Ethylmalonic Encephalopathy

Ethylmalonic encephalopathy (EE) causes damage to the brain, nerves, and blood vessels. Symptoms are present at birth and tend to get worse over time. These include low muscle tone, spasms of the arms and legs, seizures, and developmental delay. Blood vessel damage causes tiny red spots under the skin (petechiae) and blue discoloration in the hands and feet due to reduced blood flow (acrocyanosis). Chronic bloody diarrhea and difficulty swallowing leads to poor growth. EE is considered a lethal condition, and most people die in childhood. Ethylmalonic encephalopathy is caused by a variant in the ETHE1 gene and is inherited in an autosomal recessive pattern. Diagnosis is based on the symptoms, clinical exam, laboratory testing of blood and urine, and imaging studies of the brain. The result of genetic testing can be used to confirm the diagnosis. Treatment is focused on support and managing the symptoms.