Clinical, biochemical and neuroradiological findings in L-5-hydroxyglutaric aciduria

L-2-Hydroxyglutaric aciduria is a rare inborn error of metabolism, marked b y a large and persistent increase of L-2-hydroxyglutaric acid in urine, blo od and cerebrospinal fluid (CSF). We present clinical, biochemical and neur oradiological findings of seven Italian patients aged 4-19 years presenting at different stages of the disease. The disorder was characterized by a pr ogressive neurological syndrome with cerebellar and pyramidal signs, mental deterioration, epilepsy and subcortical leukoencephalopathy on magnetic re sonance imaging (MRI). We observed a good correlation between the severity of the disease and the extent of lesions on MRI. We report the result of th e first positive prenatal diagnosis.