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PSPH deficiency

ICD-10 Codes

Related ICD-10:

H18.04 E71.310 E71.51 E71.518 Q55.6 Q34 H16.423 H21.561 H51 G11.4 T17.50 E56.1 L74.519 H44.443 E52 M79.643 E72.20 M12.17 Z89.44 M25.674 Q18.8 J01.31 Q79.69 M89.1 E74.820 H02.041 H81.0 G80.1 O45.01 O45.019 Z71.1 G32.81 L89.814 M40.00 M71.851 D58.2 E74.810 E00.1 H35.17 K08.123 Z87.1 A50.31 F40.10 P19 T57.1X2 T82.0 A50.4 L12.1 R40.231 P11 Q66.5 G25.9 P92.2 H35.171 Q63.8 I69.192 J39.2 R43.2 M21.15 P14.3 Q20 E83.89 M70.4 A80.3 T15.0 S04 M41.4 E88.09 S14.156 A51.42 D61.03 M24.311 H68.11 I97.61 S93.14 E70.320 I69.96 Q25.79 R70.1 F10.26 H51.2 P59.1 Q93.0 T18.2 E71.313 H31.121 E71.111 E53 G45.2 T44.1X1 H44.44 L66.0 M99.22 D75.8 E74.03 G83.8 K91.83 J70.5 N48.33 H18.312 I69.259 E75 E59 G90.2 T71.19 T71.193 H02.51 H52.52 H53.15 M61.21 Q56 S01.15 T45.511 H35.732 E78.72 N13.732 Z89.62 M61.1 Q43.3 E20.811 Z91.11 M12.16 E75.19 M76.11 N01.4 E88.42 H90 Z85.850 C13 O45.0 Q65.89 R47.89 H57.0 E20.81 E76.2 H44.2 S27.41 E72.03 I27.21 Z85.51 E76.22 A39.1 H47.333 P27.0 T44.1X6 E75.26 G71.02 R09.A2 Z87.44 G95.9 M89.153 G90.511 T44.906 D81.810 E75.09 D55.29 K31.3 M12.19 G12.9 D51.2 I67.83 I69.919 E20 M12.10 G31.81 H90.A32 E20.8 E61.3 E80.5 Z87.430 H83 H52.522 E71.50 Q79.61 T71.143 E72.59 M89.123 H44.449 M41.54 E70 M62.44 Q87.81 Q87.83 A50.40 N99.5 E61.2 E87 Q18 S11.25 G23.3 I69.822 E70.1 F07.9 H21.223 E61.7 E71.41 M12.131 T19.1 E34.52 H05.26 E74.29 T86.85 T56.7X1 Q56.2 D55.0 A50.39 Q78.1 G90.89 A51.44 E20.89 T57.1X3 T86.891 E72.53 E75.25 E71.0 J93.11 Q60.6 E61.9 E71.541 N99.532 G51.39 R39.12 M62.521 M61.251 H57.051 H11.053 I69.813 E80.3 E70.5 D81.0 G44.83 R13.11 V00.811 E71.53 H95.51 T59.891 H49.21 T18.8 L40.1 G82.51 A52.75 N48.32 A52.09 G12.22 H49.41 E75.27 T48.0X5 F98.3 E51.8 E75.243 T49.3X6 Q23.88 T38.815 E75.01 T71.1 R47.1 G90.8 E78.0 L89.213 G97.51 A36.83 H04.211 H49.1 G21.9 L10.4 Q56.1 E71.44 H44.441 K22 E71.510 H47.6 D81.81 E20.818 Q38.4 R77.2 M76.4 D73.8 P29.30 E71.520 E76.03 H18.311 G12.25 A81.1 C71 N70.9 L89.614 T17.3 E80.0 E83.01 M85.14 T19.2 T45.625 E76.02 Q92.9 D81.6 T44.8X6 N02.3 B56.1 J38.00 S14.5 E89.3 M12.13 T39.1X4 M12.172 Q64.70 S73.01 O86.8 E83.3 F48.2 K08.22 H02.429 E75.242 G81.14 G93.8 E71.542 R77 T17.200 G12.1 E71.312 N81.82 M61.14 I69.341 G04.1 I97.120 L81.6 N25.81 A52.05 G70.2 G71.22 M12.179 Q89.1 E72.51 F10 Q66.51 L89.216 Z86.5 F51.11 M26.51 H02.725 O66.2 Q05.1 D78.32 E64.1 D81.32 H21.243 E70.321 H02.88 H55 H21.233 G51.31 L73.1 Z87.710 K74.3 R49.22 S04.52 T57.1X4 K14.2 M12.141 E70.81 Q68.0 D50.1 Q93.52 T44.2X1 B46.1 H50.65 H02.519 N46 H18.32 H18.323 M89.157 R09.A H54.0X4 Q38.7 M12.11 D60.8 K22.89 O65 T32.31 E75.23 T71.11 S06.8A6 T54.0X3 G71.0340 Q54.0 Q72.3 R94.5 G21.2 H52.4 L13.1 M99.04 G57.62 H16.05 S34.11 L74.4 A66.6 E64.0 L89.226 E70.331 G40.84 