajhg.2011.11.030&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="22243965">Huppke et al. (2012)</a> was consistent with autosomal recessive inheritance. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=22243965" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p>
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<p>By linkage analysis followed by candidate gene sequencing in 3 consanguineous families with Huppke-Brendel syndrome, <a href="#3" class="mim-tip-reference" title="Huppke, P., Brendel, C., Kalscheuer, V., Korenke, G. C., Marquardt, I., Freisinger, P., Christodoulou, J., Hillebrand, M., Pitelet, G., Wilson, C., Gruber-Sedlmayr, U., Ullmann, R., Haas, S., Elpeleg, O., Nurnberg, G., Nurnberg, P., Dad, S., Moller, L. B., Kaler, S. G., Gartner, J. &lt;strong&gt;Mutations in SLC33A1 cause a lethal autosomal-recessive disorder with congenital cataracts, hearing loss, and low serum copper and ceruloplasmin.&lt;/strong&gt; Am. J. Hum. Genet. 90: 61-68, 2012. Note: Erratum: Am. J. Hum. Genet. 90: 378 only, 2012.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/22243965/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;22243965&lt;/a&gt;, &lt;a href=&quot;https://www.ncbi.nlm.nih.gov/pmc/?term=22243965[PMID]&amp;report=imagesdocsum&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed Image&#x27;, &#x27;domain&#x27;: &#x27;ncbi.nlm.nih.gov&#x27;})&quot;&gt;images&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1016/j.ajhg.2011.11.030&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="22243965">Huppke et al. (2012)</a> identified 5 different pathogenic mutations in the SLC33A1 gene in homozygous or compound heterozygous state (<a href="/entry/603690#0002">603690.0002</a>-<a href="/entry/603690#0006">603690.0006</a>). Knockdown of SLC33A1 in hepatic cells caused a 30% reduction of ceruloplasmin secretion, indicating that SLC33A1 expression and ceruloplasmin secretion are connected. None of the parents who were heterozygous carriers showed signs of spastic paraplegia. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=22243965" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p><p>One of the patients reported by <a href="#3" class="mim-tip-reference" title="Huppke, P., Brendel, C., Kalscheuer, V., Korenke, G. C., Marquardt, I., Freisinger, P., Christodoulou, J., Hillebrand, M., Pitelet, G., Wilson, C., Gruber-Sedlmayr, U., Ullmann, R., Haas, S., Elpeleg, O., Nurnberg, G., Nurnberg, P., Dad, S., Moller, L. B., Kaler, S. G., Gartner, J. &lt;strong&gt;Mutations in SLC33A1 cause a lethal autosomal-recessive disorder with congenital cataracts, hearing loss, and low serum copper and ceruloplasmin.&lt;/strong&gt; Am. J. Hum. Genet. 90: 61-68, 2012. Note: Erratum: Am. J. Hum. Genet. 90: 378 only, 2012.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/22243965/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;22243965&lt;/a&gt;, &lt;a href=&quot;https://www.ncbi.nlm.nih.gov/pmc/?term=22243965[PMID]&amp;report=imagesdocsum&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed Image&#x27;, &#x27;domain&#x27;: &#x27;ncbi.nlm.nih.gov&#x27;})&quot;&gt;images&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1016/j.ajhg.2011.11.030&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="22243965">Huppke et al. (2012)</a>, who had a nonsense mutation (<a href="/entry/603690#0004">603690.0004</a>), was a Turkish boy who had additional features not found in the other patients, including neonatal hypotonia, hypoglycemia, and a pericardial effusion. In this patient, <a href="#4" class="mim-tip-reference" title="Huppke, P., Brendel, C., Korenke, G. C., Marquardt, I., Donsante, A., Yi, L., Hicks, J. D., Steinbach, P. J., Wilson, C., Elpeleg, O., Moller, L. B., Christodoulou, J., Kaler, S. G., Gartner, J. &lt;strong&gt;Molecular and biochemical characterization of a unique mutation in CCS, the human copper chaperone to superoxide dismutase.&lt;/strong&gt; Hum. Mutat. 33: 1207-1215, 2012.