Creatine transporter deficiency: prevalence among patients with mental retardation and pitfalls in metabolite screening

A Arias, M Corbella, C Fons, A Sempere… - Clinical …, 2007 - Elsevier
A Arias, M Corbella, C Fons, A Sempere, J García-Villoria, A Ormazabal, P Poo, M Pineda…
Clinical biochemistry, 2007Elsevier
OBJECTIVES: To report the prevalence of creatine transporter deficiency in males with
mental retardation and to study whether a protein-rich food intake might be a potential
diagnostic pitfall. DESIGN AND METHODS: We determined creatine/creatinine ratio in urine
samples from 1600 unrelated male patients with mental retardation and/or autism. Urine
creatine was analyzed by HPLC-MS/MS. RESULTS: Thirty-three of 1600 cases showed
increased urine creatine/creatinine ratio. Four out of these thirty-three cases were definitively …
OBJECTIVES
To report the prevalence of creatine transporter deficiency in males with mental retardation and to study whether a protein-rich food intake might be a potential diagnostic pitfall.
DESIGN AND METHODS
We determined creatine/creatinine ratio in urine samples from 1600 unrelated male patients with mental retardation and/or autism. Urine creatine was analyzed by HPLC-MS/MS.
RESULTS
Thirty-three of 1600 cases showed increased urine creatine/creatinine ratio. Four out of these thirty-three cases were definitively diagnosed with creatine transporter deficiency, while the other 29 were false positive results. Significantly higher values were observed for urine Cr/Crn ratio in healthy volunteers after a meal based on beef or oily fish as compared to eggs, pasta or salad (Wilcoxon test: p<0.005).
CONCLUSIONS
False positive results may be observed in biochemical screening for creatine transporter deficiency, and they may be due to intake of meals rich in creatine prior to urine samples analysis.
Elsevier