Case No. 2:
A 2 years old female child was referred to the Institute with the complaint of delay in,d evelopmental milestones. The history revealed that she was normal at birth and born after a full-term pregnancy. She had parental consanguinity of uncle niece type. She had one elder sister who also had complaints of mental retardation and convulsions.
Height was 70cm, weight was 7kgs, head circumference was 37.5cm and chest dmumference was 5cm. Psychometric analysis revealed low developmental quotience. She was unable to walk without support. Anterior fontonalle was closed. Spasticity of all the limbs was observed. No cardiovascular, respiratory and nervous system abnormalities were observed. Preliminary analysis of urine and serum was done by paper chromatography. The results indicated elevated levels of proline and hydroxyproline in urine but in serum amino acid levels were found normal. The quantification of amino acids in urine was carded out on amino acid analyzer and the results are given in table-2. In urine, proline and hydroxyproline were elevated whereas other amino acids like threonine, serine, glutamic acid, alanine and histidine were within the normal limits. Cytogenetic analysis of the patient showed normal karyotype of 46, XX.