Riboflavin 1 Transporter Deficiency: Novel SLC52A1 Variants and Expansion of the Phenotypic Spectrum

Genes (Basel). 2023 Jul 7;14(7):1408. doi: 10.3390/genes14071408.

Abstract

Riboflavin transporter 1 (RFVT1) deficiency is an ultrarare metabolic disorder due to autosomal dominant pathogenic variants in SLC52A1. The RFVT1 protein is mainly expressed in the placenta and intestine. To our knowledge, only five cases of RFVT1 deficiency from three families have been reported so far. While newborns and infants with SLC52A1 variants mainly showed a multiple acyl-CoA dehydrogenase deficiency-like presentation, individuals identified in adulthood were usually clinically asymptomatic. We report two patients with novel heterozygous SLC52A1 variants. Patient 1 presented at the age of 62 with mild hyperammonemia following gastroenteritis. An acylcarnitine analysis in dried blood spots was abnormal with a multiple acyl-CoA dehydrogenase deficiency-like pattern, and genetic analysis confirmed a heterozygous SLC52A1 variant, c.68C > A, p. Ser23Tyr. Patient 2 presented with recurrent seizures and hypsarrhythmia at the age of 7 months. Metabolic investigations yielded unremarkable results. However, whole exome sequencing revealed a heterozygous start loss variant, c.3G > A, p. Met1Ile in SLC52A1. These two cases expand the clinical spectrum of riboflavin transporter 1 deficiency and demonstrate that symptomatic presentation in adulthood is possible.

Keywords: MADD; SLC52A1; riboflavin; riboflavin transporter; vitamin B2.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Female
  • Heterozygote
  • Humans
  • Infant
  • Infant, Newborn
  • Membrane Transport Proteins* / genetics
  • Multiple Acyl Coenzyme A Dehydrogenase Deficiency* / genetics
  • Pregnancy
  • Receptors, G-Protein-Coupled / genetics
  • Riboflavin / metabolism

Substances

  • Receptors, G-Protein-Coupled
  • Riboflavin
  • SLC52A1 protein, human
  • Membrane Transport Proteins

Supplementary concepts

  • Brown-Vialetto-Van Laere syndrome

Grants and funding

M.S. received funding from the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation)—Project-ID 431984000–SFB 1453) and Germany’s Excellence Strategy CIBSS—EXC-2189—project ID 390939984 under Germany’s Excellence Strategy. ST received funding from the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation)—Project-ID TU 492/3-1).