E53.8 O42.02 Q12.4 E77.8 Q04.2 H02.042 H44.412 R13 E26.0 H52.539 H44.411 G31.85 E75.24 S06.8A D69.5 E70.40 H26.03 F40.23 H52.521 E74.19 E75.11 H47.211 K31.1 E71.2 E76.210 E76.211 G23 H40.89 J68.9 E03.0 T71.9 F02.B2 S14.11 S14.116 G51.3 G51.32 K08.26 T17.8 F07.8 K68.12 Q64.8 T42.1X5 N40 H02.511 E70.49 G71.031 J93.1 H35.52 K83.4 L75.0 Z62.819 E75.29 H10.02 E07.0 F40.11 Q10.0 Z91.411 Q24.3 Z85.040 E74.01 M61.162 H34.823 E80.21 E83.00 Q22.1 Q64.5 E74.31 H21.221 E72.8 R40.235 L74.510 E89.2 Q89.0 H21.249 P29.38 G54.9 H52.533 R94.131 E83.30 T71.112 E75.00 P93.0 E74.09 Z86.12 T60.4X1 N47.1 E83.31 D81.5 E72.02 E89.0 T57.1X1 P92.1 E71.522 H15.831 M12.162 S11.035 T19.0 H02.431 R62.50 G12.24 T26.51 M88.0 B57.32 L89.124 A51.32 T85.730 M12.18 E21.3 M62.83 H35.373 D73.0 H21.261 E74.02 E51.9 S06.1X7 M89.160 Q05.2 E83.9 N01.6 Q54.1 Q54.8 H35.172 E50.9 G90.1 T71.133 M62.51 E80.2 Q93.4 P76.2 E21.1 L89.96 Q85.81 H52.523 H21.543 T71.114 Q80.4 D80.2 R34 H02.142 G21.3 H04.213 I13.11 F10.280 F42.4 D53.8 M89.011 G12.29 E73.0 G21.8 N25.89 E51.2 H44.419 T32.42 G70.80 E71.314 E72.89 H02.234 Z87.762 I69.291 E76.01 Q71.899 E83.39 G51.9 Q17.8 Q64.72 M62.551 E71.12 M62.412 H21.24 E54 N03.6 E75.244 G90.3 E74.05 D51.1 D82.8 E27.0 E74.829 D55.21 Z18.8 H02.422 F68.12 T37.0X5 H05.263 Q44.0 E76.219 Z87.763 E00 H47.11 B78.7 T83.111 E26.09 H80.12 O45.013 G21 A81.82 I63.513 T54.3X1 K11.7 T56.4X N36.4 O45.8X E61.0 O62.0 A50.57 T17.0 H21.562 H35.451 E72.19 R86.1 D51.9 L89.811 H31.123 H35.012 O65.8 E71.448 T80.211 D78.22 E71.42 M70.41 N52.37 E71.548 H55.82 Z87.19 H35.73 E83.0 G90.B T17.300 M26.02 D81.7 R20.2 P91.829 E71.121 H55.09 T17.220 M00.15 H74.323 I77.89 G81.13 I69.364 R82.991 M61.561 R53.1 A01.4 Q79.8 M12.151 D55.1 E01 E75.02 E71.110 M25.675 G37.2 K76.6 T44.0X5 M61.111 I63.09 H02.81 Q87.11 M40.204 R49.1 I69.922 T17.90 H18.81 R94.130 A50.59 T39.1X6 T71.2 G20.A M61.159 R39.1 M12.14 K59.4 Q14.8 Q40.0 T71.29 A17.8 G82.21 H90.0 I69.953 A30.5 E72.10 G83.89 H11.051 T57.2X1 A52.12 E61.6 E76.1 H02.43 N13.3 H91.0 M12.12 T71.232 Z85.858 E71.4 E71.40 H40.811 T39.4X5 N36.42 H05.261 E32.0 G71.01 L76.22 E75.248 S11.15 R71.0 H40.133 H49.42 L92.3 T54.3 Z90.411 T17.20 K90.3 T39.316 T32.10 Q41.2 B83.2 E88.02 A50.7 D73 F41.0 F80.89 Z01.31 G23.0 M24.44 E72.23 Z90.410 L76.21 M12.152 L89.511 G40.42 D75.A Q03.0 I48.19 I67.858 E75.241 G90.A H30.81 M62.4 E75.10 R62.59 E88.01 A50 Q25.6 R29.810 E56.0 H21.26 D55.3 H57.053 Q56.3 H02.411 H44.41 M63.8 O10.41 E01.0 L74.52

Description

PSPH Deficiency: A Rare Genetic Disorder

PSPH deficiency, also known as phosphoserine phosphatase deficiency, is a rare genetic disorder caused by mutations in the PSPH gene [7]. This condition is characterized by an extremely low activity of the phosphoserine phosphatase enzyme, which is essential for the synthesis of L-serine [3].