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/22508683/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;22508683&lt;/a&gt;, &lt;a href=&quot;https://www.ncbi.nlm.nih.gov/pmc/?term=22508683[PMID]&amp;report=imagesdocsum&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed Image&#x27;, &#x27;domain&#x27;: &#x27;ncbi.nlm.nih.gov&#x27;})&quot;&gt;images&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1002/humu.22099&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="22508683">Huppke et al. (2012)</a> later identified a homozygous missense mutation in the CCS gene (<a href="/entry/603864#0001">603864.0001</a>) and suggested that a defect in copper homeostasis or SOD1 deficiency may have contributed to the phenotype. <a href="https://pubmed.ncbi.nlm.nih.gov/?term=22243965+22508683" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p><p>By exome sequencing in a 7-month-old boy, born to first-cousin parents from India, with HPBDS, <a href="#1" class="mim-tip-reference" title="Chiplunkar, S., Bindu, P. S., Nagappa, M., Bineesh, C., Govindaraj, P., Gayathri, N., Bharath, M. M., Arvinda, H. R., Mathuranath, P. S., Sinha, S., Taly, A. B. &lt;strong&gt;Huppke-Brendel syndrome in a seven months old boy with a novel 2-bp deletion in SLC33A1.&lt;/strong&gt; Metab. Brain Dis. 31: 1195-1198, 2016.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/27306358/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;27306358&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1007/s11011-016-9854-6&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="27306358">Chiplunkar et al. (2016)</a> identified a homozygous 2-bp deletion in exon 1 of the SLC33A1 gene (c.542_543delTG; <a href="/entry/603690#0008">603690.0008</a>), predicted to result in a frameshift and premature truncation of the protein (Val181GlyfsTer6). The unaffected parents were heterozygous for the mutation. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=27306358" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p><p>In 2 brothers, born to consanguineous parents from Tunisia, with HPBDS, <a href="#6" class="mim-tip-reference" title="Monastiri, K., Chioukh, F. Z., Besbes, H., Ben Hmida, H. &lt;strong&gt;Huppke-Brendel syndrome: two new Tunisian cases. (Abstract)&lt;/strong&gt; J. Inher. Metab. Dis. 44: 335 only, 2021."None>Monastiri et al. (2021)</a> identified homozygosity for a splice site mutation in the SLC33A1 gene (c.1267-1G-A; <a href="/entry/603864#0003">603864.0003</a>). This mutation had been reported by <a href="#4" class="mim-tip-reference" title="Huppke, P., Brendel, C., Korenke, G. C., Marquardt, I., Donsante, A., Yi, L., Hicks, J. D., Steinbach, P. J., Wilson, C., Elpeleg, O., Moller, L. B., Christodoulou, J., Kaler, S. G., Gartner, J. &lt;strong&gt;Molecular and biochemical characterization of a unique mutation in CCS, the human copper chaperone to superoxide dismutase.&lt;/strong&gt; Hum. Mutat. 33: 1207-1215, 2012.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/22508683/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;22508683&lt;/a&gt;, &lt;a href=&quot;https://www.ncbi.nlm.nih.gov/pmc/?term=22508683[PMID]&amp;report=imagesdocsum&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed Image&#x27;, &#x27;domain&#x27;: &#x27;ncbi.nlm.nih.gov&#x27;})&quot;&gt;images&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1002/humu.22099&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="22508683">Huppke et al. (2012)</a> in Tunisian sibs, suggesting a founder effect in that population. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=22508683" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p><p>In a 3-year-old girl, born to nonconsanguineous Croatian parents, with HPBDS, <a href="#7" class="mim-tip-reference" title="Sikic, K., Peters, T. M. A., Marusic, E., Cagalj, I. C., Ramadza, D. P., Zigman, T., Fumic, K., Fernandez, E., Gevaert, K., Debeljak, Z., Wevers, R. A., Baric, I. &lt;strong&gt;Abnormal concentrations of acetylated amino acids in cerebrospinal fluid in acetyl-CoA transporter deficiency.&lt;/strong&gt; J. Inherit. Metab. Dis. 45: 1048-1058, 2022.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/35999711/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;35999711&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1002/jimd.12549&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="35999711">Sikic et al. (2022)</a> identified homozygosity for a nonsense mutation in the SLC33A1 gene (Y377X; <a href="/entry/603690#0009">603690.0009</a>). Both unaffected parents were heterozygous for the mutation. