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Acidemia

MedGen UID:
541142
Concept ID:
C0268030
Pathologic Function
SNOMED CT: Acidemia (70731005)
 
HPO: HP:0032368

Definition

An abnormally low blood pH (usually defined as less than 7.35). [from HPO]

Conditions with this feature

Maturity-onset diabetes of the young type 9
MedGen UID:
383033
Concept ID:
C2677132
Disease or Syndrome
Maturity-onset diabetes of the young (MODY) is a group of several conditions characterized by abnormally high levels of blood glucose, also called blood sugar. These forms of diabetes typically begin before age 30, although they can occur later in life. In MODY, elevated blood glucose arises from reduced production of insulin, which is a hormone produced in the pancreas that helps regulate blood glucose levels. Specifically, insulin controls how much glucose (a type of sugar) is passed from the blood into cells, where it is used as an energy source.\n\nThe different types of MODY are distinguished by their genetic causes. The most common types are HNF1A-MODY (also known as MODY3), accounting for 50 to 70 percent of cases, and GCK-MODY (MODY2), accounting for 30 to 50 percent of cases. Less frequent types include HNF4A-MODY (MODY1) and renal cysts and diabetes (RCAD) syndrome (also known as HNF1B-MODY or MODY5), which each account for 5 to 10 percent of cases. At least ten other types have been identified, and these are very rare.\n\nHNF1A-MODY and HNF4A-MODY have similar signs and symptoms that develop slowly over time. Early signs and symptoms in these types are caused by high blood glucose and may include frequent urination (polyuria), excessive thirst (polydipsia), fatigue, blurred vision, weight loss, and recurrent skin infections. Over time uncontrolled high blood glucose can damage small blood vessels in the eyes and kidneys. Damage to the light-sensitive tissue at the back of the eye (the retina) causes a condition known as diabetic retinopathy that can lead to vision loss and eventual blindness. Kidney damage (diabetic nephropathy) can lead to kidney failure and end-stage renal disease (ESRD). While these two types of MODY are very similar, certain features are particular to each type. For example, babies with HNF4A-MODY tend to weigh more than average or have abnormally low blood glucose at birth, even though other signs of the condition do not occur until childhood or young adulthood. People with HNF1A-MODY have a higher-than-average risk of developing noncancerous (benign) liver tumors known as hepatocellular adenomas.\n\nGCK-MODY is a very mild type of the condition. People with this type have slightly elevated blood glucose levels, particularly in the morning before eating (fasting blood glucose). However, affected individuals often have no symptoms related to the disorder, and diabetes-related complications are extremely rare.\n\nRCAD is associated with a combination of diabetes and kidney or urinary tract abnormalities (unrelated to the elevated blood glucose), most commonly fluid-filled sacs (cysts) in the kidneys. However, the signs and symptoms are variable, even within families, and not everyone with RCAD has both features. Affected individuals may have other features unrelated to diabetes, such as abnormalities of the pancreas or liver or a form of arthritis called gout.

Professional guidelines

PubMed

Olofsson P
Am J Obstet Gynecol 2023 May;228(5S):S1222-S1240. Epub 2023 Mar 19 doi: 10.1016/j.ajog.2022.07.001. PMID: 37164495
El-Hattab AW, Adesina AM, Jones J, Scaglia F
Mol Genet Metab 2015 Sep-Oct;116(1-2):4-12. Epub 2015 Jun 15 doi: 10.1016/j.ymgme.2015.06.004. PMID: 26095523
Forsythe SM, Schmidt GA
Chest 2000 Jan;117(1):260-7. doi: 10.1378/chest.117.1.260. PMID: 10631227

Recent clinical studies

Etiology

Koeberl D, Schulze A, Sondheimer N, Lipshutz GS, Geberhiwot T, Li L, Saini R, Luo J, Sikirica V, Jin L, Liang M, Leuchars M, Grunewald S
Nature 2024 Apr;628(8009):872-877. Epub 2024 Apr 3 doi: 10.1038/s41586-024-07266-7. PMID: 38570682Free PMC Article
Chandler RJ, Venditti CP
J Inherit Metab Dis 2024 Jan;47(1):63-79. Epub 2023 Aug 7 doi: 10.1002/jimd.12665. PMID: 37530705
Eller AG, Esplin MS
Clin Obstet Gynecol 2020 Sep;63(3):659-667. doi: 10.1097/GRF.0000000000000551. PMID: 32649322
Zayed H
Gene 2015 Jun 15;564(2):119-24. Epub 2015 Apr 9 doi: 10.1016/j.gene.2015.04.019. PMID: 25865301
Chapman KA, Summar ML
Mol Genet Metab 2012 Jan;105(1):3-4. Epub 2011 Aug 16 doi: 10.1016/j.ymgme.2011.08.007. PMID: 21908219

Diagnosis

Achanti A, Szerlip HM
Clin J Am Soc Nephrol 2023 Jan 1;18(1):102-112. Epub 2022 Aug 23 doi: 10.2215/CJN.04500422. PMID: 35998977Free PMC Article
El-Hattab AW
Clin Perinatol 2015 Jun;42(2):413-39, x. Epub 2015 Apr 8 doi: 10.1016/j.clp.2015.02.010. PMID: 26042912
Baumgartner MR, Hörster F, Dionisi-Vici C, Haliloglu G, Karall D, Chapman KA, Huemer M, Hochuli M, Assoun M, Ballhausen D, Burlina A, Fowler B, Grünert SC, Grünewald S, Honzik T, Merinero B, Pérez-Cerdá C, Scholl-Bürgi S, Skovby F, Wijburg F, MacDonald A, Martinelli D, Sass JO, Valayannopoulos V, Chakrapani A
Orphanet J Rare Dis 2014 Sep 2;9:130. doi: 10.1186/s13023-014-0130-8. PMID: 25205257Free PMC Article
Wiener SW
Emerg Med Clin North Am 2014 Feb;32(1):149-65. doi: 10.1016/j.emc.2013.09.011. PMID: 24275173
Chapman KA, Summar ML
Mol Genet Metab 2012 Jan;105(1):3-4. Epub 2011 Aug 16 doi: 10.1016/j.ymgme.2011.08.007. PMID: 21908219