Clinical Features

Individuals with PSPH deficiency may exhibit severe clinical features, including:

  • Congenital microcephaly (small head size) [5]
  • Severe developmental delay and intellectual disability [4]
  • Infantile-onset serine deficiency syndrome is characterized by seizures, microcephaly, developmental delay, intellectual disability, and spastic quadriplegia [4]
  • Juvenile-onset serine deficiency presents with seizures and many develop spastic quadriplegia [4]

Causes

PSPH deficiency is caused by mutations in the PSPH gene, which encodes for the phosphoserine phosphatase enzyme. This enzyme plays a crucial role in the third and last step of L-serine formation, catalyzing magnesium-dependent hydrolysis of L-phosphoserine [3].

Prevalence

PSPH deficiency is an extremely rare form of serine deficiency syndrome, with only a few reported cases in medical literature.

References:

[3] - Phosphoserine phosphatase is an enzyme encoded by the PSPH gene. The protein encoded by this gene belongs to a subfamily of the phosphotransferases. This encoded enzyme is responsible for the third and last step in L-serine formation. It catalyzes magnesium-dependent hydrolysis of L-phosphoserine and is also involved in an exchange reaction between L-serine and L-phosphoserine. Deficiency of this protein ...

[4] - Infantile-onset serine deficiency is characterized by seizures, microcephaly, developmental delay, intellectual disability, and spastic quadriplegia. Individuals that present with juvenile-onset serine deficiency have seizures and many develop spastic quadriplegia.

[5] - 3-Phosphoserine phosphatase deficiency is an extremely rare form of serine deficiency syndrome characterized clinically by congenital microcephaly and severe ...

[7] - Phosphoserine phosphatase deficiency is an extremely rare form of serine deficiency syndrome. This condition is caused by mutations to the PSPH gene.

Additional Characteristics

  • PSPH deficiency, also known as phosphoserine phosphatase deficiency
  • Congenital microcephaly (small head size)
  • Severe developmental delay and intellectual disability
  • Infantile-onset serine deficiency syndrome
  • Juvenile-onset serine deficiency
  • Phosphoserine phosphatase enzyme
  • Mutations in the PSPH gene
  • L-serine formation
  • Magnesium-dependent hydrolysis of L-phosphoserine

Signs and Symptoms

Clinical Signs and Symptoms of PSPH Deficiency

PSPH deficiency, also known as phosphoserine phosphatase deficiency, is a rare genetic disorder characterized by several distinct clinical signs and symptoms.

  • Congenital Microcephaly: Affected individuals are born with a smaller than normal head size ([4]).
  • Seizures: Seizure activity is a common feature of PSPH deficiency, often presenting in infancy or early childhood ([6], [5]).
  • Psychomotor Retardation: Individuals with PSPH deficiency may experience significant delays in achieving motor and mental milestones ([3], [6]).
  • Spastic Tetraparesis: This condition is characterized by stiffness and weakness of all four limbs, leading to impaired mobility ([6]).
  • Distinctive Facial Features: Affected individuals often exhibit a range of facial abnormalities, including:
    • Sloping forehead
    • Hypertelorism (increased distance between the eyes)
    • Proptotic eyes with absent lids or ectropion (a condition where the eyelids turn outward)
    • Flattened nose
    • Thick everted lips ([7])
  • Prenatal and Postnatal Growth Retardation: Individuals with PSPH deficiency may experience growth delays both before and after birth ([8])

These clinical signs and symptoms can vary in severity and presentation, but they are commonly associated with PSPH deficiency.

Additional Symptoms

  • Seizures
  • Distinctive Facial Features
  • Congenital Microcephaly
  • Psychomotor Retardation
  • Spastic Tetraparesis
  • Prenatal and Postnatal Growth Retardation

Diagnostic Tests

Diagnostic Testing for Phosphoserine Phosphatase (PSPH) Deficiency

Phosphoserine phosphatase (PSPH) deficiency is a rare genetic disorder that can be diagnosed through various diagnostic tests. The primary goal of these tests is to identify mutations in the PSPH gene, which encodes the enzyme responsible for converting 3-phosphohydroxypyruvate to L-serine.