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=35999711" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p><p>By exome sequencing in a 53-year-old Danish woman with a mild form of HPBDS who had been diagnosed with Wilson disease (<a href="/entry/277900">277900</a>), <a href="#5" class="mim-tip-reference" title="Kirk, F. T., Munk, D. E., Ek, J., Birk Moller, L., Bendixen Thorup, M., Hvid Danielsen, E., Vilstrup, H., Ott, P., Damgaard Sandahl, T. &lt;strong&gt;Case report: Huppke-Brendel syndrome in an adult, mistaken for and treated as Wilson disease for 25 years.&lt;/strong&gt; Front. Neurol. 13: 957794, 2022.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/36119696/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;36119696&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.3389/fneur.2022.957794&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="36119696">Kirk et al. (2022)</a> identified compound heterozygosity for variants in the SLC33A1 gene: a c.1331T-C transition, resulting in an ile444-to-thr (I444T) substitution, and a 3-bp deletion (c.817_819del), resulting in deletion of threonine at codon 273. The first variant was not found in gnomAD, whereas the second was found 3 times in heterozygous state only. Both affected amino acids were highly evolutionarily conserved. No clinical information on the deceased parents was available. <a href="#5" class="mim-tip-reference" title="Kirk, F. T., Munk, D. E., Ek, J., Birk Moller, L., Bendixen Thorup, M., Hvid Danielsen, E., Vilstrup, H., Ott, P., Damgaard Sandahl, T. &lt;strong&gt;Case report: Huppke-Brendel syndrome in an adult, mistaken for and treated as Wilson disease for 25 years.&lt;/strong&gt; Front. Neurol. 13: 957794, 2022.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/36119696/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;36119696&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.3389/fneur.2022.957794&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="36119696">Kirk et al. (2022)</a> classified these variants as variants of uncertain significance based on ACMG criteria. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=36119696" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p>
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<strong>REFERENCES</strong>
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<div id="mimReferencesFold" class="collapse in mimTextToggleFold">
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<a id="1" class="mim-anchor"></a>
<a id="Chiplunkar2016" class="mim-anchor"></a>
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Chiplunkar, S., Bindu, P. S., Nagappa, M., Bineesh, C., Govindaraj, P., Gayathri, N., Bharath, M. M., Arvinda, H. R., Mathuranath, P. S., Sinha, S., Taly, A. B.
<strong>Huppke-Brendel syndrome in a seven months old boy with a novel 2-bp deletion in SLC33A1.</strong>
Metab. Brain Dis. 31: 1195-1198, 2016.
[PubMed: <a href="https://pubmed.ncbi.nlm.nih.gov/27306358/" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">27306358</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=27306358" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">related citations</a>]
[<a href="https://doi.org/10.1007/s11011-016-9854-6" target="_blank">Full Text</a>]
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<a id="Horvath2005" class="mim-anchor"></a>
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Horvath, R., Freisinger, P., Rubio, R., Merl, T., Bax, R., Mayr, J. A., Shawan, Muller-Hocker, J., Pongratz, D., Moller, L. B., Horn, N., Jaksch, M.
<strong>Congenital cataract, muscular hypotonia, developmental delay and sensorineural hearing loss associated with a defect in copper metabolism.</strong>
J. Inherit. Metab. Dis. 28: 479-492, 2005.
[PubMed: <a href="https://pubmed.ncbi.nlm.nih.gov/15902551/" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">15902551</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=15902551" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">related citations</a>]
[<a href="https://doi.org/10.1007/s10545-005-0479-x" target="_blank">Full Text</a>]
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<a id="Huppke2012" class="mim-anchor"></a>
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Huppke, P., Brendel, C., Kalscheuer, V., Korenke, G. C., Marquardt, I., Freisinger, P., Christodoulou, J., Hillebrand, M., Pitelet, G., Wilson, C., Gruber-Sedlmayr, U., Ullmann, R., Haas, S., Elpeleg, O., Nurnberg, G., Nurnberg, P., Dad, S., Moller, L. B., Kaler, S. G., Gartner, J.
