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and Technology","award":["NSTC-111-2314-B-195-017"],"award-info":[{"award-number":["NSTC-111-2314-B-195-017"]}]},{"name":"Ministry of Science and Technology","award":["NSTC-111-2811-B-195-002"],"award-info":[{"award-number":["NSTC-111-2811-B-195-002"]}]},{"name":"Ministry of Science and Technology","award":["NSTC-111-2811-B-195-001"],"award-info":[{"award-number":["NSTC-111-2811-B-195-001"]}]},{"name":"Ministry of Science and Technology","award":["NSTC-110-2314-B-195-014"],"award-info":[{"award-number":["NSTC-110-2314-B-195-014"]}]},{"name":"Ministry of Science and Technology","award":["NSTC-110-2314-B 195-010-MY3"],"award-info":[{"award-number":["NSTC-110-2314-B 195-010-MY3"]}]},{"name":"Ministry of Science and Technology","award":["NSTC-110-2314-B-195-029"],"award-info":[{"award-number":["NSTC-110-2314-B-195-029"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: Lesch\u2013Nyhan syndrome (LNS) is a rare X-linked recessive metabolic disorder caused by mutations in the HPRT1 gene, resulting in hypoxanthine\u2013guanine phosphoribosyltransferase (HPRT) deficiency. Early diagnosis is critical for optimizing management and improving outcomes. This study presents a case series of three Taiwanese patients diagnosed at a single medical center. Methods: Exome sequencing and biochemical testing were used to confirm the diagnoses. Early clinical manifestations, including hyperuricemia, hypotonia, and developmental delay, were documented during the initial stages of the disease. Results: All three patients had hyperuricemia, hypotonia, spasticity, and motor developmental delay. Pathogenic variants in the HPRT1 gene were identified in two patients, while the third was confirmed by biochemical testing. Two patients had orange-colored crystalline deposits in their diapers, indicative of hyperuricosuria. Self-injurious behavior had not yet developed in two patients due to their young age. Conclusions: Early clinical features such as hyperuricemia, hypotonia, and motor delay may suggest LNS in infancy. Molecular genetic testing, particularly whole exome sequencing, can facilitate an early diagnosis before specific manifestations occur, enabling timely interventions and improving patient outcomes.<\/jats:p>","DOI":"10.3390\/diagnostics14242809","type":"journal-article","created":{"date-parts":[[2024,12,13]],"date-time":"2024-12-13T10:34:12Z","timestamp":1734086052000},"page":"2809","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Whole Exome Sequencing Facilitates Early Diagnosis of Lesch\u2013Nyhan Syndrome: A Case Series"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5652-8486","authenticated-orcid":false,"given":"Hung-Hsiang","family":"Fang","sequence":"first","affiliation":[{"name":"Department of Pediatrics, MacKay Memorial Hospital, Taipei 104217, Taiwan"},{"name":"Department of Pediatrics, Tri-Service General Hospital, National Defense Medical Center, Taipei 114202, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8178-6938","authenticated-orcid":false,"given":"Chung-Lin","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, MacKay Memorial Hospital, Taipei 104217, Taiwan"},{"name":"Institute of Clinical Medicine, National Yang-Ming Chiao-Tung University, Taipei 112304, Taiwan"},{"name":"Department of Rare Disease Center, MacKay Memorial Hospital, Taipei 104217, Taiwan"},{"name":"Department of Medicine, Mackay Medical College, New Taipei City 252005, Taiwan"},{"name":"Department of Childhood Care and Education, Mackay Junior College of Medicine, Nursing and Management, Taipei 112021, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9625-2306","authenticated-orcid":false,"given":"Hui-Ju","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, MacKay Memorial Hospital, Taipei 104217, Taiwan"},{"name":"Department of Medicine, Mackay Medical College, New Taipei City 252005, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9776-2092","authenticated-orcid":false,"given":"Chih-Kuang","family":"Chuang","sequence":"additional","affiliation":[{"name":"Department of Medical Research, MacKay Memorial Hospital, Taipei 104217, Taiwan"},{"name":"College of Medicine, Fu-Jen Catholic University, Taipei 24205, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huei-Ching","family":"Chiu","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, MacKay Memorial Hospital, Taipei 104217, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ya-Hui","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, MacKay Memorial Hospital, Taipei 104217, Taiwan"},{"name":"Department of Rare Disease Center, MacKay Memorial Hospital, Taipei 104217, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan-Rong","family":"Tu","sequence":"additional","affiliation":[{"name":"Department of Medical Research, MacKay Memorial Hospital, Taipei 104217, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun-Ting","family":"Lo","sequence":"additional","affiliation":[{"name":"Department of Rare Disease Center, MacKay Memorial Hospital, Taipei 104217, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9619-0990","authenticated-orcid":false,"given":"Hsiang-Yu","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, MacKay Memorial Hospital, Taipei 104217, Taiwan"},{"name":"Department of Rare Disease Center, MacKay Memorial Hospital, Taipei 104217, Taiwan"},{"name":"Department of Medicine, Mackay Medical College, New Taipei City 252005, Taiwan"},{"name":"Department of Childhood Care and Education, Mackay Junior College of Medicine, Nursing and Management, Taipei 112021, Taiwan"},{"name":"Department of Medical Research, MacKay Memorial Hospital, Taipei 104217, Taiwan"},{"name":"Department of Medical Research, China Medical University Hospital, China Medical University, Taichung 404328, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuan-Pei","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, MacKay Memorial Hospital, Taipei 104217, Taiwan"},{"name":"Department of Rare Disease Center, MacKay Memorial Hospital, Taipei 104217, Taiwan"},{"name":"Department of Medicine, Mackay Medical College, New Taipei City 252005, Taiwan"},{"name":"Department of Medical Research, MacKay Memorial Hospital, Taipei 104217, Taiwan"},{"name":"Department of Infant and Child Care, National Taipei University of Nursing and Health Sciences, Taipei 11219, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,12,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1016\/0002-9343(64)90104-4","article-title":"A familial disorder of uric acid metabolism and central nervous system function","volume":"36","author":"Lesch","year":"1964","journal-title":"Am. 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