  • Genetic Testing: This is the most common method used to diagnose PSPH deficiency. Genetic testing involves analyzing DNA samples from an individual or their family members to detect mutations in the PSPH gene [9]. Next-generation sequencing (NGS) and other advanced techniques can be employed to identify specific mutations associated with this condition.
  • Urine or Blood Sample Analysis: A urine or blood sample can be used to check the level of metabolites present within an individual's body, which can help diagnose PSPH deficiency [5].
  • Targeted Mutation Analysis: This involves analyzing a DNA sample for specific mutations in the PSPH gene that are associated with this condition [1].

Clinical Genetic Tests

Several clinical genetic tests are available to diagnose PSPH deficiency. These include:

  • Amsterdam UMC, Location AMC: Offers targeted mutation analysis and other diagnostic testing for conditions related to PSPH deficiency [2].
  • Intergen: Provides clinical genetic testing for conditions including phosphoserine phosphatase deficiency, which involves analyzing the PSPH gene [3].

Diagnostic Strengths

The strengths of these tests include:

  • CAP accredited laboratory
  • CLIA-certified personnel performing clinical testing in a CLIA- certified environment [6]
  • Antenatal and post-natal diagnosis capabilities [7]

References:

[1] Context 1, 2, 3 [5] Context 5 [9] Context 9

Additional Diagnostic Tests

  • Genetic Testing
  • Urine or Blood Sample Analysis
  • Targeted Mutation Analysis

Treatment

Treatment Options for PSPH Deficiency

PSPH (Phosphoserine Phosphatase) deficiency, also known as 3-phosphoserine phosphatase deficiency, is a rare genetic disorder that affects the synthesis of the amino acid L-serine. While there are no specific treatments available to cure this condition, various medications and therapies can help alleviate its symptoms.

Medications

  • L-Serine Supplementation: Early treatment with L-serine supplementation has been used in some individuals to help manage the condition.
  • Glycine Supplementation: Glycine supplementation with L-serine has also been employed in some cases, although more research is needed to confirm its effectiveness.

Other Therapies

  • Antiparkinsonian Medications:

Recommended Medications

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Differential Diagnosis

Differential Diagnosis of PSPH Deficiency

PSPH deficiency, also known as phosphoserine phosphatase deficiency, is a rare genetic disorder caused by mutations in the PSPH gene. When considering differential diagnosis for this condition, several other disorders should be taken into account.

  • Serine Biosynthesis Disorders: Other conditions that affect serine biosynthesis, such as 3-phosphoserine aminotransferase deficiency, can present with similar symptoms to PSPH deficiency.
  • Microcephaly and Global Developmental Delay: Conditions like microcephaly and global developmental delay can also be associated with prenatal growth restriction and postnatal growth retardation, which are characteristic of PSPH deficiency.
  • Intellectual Disability and Seizure Disorders: Intellectual disability and seizure disorders, such as epilepsy, can be part of the differential diagnosis for PSPH deficiency due to their association with cerebral atrophy and global developmental delay.

Key Features to Consider

When differentiating PSPH deficiency from other conditions, consider the following key features:

  • Prenatal Growth Restriction: Prenatal growth restriction is a hallmark of PSPH deficiency.
  • Postnatal Growth Retardation: Postnatal growth retardation and microcephaly are also characteristic of this condition.
  • Seizures and Intellectual Disability: Seizures and intellectual disability can be part of the clinical presentation, but they are not unique to PSPH deficiency.

Genetic Testing

Genetic testing for mutations in the PSPH gene is essential for confirming a diagnosis of PSPH deficiency. This should be considered alongside other diagnostic tests, such as enzymatic assays and mutation analysis, to rule out other conditions with similar presentations.

References

  • [1] Phosphoserine phosphatase deficiency (PSPHD) ... An autosomal recessive disorder that results in pre- and postnatal growth retardation, moderate psychomotor ...
  • [3] by CE Hart · 2007 · Cited by 143 — The first two individuals with phosphoserine aminotransferase deficiency have been identified and described. This disorder is characterized biochemically by low ...
  • [5] Phosphoserine phosphatase deficiency (PSPHD) [MIM:614023]: An autosomal recessive disorder that results in pre- and postnatal growth retardation, moderate ...

Additional Differential Diagnoses

  • Serine Biosynthesis Disorders
  • Microcephaly and Global Developmental Delay
  • Intellectual Disability and Seizure Disorders

Additional Information

relatedICD
http://example.org/icd10/E70.321
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https://w3id.org/def/predibionto#has_symptom_760
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oboInOwl#creation_date
2012-06-13T03:09:31Z
oboInOwl#id
DOID:0050724
oboInOwl#hasDbXref
MIM:614023
IAO_0000115
A serine deficiency that has_material_basis_in deficiency of phosphoserine phosphatase impeding the synthesis of L-serine.
oboInOwl#hasExactSynonym
PSPHD
core#notation
DOID:0050724
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http://purl.obolibrary.org/obo/DOID_0050721
22-rdf-syntax-ns#type
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