<strong>Mutations in SLC33A1 cause a lethal autosomal-recessive disorder with congenital cataracts, hearing loss, and low serum copper and ceruloplasmin.</strong>
Am. J. Hum. Genet. 90: 61-68, 2012. Note: Erratum: Am. J. Hum. Genet. 90: 378 only, 2012.
[PubMed: <a href="https://pubmed.ncbi.nlm.nih.gov/22243965/" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">22243965</a>, <a href="https://www.ncbi.nlm.nih.gov/pmc/?term=22243965[PMID]&report=imagesdocsum" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Image', 'domain': 'ncbi.nlm.nih.gov'})">images</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=22243965" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">related citations</a>]
[<a href="https://doi.org/10.1016/j.ajhg.2011.11.030" target="_blank">Full Text</a>]
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<a id="Huppke2012" class="mim-anchor"></a>
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Huppke, P., Brendel, C., Korenke, G. C., Marquardt, I., Donsante, A., Yi, L., Hicks, J. D., Steinbach, P. J., Wilson, C., Elpeleg, O., Moller, L. B., Christodoulou, J., Kaler, S. G., Gartner, J.
<strong>Molecular and biochemical characterization of a unique mutation in CCS, the human copper chaperone to superoxide dismutase.</strong>
Hum. Mutat. 33: 1207-1215, 2012.
[PubMed: <a href="https://pubmed.ncbi.nlm.nih.gov/22508683/" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">22508683</a>, <a href="https://www.ncbi.nlm.nih.gov/pmc/?term=22508683[PMID]&report=imagesdocsum" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Image', 'domain': 'ncbi.nlm.nih.gov'})">images</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=22508683" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">related citations</a>]
[<a href="https://doi.org/10.1002/humu.22099" target="_blank">Full Text</a>]
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<a id="Kirk2022" class="mim-anchor"></a>
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Kirk, F. T., Munk, D. E., Ek, J., Birk Moller, L., Bendixen Thorup, M., Hvid Danielsen, E., Vilstrup, H., Ott, P., Damgaard Sandahl, T.
<strong>Case report: Huppke-Brendel syndrome in an adult, mistaken for and treated as Wilson disease for 25 years.</strong>
Front. Neurol. 13: 957794, 2022.
[PubMed: <a href="https://pubmed.ncbi.nlm.nih.gov/36119696/" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">36119696</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=36119696" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">related citations</a>]
[<a href="https://doi.org/10.3389/fneur.2022.957794" target="_blank">Full Text</a>]
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<a id="Monastiri2021" class="mim-anchor"></a>
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Monastiri, K., Chioukh, F. Z., Besbes, H., Ben Hmida, H.
<strong>Huppke-Brendel syndrome: two new Tunisian cases. (Abstract)</strong>
J. Inher. Metab. Dis. 44: 335 only, 2021.
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<a id="Sikic2022" class="mim-anchor"></a>
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Sikic, K., Peters, T. M. A., Marusic, E., Cagalj, I. C., Ramadza, D. P., Zigman, T., Fumic, K., Fernandez, E., Gevaert, K., Debeljak, Z., Wevers, R. A., Baric, I.
