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Hyperglycinemia, transient neonatal(TNH)

MedGen UID:
82818
Concept ID:
C0268560
Disease or Syndrome
Synonym: TNH
SNOMED CT: Transient neonatal hyperglycinemia (51097006)
 
Monarch Initiative: MONDO:0800331
OMIM®: 605899

Clinical features

From HPO
Recurrent singultus
MedGen UID:
893074
Concept ID:
C0744897
Finding
A contraction of the diaphragm that repeats several times per minute. In humans, the abrupt rush of air into the lungs causes the epiglottis to close, creating a hic sound. Also known as synchronous diaphragmatic flutter (SDF), or singultus, from the Latin singult, the act of catching one's breath while sobbing. The hiccup is an involuntary action involving a reflex arc.
Hyperglycinuria
MedGen UID:
107456
Concept ID:
C0543541
Disease or Syndrome
The imino acids, proline and hydroxyproline, share a renal tubular reabsorptive mechanism with glycine. Iminoglycinuria (IG; 242600), a benign inborn error of amino acid transport, is also a normal finding in neonates and infants under 6 months of age (Chesney, 2001). Early studies of families with iminoglycinuria suggested genetic complexity, with homozygotes developing IG and heterozygotes manifesting only hyperglycinuria (HG) (summary by Broer et al., 2008). A phenotype of combined glucosuria and glycinuria has been described (see 138070).
Aggressive behavior
MedGen UID:
1375
Concept ID:
C0001807
Individual Behavior
Behavior or an act aimed at harming a person, animal, or physical property (e.g., acts of physical violence; shouting, swearing, and using harsh language; slashing someone's tires).
Impulsivity
MedGen UID:
43850
Concept ID:
C0021125
Mental or Behavioral Dysfunction
Acting on the spur of the moment or on a momentary basis without consideration of outcomes; having difficulty establishing or following plans; experiencing a sense of urgency and engaging in behavior that is uninhibited, cannot be inhibited, and is uncontrolled. The possibility of repression is inconceivable.
Lethargy
MedGen UID:
7310
Concept ID:
C0023380
Sign or Symptom
A state of fatigue, either physical or mental slowness and sluggishness, with difficulties in initiating or performing simple tasks. Distinguished from apathy which implies indifference and a lack of desire or interest in the task. A person with lethargy may have the desire, but not the energy to engage in personal or socially relevant tasks.
Myoclonus
MedGen UID:
10234
Concept ID:
C0027066
Finding
Very brief, involuntary random muscular contractions occurring at rest, in response to sensory stimuli, or accompanying voluntary movements.
Seizure
MedGen UID:
20693
Concept ID:
C0036572
Sign or Symptom
A seizure is an intermittent abnormality of nervous system physiology characterized by a transient occurrence of signs and/or symptoms due to abnormal excessive or synchronous neuronal activity in the brain.
Encephalopathy
MedGen UID:
39314
Concept ID:
C0085584
Disease or Syndrome
Encephalopathy is a term that means brain disease, damage, or malfunction. In general, encephalopathy is manifested by an altered mental state.
Hyperreflexia
MedGen UID:
57738
Concept ID:
C0151889
Finding
Hyperreflexia is the presence of hyperactive stretch reflexes of the muscles.
Corpus callosum, agenesis of
MedGen UID:
104498
Concept ID:
C0175754
Congenital Abnormality
The corpus callosum is the largest fiber tract in the central nervous system and the major interhemispheric fiber bundle in the brain. Formation of the corpus callosum begins as early as 6 weeks' gestation, with the first fibers crossing the midline at 11 to 12 weeks' gestation, and completion of the basic shape by age 18 to 20 weeks (Schell-Apacik et al., 2008). Agenesis of the corpus callosum (ACC) is one of the most frequent malformations in brain with a reported incidence ranging between 0.5 and 70 in 10,000 births. ACC is a clinically and genetically heterogeneous condition, which can be observed either as an isolated condition or as a manifestation in the context of a congenital syndrome (see MOLECULAR GENETICS and Dobyns, 1996). Also see mirror movements-1 and/or agenesis of the corpus callosum (MRMV1; 157600). Schell-Apacik et al. (2008) noted that there is confusion in the literature regarding radiologic terminology concerning partial absence of the corpus callosum, where various designations have been used, including hypogenesis, hypoplasia, partial agenesis, or dysgenesis.
Hyperactivity
MedGen UID:
98406
Concept ID:
C0424295
Finding
Hyperactivity is a condition characterized by constant and unusually high levels of activity, even in situations where it is deemed inappropriate.
Hyporeflexia
MedGen UID:
195967
Concept ID:
C0700078
Finding
Reduction of neurologic reflexes such as the knee-jerk reaction.
Irritability
MedGen UID:
397841
Concept ID:
C2700617
Mental Process
A proneness to anger, i.e., a tendency to become easily bothered or annoyed.
Intellectual disability
MedGen UID:
811461
Concept ID:
C3714756
Mental or Behavioral Dysfunction
Intellectual disability, previously referred to as mental retardation, is characterized by subnormal intellectual functioning that occurs during the developmental period. It is defined by an IQ score below 70.
Restlessness
MedGen UID:
854457
Concept ID:
C3887611
Sign or Symptom
A state of unease is characterized by diffuse motor activity or motion, which is subject to limited control, nonproductive, or disorganized behavior.
Hypotonia
MedGen UID:
10133
Concept ID:
C0026827
Finding
Hypotonia is an abnormally low muscle tone (the amount of tension or resistance to movement in a muscle). Even when relaxed, muscles have a continuous and passive partial contraction which provides some resistance to passive stretching. Hypotonia thus manifests as diminished resistance to passive stretching. Hypotonia is not the same as muscle weakness, although the two conditions can co-exist.
Generalized hypotonia
MedGen UID:
346841
Concept ID:
C1858120
Finding
Generalized muscular hypotonia (abnormally low muscle tone).
Hyperglycinemia
MedGen UID:
82817
Concept ID:
C0268559
Disease or Syndrome
An elevated concentration of glycine in the blood.

