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It mainly catalyses the reversible transfer of adenosine nucleotide phosphate groups and plays an important role in maintaining energy metabolism. AK deficiency is a rare genetic disorder that is related to haemolytic anaemia. Chronic haemolytic anaemia associated with AK deficiency is a rare condition, and only 14 unrelated families have been reported thus far. Moreover, only 11 mutations have been identified in the<jats:italic>AK1<\/jats:italic>gene<jats:italic>,<\/jats:italic>with only 3 cases of psychomotor impairment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case presentation<\/jats:title><jats:p>The patient was a 3-year-old boy with severe haemolytic anaemia and psychomotor retardation. A molecular study of the patient\u2019s<jats:italic>AK<\/jats:italic>gene revealed 2 different mutations: a heterozygous missense mutation in exon 6 (c.413G\u2009&gt;\u2009A) and a heterozygous frameshift mutation in exon 5 (c.223dupA). Molecular modelling analyses indicated that AK gene inactivation resulted in a lack of AK activity. The patient recovered after regular blood transfusion therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>AK1 deficiency was diagnosed on the basis of low enzymatic activity and the identification of a mutation in the<jats:italic>AK1<\/jats:italic>gene located on chromosome 9q. Here, we report the first case of moderate red cell AK1 deficiency associated with chronic nonspherocytic haemolytic anaemia (CNSHA) in China. The genetic mutations were confirmed by Sanger sequencing. The variants were classified as pathogenic by bioinformatics tools, such as ACMG\/AMP guidelines, Mutation Taster, SIFT, MACP, REVEL and PolyPhen2.2. Based on our evidence and previous literature reports, we speculate that the site of the<jats:italic>AK1<\/jats:italic>gene c.413G\u2009&gt;\u2009A (p.Arg138His) mutation may be a high-frequency mutation site and the other mutation (c.223dupA) might be related to the neuropathogenicity caused by AK1 deficiency. NGS should be a part of newborn to early childhood screening to diagnose rare and poorly diagnosed genetic diseases as early as possible.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s12920-022-01248-2","type":"journal-article","created":{"date-parts":[[2022,5,4]],"date-time":"2022-05-04T11:02:58Z","timestamp":1651662178000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Red cell adenylate kinase deficiency in China: molecular study of 2 new mutations (413G\u2009&gt;\u2009A, 223dupA)"],"prefix":"10.1186","volume":"15","author":[{"given":"Sijia","family":"He","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hongbo","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xia","family":"Guo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ju","family":"Gao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,5,4]]},"reference":[{"issue":"7","key":"1248_CR1","doi-asserted-by":"publisher","first-page":"148409","DOI":"10.1016\/j.bbabio.2021.148409","volume":"1862","author":"ML Deline","year":"2021","unstructured":"Deline ML, Grashei M, van Heijster FHA, Schilling F, Straub J, Fromme T. 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We obtained written informed consent from all individual members included in the study. In a minor, we received written consent from the parents or legal guardians.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The parents of the patients consented to the publication of the case and any accompanying images with written consent.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publish"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"102"}}