Journal of Inherited Metabolic Disease

, Volume 20, Issue 2, pp 193–202 | Cite as

Inborn errors of the purine nucleotide cycle: Adenylosuccinase deficiency

  • G. Van den Berghe
  • M. F. Vincent
  • J. Jaeken


Adenylosuccinase catalyses two reactions in purine metabolism: the conversion of succinylaminoimidazole carboxamide ribotide (SAICAR) into amino-imidazole carboxamide ribotide (AICAR) along the de novo synthesis of purine nucleotides, and the conversion of adenylosuccinate (S-AMP) into AMP in the conversion of IMP into AMP. The hallmarks of adenylosuccinase deficiency are the presence of succinylaminoimidazole carboxamide riboside (SAICAriboside) and succinyladenosine (S-Ado) in body fluids. These normally undetectable succinyl-purines are the products of the dephosphorylation, by cytosolic 5′-nucleotidase, of the two substrates of adenylosuccinase. The clinical picture of the enzyme deficiency is markedly heterogeneous with, as a rule, a profound, but nevertheless variable degree of psychomotor delay, often convulsions and/or autistic features, sometimes growth retardation and muscular dystrophy. The diagnostic tests that can be used for diagnosis, the enzyme and gene defects that have been identified, and the hypotheses that have been put forward to explain the pathophysiology of the disorder are reviewed.


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Copyright information

© Kluwer Academic Publishers 1997

Authors and Affiliations

  • G. Van den Berghe
    • 1
  • M. F. Vincent
    • 1
  • J. Jaeken
    • 2
  1. 1.Laboratory of Physiological ChemistryInternational Institute of Cellular and Molecular PathologyBrusselsBelgium
  2. 2.Department of PediatricsUniversity of LeuvenLeuvenBelgium

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