Therapy

Koeberl D, Schulze A, Sondheimer N, Lipshutz GS, Geberhiwot T, Li L, Saini R, Luo J, Sikirica V, Jin L, Liang M, Leuchars M, Grunewald S
Nature 2024 Apr;628(8009):872-877. Epub 2024 Apr 3 doi: 10.1038/s41586-024-07266-7. PMID: 38570682Free PMC Article
Gallo DM, Romero R, Bosco M, Gotsch F, Jaiman S, Jung E, Suksai M, Ramón Y Cajal CL, Yoon BH, Chaiworapongsa T
Am J Obstet Gynecol 2023 May;228(5S):S1158-S1178. Epub 2023 Apr 1 doi: 10.1016/j.ajog.2022.11.1283. PMID: 37012128Free PMC Article
Achanti A, Szerlip HM
Clin J Am Soc Nephrol 2023 Jan 1;18(1):102-112. Epub 2022 Aug 23 doi: 10.2215/CJN.04500422. PMID: 35998977Free PMC Article
A Sepúlveda R, Selamé E, Roessler E, Tagle R, Valdivieso A
Rev Med Chil 2019 Dec;147(12):1572-1578. doi: 10.4067/S0034-98872019001201572. PMID: 32186622
Forsythe SM, Schmidt GA
Chest 2000 Jan;117(1):260-7. doi: 10.1378/chest.117.1.260. PMID: 10631227

Prognosis

Duriseti P, Moreno Vanegas Y, Jaber BL, Balakrishnan VS, Madias NE
Clin Nephrol 2021 Jan;95(1):1-21. doi: 10.5414/CN110116. PMID: 32589134
Iacobelli S, Guignard JP
Pediatr Nephrol 2020 Feb;35(2):221-228. Epub 2018 Nov 19 doi: 10.1007/s00467-018-4142-9. PMID: 30456666
Miura S, Fujioka R, Taniwaki T
Kurume Med J 2017 May 8;63(3.4):81-84. Epub 2017 Mar 15 doi: 10.2739/kurumemedj.MS00015. PMID: 28302933
Seravalli V, Baschat AA
Obstet Gynecol Clin North Am 2015 Jun;42(2):275-88. doi: 10.1016/j.ogc.2015.01.005. PMID: 26002166
Teijema HL, Brubakk AM, van Gelderen HH, Ruys JH
Monogr Hum Genet 1978;9:75-9. doi: 10.1159/000401613. PMID: 732854

Clinical prediction guides

Hermesch AC, Kernberg AS, Layoun VR, Caughey AB
Am J Obstet Gynecol 2024 Mar;230(3S):S729-S739. Epub 2023 Jul 16 doi: 10.1016/j.ajog.2023.06.041. PMID: 37460365
Barroso M, Gertzen M, Puchwein-Schwepcke AF, Preisler H, Sturm A, Reiss DD, Danecka MK, Muntau AC, Gersting SW
Int J Mol Sci 2023 Aug 24;24(17) doi: 10.3390/ijms241713158. PMID: 37685964Free PMC Article
Miura S, Fujioka R, Taniwaki T
Kurume Med J 2017 May 8;63(3.4):81-84. Epub 2017 Mar 15 doi: 10.2739/kurumemedj.MS00015. PMID: 28302933
Seravalli V, Baschat AA
Obstet Gynecol Clin North Am 2015 Jun;42(2):275-88. doi: 10.1016/j.ogc.2015.01.005. PMID: 26002166
ACOG Committee on Obstetric Practice
Obstet Gynecol 2006 Nov;108(5):1319-22. doi: 10.1097/00006250-200611000-00058. PMID: 17077266

Recent systematic reviews

Arhip L, Brox-Torrecilla N, Romero I, Motilla M, Serrano-Moreno C, Miguélez M, Cuerda C
Orphanet J Rare Dis 2024 Jan 20;19(1):20. doi: 10.1186/s13023-024-03021-3. PMID: 38245797Free PMC Article
Gallo DM, Romero R, Bosco M, Gotsch F, Jaiman S, Jung E, Suksai M, Ramón Y Cajal CL, Yoon BH, Chaiworapongsa T
Am J Obstet Gynecol 2023 May;228(5S):S1158-S1178. Epub 2023 Apr 1 doi: 10.1016/j.ajog.2022.11.1283. PMID: 37012128Free PMC Article
Boy N, Mengler K, Heringer-Seifert J, Hoffmann GF, Garbade SF, Kölker S
Genet Med 2021 Jan;23(1):13-21. Epub 2020 Sep 28 doi: 10.1038/s41436-020-00971-4. PMID: 32981931Free PMC Article
Almási T, Guey LT, Lukacs C, Csetneki K, Vokó Z, Zelei T
Orphanet J Rare Dis 2019 Feb 13;14(1):40. doi: 10.1186/s13023-018-0987-z. PMID: 30760309Free PMC Article
Moorthie S, Cameron L, Sagoo GS, Bonham JR, Burton H
J Inherit Metab Dis 2014 Nov;37(6):889-98. Epub 2014 Jul 15 doi: 10.1007/s10545-014-9729-0. PMID: 25022222

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