Professional guidelines

PubMed

Boneh A, Allan S, Mendelson D, Spriggs M, Gillam LH, Korman SH
Mol Genet Metab 2008 Jun;94(2):143-7. Epub 2008 Apr 18 doi: 10.1016/j.ymgme.2008.02.010. PMID: 18395481

Recent clinical studies

Etiology

Stence NV, Fenton LZ, Levek C, Tong S, Coughlin CR 2nd, Hennermann JB, Wortmann SB, Van Hove JLK
J Inherit Metab Dis 2019 May;42(3):438-450. Epub 2019 Mar 20 doi: 10.1002/jimd.12072. PMID: 30737808
Bhamkar RP, Colaco P
Indian J Pediatr 2007 Dec;74(12):1124-6. doi: 10.1007/s12098-007-0212-x. PMID: 18174652
Lin FY, Gascon GG, Hyland K, Chugani H, Chugani D
J Child Neurol 2006 Oct;21(10):900-3. doi: 10.1177/08830738060210101001. PMID: 17005111
Schiffmann R, Kaye EM, Willis JK 3rd, Africk D, Ampola M
Ann Neurol 1989 Feb;25(2):201-3. doi: 10.1002/ana.410250218. PMID: 2919871
Luder AS, Davidson A, Goodman SI, Greene CL
J Pediatr 1989 Jun;114(6):1013-5. doi: 10.1016/s0022-3476(89)80453-6. PMID: 2723894

Diagnosis

Poothrikovil RP, Al Thihli K, Al Futaisi A, Al Murshidi F
Neurodiagn J 2019;59(3):142-151. Epub 2019 Aug 21 doi: 10.1080/21646821.2019.1645549. PMID: 31433733
Dulac O
Handb Clin Neurol 2013;113:1785-97. doi: 10.1016/B978-0-444-59565-2.00048-4. PMID: 23622401
Boneh A, Allan S, Mendelson D, Spriggs M, Gillam LH, Korman SH
Mol Genet Metab 2008 Jun;94(2):143-7. Epub 2008 Apr 18 doi: 10.1016/j.ymgme.2008.02.010. PMID: 18395481
Bhamkar RP, Colaco P
Indian J Pediatr 2007 Dec;74(12):1124-6. doi: 10.1007/s12098-007-0212-x. PMID: 18174652
Schiffmann R, Kaye EM, Willis JK 3rd, Africk D, Ampola M
Ann Neurol 1989 Feb;25(2):201-3. doi: 10.1002/ana.410250218. PMID: 2919871