<strong>Abnormal concentrations of acetylated amino acids in cerebrospinal fluid in acetyl-CoA transporter deficiency.</strong>
J. Inherit. Metab. Dis. 45: 1048-1058, 2022.
[PubMed: <a href="https://pubmed.ncbi.nlm.nih.gov/35999711/" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">35999711</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=35999711" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">related citations</a>]
[<a href="https://doi.org/10.1002/jimd.12549" target="_blank">Full Text</a>]
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Sonja A. Rasmussen - updated : 02/16/2024
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Cassandra L. Kniffin - updated : 9/5/2012
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Cassandra L. Kniffin : 2/14/2012
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carol : 02/29/2024
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alopez : 02/16/2024<br>joanna : 11/21/2023<br>carol : 11/07/2023<br>carol : 11/07/2023<br>carol : 01/17/2018<br>carol : 09/05/2012<br>ckniffin : 9/5/2012<br>carol : 8/31/2012<br>carol : 2/17/2012<br>ckniffin : 2/14/2012
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<strong>#</strong> 614482
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HUPPKE-BRENDEL SYNDROME; HPBDS
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<em>Alternative titles; symbols</em>
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CONGENITAL CATARACTS, HEARING LOSS, AND NEURODEGENERATION; CCHLND<br />
ACETYL-CoA TRANSPORTER DEFICIENCY
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<strong>SNOMEDCT:</strong> 773648002; &nbsp;
<strong>ORPHA:</strong> 300313; &nbsp;
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<strong>Phenotype-Gene Relationships</strong>
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Location
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Phenotype
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Phenotype <br /> MIM number
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Inheritance
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Phenotype <br /> mapping key
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Gene/Locus
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Gene/Locus <br /> MIM number
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3q25.31
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Huppke-Brendel syndrome
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614482
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Autosomal recessive
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3
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SLC33A1
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603690
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<strong>TEXT</strong>
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<p>A number sign (#) is used with this entry because of evidence that Huppke-Brendel syndrome (HPBDS) is caused by homozygous or compound heterozygous mutation in the SLC33A1 gene (603690) on chromosome 3q25.</p>
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<strong>Description</strong>
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<p>Huppke-Brendel syndrome (HPBDS) is an autosomal recessive disorder characterized by congenital cataracts, severe psychomotor retardation, and hearing loss associated with decreased serum ceruloplasmin and copper. Brain MRI shows cerebral and cerebellar atrophy and hypomyelination (summary by Huppke et al., 2012). </p>
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<strong>Clinical Features</strong>
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<p>Horvath et al. (2005) reported a boy, born of consanguineous Arab parents, who presented in the first weeks of life with severe hypotonia, weakness of the neck muscles, and bilateral congenital cataracts. Examination at age 4 months showed delayed psychomotor development, severe hypotonia, inability to fix gaze, and rotary nystagmus. Laboratory studies showed low serum copper and ceruloplasmin, and neutropenia. Skeletal muscle biopsy showed some enlarged and abnormal mitochondria and decreased cytochrome c oxidase activity. Brain MRI at age 5 months revealed Dandy-Walker malformation, hypoplasia of the cerebellar vermis, and hypoplasia of the temporal lobes. Treatment with copper histidinate supplementation resulted in marked clinical improvement by ages 8 and 13 months: hypotonia was less severe, and there was complete restoration of cytochrome c oxidase activity in skeletal muscle, although serum copper levels did not increase significantly. At age 13 months, he was noted to have bilateral hearing impairment. Patient fibroblasts showed an increased copper uptake with normal retention. Immunoblot analysis excluded deficiencies of ATP7A (300011), which causes Menkes disease (309400), and ATP7B (606882), which