Purine salvage defects Deficiency of hypoxanthine-guanine phosphoribosyltransferase (HGPRT) leads to which inherited disorder?

Difficulty: Easy

Correct Answer: Lesch–Nyhan syndrome

Explanation:

Introduction / Context:HGPRT is a key enzyme in the purine salvage pathway, recycling hypoxanthine and guanine to IMP and GMP. Its deficiency disrupts nucleotide balance and elevates uric acid production.

Given Data / Assumptions:

  • X-linked recessive inheritance pattern.
  • Clinical triad includes hyperuricemia, neurologic dysfunction, and self-injurious behavior.

Concept / Approach:Without HGPRT, purine bases are degraded rather than salvaged, increasing uric acid and reducing purine nucleotide availability in certain tissues. The classic syndrome is Lesch–Nyhan.

Step-by-Step Solution:

Identify pathway: purine salvage via HGPRT.Link deficiency to hallmark signs: gouty tophi, neurologic symptoms, self-mutilation.Select the named disorder: Lesch–Nyhan syndrome.

Verification / Alternative check:Biochemical assays show absent or reduced HGPRT activity; genetic testing reveals HPRT1 mutations on X chromosome.

Why Other Options Are Wrong:

  • Gaucher: glucocerebrosidase deficiency (lysosomal storage), not purine salvage.
  • Ehlers–Danlos: collagen defects.
  • Klinefelter’s: sex chromosome aneuploidy (47,XXY).
  • Marfan: fibrillin-1 mutation.

Common Pitfalls:Confusing gout from overproduction with specific salvage enzyme deficiencies; Lesch–Nyhan is distinct due to neurological features.

Final Answer:Lesch–Nyhan syndrome

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