Therapy

Riché R, Liao M, Pena IA, Leung KY, Lepage N, Greene NDE, Sarafoglou K, Schimmenti LA, Drapeau P, Samarut É
JCI Insight 2018 Nov 2;3(21) doi: 10.1172/jci.insight.124642. PMID: 30385710Free PMC Article
Tsuyusaki Y, Shimbo H, Wada T, Iai M, Tsuji M, Yamashita S, Aida N, Kure S, Osaka H
Brain Dev 2012 Jan;34(1):72-5. Epub 2011 Feb 12 doi: 10.1016/j.braindev.2011.01.005. PMID: 21316884
Korman SH, Boneh A, Ichinohe A, Kojima K, Sato K, Ergaz Z, Gomori JM, Gutman A, Kure S
Ann Neurol 2004 Jul;56(1):139-43. doi: 10.1002/ana.20159. PMID: 15236413
Maeda T, Inutsuka M, Goto K, Izumi T
Pediatr Neurol 2000 Mar;22(3):225-7. doi: 10.1016/s0887-8994(99)00138-1. PMID: 10734255
von Wendt L, Similä S, Saukkonen AL, Koivisto M
Pediatrics 1980 Jun;65(6):1166-9. PMID: 7375243

Prognosis

Dulac O
Handb Clin Neurol 2013;113:1785-97. doi: 10.1016/B978-0-444-59565-2.00048-4. PMID: 23622401
Boneh A, Allan S, Mendelson D, Spriggs M, Gillam LH, Korman SH
Mol Genet Metab 2008 Jun;94(2):143-7. Epub 2008 Apr 18 doi: 10.1016/j.ymgme.2008.02.010. PMID: 18395481
Bhamkar RP, Colaco P
Indian J Pediatr 2007 Dec;74(12):1124-6. doi: 10.1007/s12098-007-0212-x. PMID: 18174652
Aliefendioğlu D, Tana Aslan Ay, Coşkun T, Dursun A, Cakmak FN, Kesimer M
Pediatr Neurol 2003 Feb;28(2):151-5. doi: 10.1016/s0887-8994(02)00501-5. PMID: 12699870
Schiffmann R, Kaye EM, Willis JK 3rd, Africk D, Ampola M
Ann Neurol 1989 Feb;25(2):201-3. doi: 10.1002/ana.410250218. PMID: 2919871

Clinical prediction guides

Stence NV, Fenton LZ, Levek C, Tong S, Coughlin CR 2nd, Hennermann JB, Wortmann SB, Van Hove JLK
J Inherit Metab Dis 2019 May;42(3):438-450. Epub 2019 Mar 20 doi: 10.1002/jimd.12072. PMID: 30737808
Boneh A, Allan S, Mendelson D, Spriggs M, Gillam LH, Korman SH
Mol Genet Metab 2008 Jun;94(2):143-7. Epub 2008 Apr 18 doi: 10.1016/j.ymgme.2008.02.010. PMID: 18395481
Aliefendioğlu D, Tana Aslan Ay, Coşkun T, Dursun A, Cakmak FN, Kesimer M
Pediatr Neurol 2003 Feb;28(2):151-5. doi: 10.1016/s0887-8994(02)00501-5. PMID: 12699870
Lu FL, Wang PJ, Hwu WL, Tsou Yau KI, Wang TR
Pediatr Neurol 1999 Apr;20(4):295-300. doi: 10.1016/s0887-8994(98)00157-x. PMID: 10328279
Eyskens FJ, Van Doorn JW, Mariën P
J Pediatr 1992 Oct;121(4):620-1. doi: 10.1016/s0022-3476(05)81158-8. PMID: 1403401

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