Dopamine beta-hydroxylase deficiency

General Information (adopted from Orphanet):

Synonyms, Signs: norepinephrine deficiency
noradrenaline deficiency
Number of Symptoms 30
OrphanetNr: 230
OMIM Id: 223360
ICD-10: G90.8
UMLs: C0342687
MeSH: C535600
MedDRA:
Snomed: 237923004

Prevalence, inheritance and age of onset:

Prevalence: 12 cases [Orphanet]
Inheritance: Autosomal recessive
[Orphanet]
Age of onset: Neonatal
Infancy
[Orphanet]

Disease classification (adopted from Orphanet):

Parent Diseases: Disorder of catecholamine synthesis
 -Rare genetic disease
Neurometabolic disease
 -Rare genetic disease
 -Rare neurologic disease
Primary orthostatic hypotension
 -Rare neurologic disease
Ptosis
 -Rare eye disease
 -Rare genetic disease

Symptom Information: Sort by abundance 

1
(HPO:0000855) Insulin resistance 27778639 IBIS 32 / 7739
2
(HPO:0000842) Hyperinsulinemia 27778639 IBIS 39 / 7739
3
(HPO:0011979) Elevated urinary dopamine Very frequent [IBIS] 27778639 IBIS 2 / 7739
4
(HPO:0012099) Abnormality of circulating catecholamine level Very frequent [IBIS] 27778639 IBIS 2 / 7739
5
(HPO:0000017) Nocturia 5 / 7739
6
(HPO:0000218) High palate 356 / 7739
7
(HPO:0000508) Ptosis 459 / 7739
8
(HPO:0001278) Orthostatic hypotension Very frequent [IBIS] 27778639 IBIS 24 / 7739
9
(HPO:0001250) Seizures 1245 / 7739
10
(HPO:0005964) Intermittent hypothermia 2 / 7739
11
(HPO:0001998) Neonatal hypoglycemia 22 / 7739
12
(OMIM) Decreased serum prolactin 2 / 7739
13
(OMIM) Impaired ejaculation due to impaired sympathetic activity 1 / 7739
14
(HPO:0000007) Autosomal recessive inheritance 2538 / 7739
15
(HPO:0012877) Retrograde ejaculation 1 / 7739
16
(OMIM) Increased plasma dihydroxyphenylacetic acid (DOPAC) 1 / 7739
17
(OMIM) Undetectable norepinephrine (noradrenaline) in plasma, urine, CSF Very frequent [IBIS] 27778639 IBIS 1 / 7739
18
(OMIM) Hypothermia, episodic, in infants 1 / 7739
19
(MedDRA:10038967) Retrograde ejaculation 1 / 7739
20
(OMIM) Hypoglycemia, episodic, in infants 1 / 7739
21
(OMIM) Undetectable epinephrine (adrenaline) in plasma, urine, CSF 1 / 7739
22
(OMIM) Seizures may occur during hypotensive episodes 1 / 7739
23
(OMIM) Fainting spells 1 / 7739
24
(OMIM) Nasal stuffiness 2 / 7739
25
(OMIM) Orthostatic hypotension, severe, recurrent 1 / 7739
26
(OMIM) Delayed eye opening as a neonate (up to 2 weeks) 1 / 7739
27
(OMIM) Undetectable plasma DBH activity 1 / 7739
28
(OMIM) Undetectable dopamine beta-hydroxylase (DBH) protein in plasma, CSF, or sympathetic fibers 1 / 7739
29
(OMIM) Greatly increased dopamine in plasma, urine, CSF (approximately 10-fold increase) 1 / 7739
30
(OMIM) Stimulation of sympathetic fibers results in release of dopamine, not norepinephrine 1 / 7739

Associated genes:

ClinVar (via SNiPA)

Gene symbol Variation Clinical significance Reference

Additional Information:

Clinical Description OMIM Robertson et al. (1986) reported a 33-year-old woman of Scottish-Irish descent with isolated failure of autonomic noradrenergic neurotransmission caused by a defect in the beta-hydroxylation of dopamine in peripheral nerves. Clinical features included orthostatic hypotension, ptosis, nasal stuffiness, ...
Molecular genetics OMIM In 2 unrelated patients with dopamine beta-hydroxylase deficiency reported by Robertson et al. (1986) and Biaggioni et al. (1990), Kim et al. (2002) identified compound heterozygosity for mutations in the DBH gene (609312.0002-609312.0004).
Diagnosis GeneReviews Physical examination of individuals with dopamine beta-hydroxylase (DBH) deficiency reveals the following [Vincent & Robertson 2002, Timmers et al 2004]:...
Clinical Description GeneReviews Dopamine beta-hydroxylase (DBH) deficiency is characterized by a lack of sympathetic noradrenergic function but normal parasympathetic and sympathetic cholinergic function. Affected individuals exhibit profound deficits in autonomic regulation of cardiovascular function, but apparently only subtle signs of central nervous system dysfunction [Robertson et al 1986, Man in ‘t Veld et al 1987, Timmers et al 2004]....
Genotype-Phenotype Correlations GeneReviews Because of the small number of individuals diagnosed with DBH deficiency, it is not possible to determine correlations between specific phenotypes and mutations in DBH....
Differential Diagnosis GeneReviews The striking catecholamine abnormalities distinguish DBH deficiency from other disorders. Other catecholamine disorders, such as aromatic amino acid decarboxylase deficiency, have clinical presentations distinct from that of DBH deficiency [Swoboda et al 2003]....
Management GeneReviews To determine the extent of functional disturbance in an individual diagnosed with dopamine beta-hydroxylase (DBH) deficiency, the following are indicated:...
Molecular genetics GeneReviews Information in the Molecular Genetics and OMIM tables may differ from that elsewhere in the GeneReview: tables may contain more recent information. —ED....