causes Wilson disease (277900), 2 disorders of copper metabolism. Huppke et al. (2012) provided follow-up of the patient reported by Horvath et al. (2005), who died at age 4 years. </p><p>Huppke et al. (2012) reported 4 patients from 3 families with a phenotype similar to that reported in the patient by Horvath et al. (2005). All had severe psychomotor retardation, with inability to sit or walk independently and lack of speech, as well as congenital cataracts and hearing loss. Additional, more variable neurologic features included nystagmus (3) and seizures (2). Brain MRI showed cerebral and cerebellar atrophy, wide subarachnoid spaces, and hypomyelination. Serum copper was low (10 to 20% of normal), and ceruloplasmin was very low. All patients died between ages 22 months and 6 years, from various causes. Two patients treated with copper supplementation showed no clinical improvement. The patients did not show evidence of total body copper deficiency or copper toxicity. </p><p>Chiplunkar et al. (2016) reported a 7-month-old boy, born to first-cousin parents from India, with Huppke-Brendel syndrome. The patient had hypopigmented hair and bilateral congenital cataracts at birth. He underwent surgery for cataracts at 2 months of age. At 7 months of age, he was noted to have a full face with hypopigmented hair and skin and small male genitalia. His weight was at the 75th centile for age, while head circumference was less than the 3rd centile. He had nystagmus and significant developmental delay. Serum copper and ceruloplasmin levels were low. MRI of the brain showed hypomyelination and cerebellar hypoplasia. He died at age 10 months. </p><p>Monastiri et al. (2021) reported 2 brothers, born of consanguineous Tunisian parents, with Huppke-Brendel syndrome. The 1-year-old brother had cutis marmorata, recurrent pneumonia, neurologic regression, and seizures with onset at 7 months of age. Brain MRI showed cerebral atrophy, mega cisterna magna, and suspected Leigh syndrome. Serum copper was slightly elevated and plasma ceruloplasmin was low. He died at the age of 16 months. In the 5-month-old brother, mild hypotonia, horizontal nystagmus, and bilateral cataracts were noted. He had neurodevelopmental regression with recurrent aspiration pneumonia. Both serum copper and plasma ceruloplasmin were low. He was treated with enteral copper without improvement.</p><p>Sikic et al. (2022) reported a 3-year-old girl, born to nonconsanguineous Croatian parents, with Huppke-Brendel syndrome She had mild hypotonia and bilateral cataracts in the newborn period. At 5 months, deterioration in her development was noted, with improvement after 6 months of intensive therapies. Clinical deterioration was again noted at 14 months, when she was hospitalized due to meningitis and urosepsis. She was noted to have significant dyskinesia of the arms, head and trunk and uncoordinated eye movements. She had nystagmus. Joints were hypermobile, and facial features included hypotelorism, thin upper lip, and micrognathia. Recurrent seizures developed, leading to initiation of antiepileptic therapy. A brain MRI showed bilateral frontal subdural hygromas, cystic formation in the posterior cranial fossa, and diffuse hypomyelination and cerebellar hypoplasia. Bilateral hearing loss was identified. She had low serum copper and ceruloplasmin concentrations. Subcutaneous copper histidinate therapy was started at age 18 months with no clinical improvement, although an increase in serum copper and ceruloplasmin was noted. She was noted to have a distal femur fracture at age 3 years without preceding trauma. At her last evaluation at age 3 years and 4 months, she was microcephalic (head circumference less than 1st centile) and had pale skin and white sparse kinky hair. She had severe psychomotor disability: she was bedridden, somnolent with no visual contact, responded only to painful stimuli, was tube-fed, and used tracheostomy with noninvasive ventilation as breathing support. She continued to have daily seizures despite treatment with 3 antiepileptic medications, and an EEG shows burst suppression elements. Levels of ceruloplasmin and copper were low, despite continuous copper histidinate therapy. Although N-terminal protein acetylation and acetyl-CoA levels in fibroblasts appeared normal, the authors found decreased levels of many N-acetylated amino acids in the cerebrospinal fluid and suggested that these could be potential biomarkers for the condition. Sikic et al. (2022) also reviewed phenotype and genotype of previously reported patients with Huppke-Brendel syndrome. </p><p>Kirk et al. (2022) reported a 53-year-old Danish woman with a mild form of Huppke-Brendel syndrome who had previously been diagnosed with Wilson disease (277900) because of elevated urinary copper and low ceruloplasmin levels. The patient initially presented in childhood with