Journal of Inherited Metabolic Disease

, Volume 18, Issue 3, pp 283–290

Defective molybdopterin biosynthesis: clinical heterogeneity associated with molybdenum cofactor deficiency


  • C. Mize
    • Department of PediatricsUT Southwestern Medical Center
  • J. L. Johnson
    • Department of BiochemistryDuke University Medical Center
  • K. V. Rajagopalan
    • Department of BiochemistryDuke University Medical Center

DOI: 10.1007/BF00710416

Cite this article as:
Mize, C., Johnson, J.L. & Rajagopalan, K.V. J Inherit Metab Dis (1995) 18: 283. doi:10.1007/BF00710416


A patient with molybdenum cofactor deficiency (producing the biochemical abnormalities associated with deficiencies of sulphite oxidase and xanthine dehydrogenase) clinically expressed Marfan-like habitus with dislocated lenses, vertebral abnormality, learning disability, moderate hemiplegia, increased medial lentiform MRI signal and intermittent microscopic haematuria.S-Sulphocysteine was present in plasma and urine, and the oxidized derivative of a molybdopterin precursor (precursor Z), together with xanthine and hypoxanthine, were elevated in urine. Blood uric acid was <1 mg/dl, while urinary urothione was not detected. These data indicate a functionally inadequate terminal enzyme for converting precursor Z to active molybdopterin (complementation group B of general molybdenum cofactor deficiency). Although the biochemical parameters were indicative of a severe deficiency state, the patient has survived into the third decade with a less severe clinical spectrum than has generally been associated with this disease.

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© Society for the Study of Inborn Errors of Metabolism and Kluwer Academic Publishers 1995