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Biochemistry · Amino acid metabolism: tyrosinaemia type II
Sample itemA 4-year-old boy has painful, photophobic eye lesions with pseudodendritic corneal erosions, painful thickening of the palms and soles, and mild intellectual disability. Plasma tyrosine is markedly raised, but succinylacetone is absent in urine. Which enzyme is deficient?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
D. Tyrosine aminotransferase
Deficiency of cytosolic hepatic tyrosine aminotransferase causes tyrosinaemia type II (Richner-Hanhart syndrome). High tyrosine crystallises in tissues, producing corneal lesions and palmoplantar keratosis. Absence of succinylacetone excludes type I, which is caused by the hydrolase defect.
Option by option
A. Homogentisate 1,2-dioxygenase
Homogentisate dioxygenase deficiency gives alkaptonuria with dark urine and ochronosis, not high tyrosine.
B. Phenylalanine hydroxylase
Phenylalanine hydroxylase deficiency gives raised phenylalanine, with tyrosine low or normal.
C. Fumarylacetoacetate hydrolase
Deficiency of the hydrolase gives type I disease with liver failure, rickets and urinary succinylacetone.
D. Tyrosine aminotransferase (correct)
Correct. This transamination step is the first in tyrosine catabolism; its failure gives eye and skin lesions.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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