developmental delay and partial hearing loss. At age 29 years, she had moderately impaired intellectual development, partial hearing loss, spastic ataxia, hypotonia, and a unilateral tremor of parkinsonian type. She had low serum ceruloplasmin and serum copper levels, and urinary excretion of copper was moderately elevated, and Wilson disease was diagnosed. Zinc therapy was initiated, and she remained stable, without progression of her neurologic symptoms. At 49 years of age, she developed severe dysphagia and experienced a loss of mobility and bladder and bowel control. Penicillamine was added and her antipsychotic and antiepileptic medications were adjusted, with improvement in her dysphagia and mobility. Brain MRI showed no changes consistent with Wilson disease but showed global atrophy including cerebellar atrophy. These findings, along with genetic analysis finding no variants in the ATP7B (606882) gene and identifying variants in the SLC33A1 gene, led to a diagnosis of Huppke-Brendel syndrome. </p>
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<strong>Inheritance</strong>
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<p>The transmission pattern of Huppke-Brendel syndrome in the families reported by Huppke et al. (2012) was consistent with autosomal recessive inheritance. </p>
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<strong>Molecular Genetics</strong>
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<p>By linkage analysis followed by candidate gene sequencing in 3 consanguineous families with Huppke-Brendel syndrome, Huppke et al. (2012) identified 5 different pathogenic mutations in the SLC33A1 gene in homozygous or compound heterozygous state (603690.0002-603690.0006). Knockdown of SLC33A1 in hepatic cells caused a 30% reduction of ceruloplasmin secretion, indicating that SLC33A1 expression and ceruloplasmin secretion are connected. None of the parents who were heterozygous carriers showed signs of spastic paraplegia. </p><p>One of the patients reported by Huppke et al. (2012), who had a nonsense mutation (603690.0004), was a Turkish boy who had additional features not found in the other patients, including neonatal hypotonia, hypoglycemia, and a pericardial effusion. In this patient, Huppke et al. (2012) later identified a homozygous missense mutation in the CCS gene (603864.0001) and suggested that a defect in copper homeostasis or SOD1 deficiency may have contributed to the phenotype. </p><p>By exome sequencing in a 7-month-old boy, born to first-cousin parents from India, with HPBDS, Chiplunkar et al. (2016) identified a homozygous 2-bp deletion in exon 1 of the SLC33A1 gene (c.542_543delTG; 603690.0008), predicted to result in a frameshift and premature truncation of the protein (Val181GlyfsTer6). The unaffected parents were heterozygous for the mutation. </p><p>In 2 brothers, born to consanguineous parents from Tunisia, with HPBDS, Monastiri et al. (2021) identified homozygosity for a splice site mutation in the SLC33A1 gene (c.1267-1G-A; 603864.0003). This mutation had been reported by Huppke et al. (2012) in Tunisian sibs, suggesting a founder effect in that population. </p><p>In a 3-year-old girl, born to nonconsanguineous Croatian parents, with HPBDS, Sikic et al. (2022) identified homozygosity for a nonsense mutation in the SLC33A1 gene (Y377X; 603690.0009). Both unaffected parents were heterozygous for the mutation. </p><p>By exome sequencing in a 53-year-old Danish woman with a mild form of HPBDS who had been diagnosed with Wilson disease (277900), Kirk et al. (2022) identified compound heterozygosity for variants in the SLC33A1 gene: a c.1331T-C transition, resulting in an ile444-to-thr (I444T) substitution, and a 3-bp deletion (c.817_819del), resulting in deletion of threonine at codon 273. The first variant was not found in gnomAD, whereas the second was found 3 times in heterozygous state only. Both affected amino acids were highly evolutionarily conserved. No clinical information on the deceased parents was available. Kirk et al. (2022) classified these variants as variants of uncertain significance based on ACMG criteria. </p>
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<strong>REFERENCES</strong>
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Chiplunkar, S., Bindu, P. S., Nagappa, M., Bineesh, C., Govindaraj, P., Gayathri, N., Bharath, M. M., Arvinda, H. R., Mathuranath, P. S., Sinha, S., Taly, A. B.
<strong>Huppke-Brendel syndrome in a seven months old boy with a novel 2-bp deletion in SLC33A1.</strong>
Metab. Brain Dis. 31: 1195-1198, 2016.
[PubMed: 27306358]
[Full Text: https://doi.org/10.1007/s11011-016-9854-6]
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<p class="mim-text-font">
Horvath, R., Freisinger, P., Rubio, R., Merl, T., Bax, R., Mayr, J. A., Shawan, Muller-Hocker, J., Pongratz, D., Moller, L. B., Horn, N., Jaksch, M.
