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Hartnup disease

Hartnup disease is a metabolic disorder characterized by abnormal transport of certain amino acids in the kidney and gastrointestinal system

Prevalence

1-9 / 100 000

3,300–29,800

US Estimated

4,500–40,500

Europe Estimated

Age of Onset

Childhood

ICD-10

E72

Inheritance Pattern

Autosomal dominant

Autosomal recessive

Mitochondrial/Multigenic

X-linked dominant

X-linked recessive

Rare View

Hartnup Disease is a rare genetic metabolic disorder affecting the absorption of neutral amino acids, particularly tryptophan, in the intestine and kidneys. It is caused by mutations in the SLC6A19 gene, leading to niacin deficiency, which can result in symptoms similar to pellagra.

 

5 Facts you should know

FACT

1

Hartnup Disease is a rare, autosomal recessive disorder characterized by the impaired absorption of certain amino acids, particularly tryptophan, from the intestines and kidneys

FACT

2

It is caused by mutations in the SLC6A19 gene, affecting the transportation of amino acids across cell membranes, leading to tryptophan deficiency

FACT

3

Symptoms may vary widely but often include skin rash when exposed to sunlight (pellagra-like symptoms), neurological issues, such as ataxia and tremors, and psychiatric manifestations

FACT

4

Diagnosis involves clinical evaluation, urine tests demonstrating amino acid abnormalities (low levels of tryptophan), and genetic testing to confirm mutations in the SLC6A19 gene

FACT

5

Treatment involves managing symptoms through dietary modifications, including increased tryptophan intake, nicotinamide supplements to alleviate skin symptoms, and monitoring for associated complications

Hartnup disease is also known as...

Hartnup disease is also known as:

  • Hartnup disorder
  • Pellagra-like syndrome due to neutral aminoaciduria

What’s your Rare IQ?

Which amino acid deficiency plays a central role in the symptoms of Hartnup disease?

Common signs & symptoms

Photosensitive dermatitis (pellagra-like), classically on sun-exposed areas

Intermittent episodes precipitated by illness, malnutrition, stress

Cerebellar ataxia, gait instability, tremor

Neuropsychiatric symptoms (irritability, mood changes; variable)

GI symptoms may occur during episodes (e.g., diarrhea) in some patients

Lab hallmark: neutral aminoaciduria; supportive testing may include low niacin status/tryptophan issues

Current treatments

Nicotinamide (niacinamide) supplementation (preferred over niacin to avoid flushing)

High-protein/nutritionally adequate diet; avoid prolonged fasting

Sun protection; manage triggers (intercurrent illness)

Symptom-directed support during acute episodes

References:

  1. Orphanet. Hartnup disorder (prevalence estimate)