<strong>Congenital cataract, muscular hypotonia, developmental delay and sensorineural hearing loss associated with a defect in copper metabolism.</strong>
J. Inherit. Metab. Dis. 28: 479-492, 2005.
[PubMed: 15902551]
[Full Text: https://doi.org/10.1007/s10545-005-0479-x]
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<p class="mim-text-font">
Huppke, P., Brendel, C., Kalscheuer, V., Korenke, G. C., Marquardt, I., Freisinger, P., Christodoulou, J., Hillebrand, M., Pitelet, G., Wilson, C., Gruber-Sedlmayr, U., Ullmann, R., Haas, S., Elpeleg, O., Nurnberg, G., Nurnberg, P., Dad, S., Moller, L. B., Kaler, S. G., Gartner, J.
<strong>Mutations in SLC33A1 cause a lethal autosomal-recessive disorder with congenital cataracts, hearing loss, and low serum copper and ceruloplasmin.</strong>
Am. J. Hum. Genet. 90: 61-68, 2012. Note: Erratum: Am. J. Hum. Genet. 90: 378 only, 2012.
[PubMed: 22243965]
[Full Text: https://doi.org/10.1016/j.ajhg.2011.11.030]
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<li>
<p class="mim-text-font">
Huppke, P., Brendel, C., Korenke, G. C., Marquardt, I., Donsante, A., Yi, L., Hicks, J. D., Steinbach, P. J., Wilson, C., Elpeleg, O., Moller, L. B., Christodoulou, J., Kaler, S. G., Gartner, J.
<strong>Molecular and biochemical characterization of a unique mutation in CCS, the human copper chaperone to superoxide dismutase.</strong>
Hum. Mutat. 33: 1207-1215, 2012.
[PubMed: 22508683]
[Full Text: https://doi.org/10.1002/humu.22099]
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<li>
<p class="mim-text-font">
Kirk, F. T., Munk, D. E., Ek, J., Birk Moller, L., Bendixen Thorup, M., Hvid Danielsen, E., Vilstrup, H., Ott, P., Damgaard Sandahl, T.
<strong>Case report: Huppke-Brendel syndrome in an adult, mistaken for and treated as Wilson disease for 25 years.</strong>
Front. Neurol. 13: 957794, 2022.
[PubMed: 36119696]
[Full Text: https://doi.org/10.3389/fneur.2022.957794]
</p>
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<li>
<p class="mim-text-font">
Monastiri, K., Chioukh, F. Z., Besbes, H., Ben Hmida, H.
<strong>Huppke-Brendel syndrome: two new Tunisian cases. (Abstract)</strong>
J. Inher. Metab. Dis. 44: 335 only, 2021.
</p>
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<li>
<p class="mim-text-font">
Sikic, K., Peters, T. M. A., Marusic, E., Cagalj, I. C., Ramadza, D. P., Zigman, T., Fumic, K., Fernandez, E., Gevaert, K., Debeljak, Z., Wevers, R. A., Baric, I.
<strong>Abnormal concentrations of acetylated amino acids in cerebrospinal fluid in acetyl-CoA transporter deficiency.</strong>
J. Inherit. Metab. Dis. 45: 1048-1058, 2022.
[PubMed: 35999711]
[Full Text: https://doi.org/10.1002/jimd.12549]
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<span class="mim-text-font">
Sonja A. Rasmussen - updated : 02/16/2024<br>Cassandra L. Kniffin - updated : 9/5/2012
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Cassandra L. Kniffin : 2/14/2012
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carol : 02/29/2024<br>alopez : 02/16/2024<br>joanna : 11/21/2023<br>carol : 11/07/2023<br>carol : 11/07/2023<br>carol : 01/17/2018<br>carol : 09/05/2012<br>ckniffin : 9/5/2012<br>carol : 8/31/2012<br>carol : 2/17/2012<br>ckniffin : 2/14/2012
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Ada Hamosh, MD, MPH <br />
Scientific Director, OMIM <br />
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