Name short: TFP

Name long: Trifunctional protein deficiency

Description: The mitochondrial trifunctional protein, composed of 4 alpha and 4 beta subunits, catalyzes 3 steps in mitochondrial beta-oxidation of fatty acids: long-chain 3-hydroxyacyl-CoA dehydrogenase (LCHAD), long-chain enoyl-CoA hydratase, and long-chain thiolase activities. Trifunctional protein deficiency is characterized by decreased activity of all 3 enzymes. Clinically, classic trifunctional protein deficiency can be classified into 3 main clinical phenotypes: neonatal onset of a severe, lethal condition resulting in sudden unexplained infant death (SIDS; 272120), infantile onset of a hepatic Reye-like syndrome, and late-adolescent onset of primarily a skeletal myopathy. Some patients with MTP deficiency show a protracted progressive course associated with myopathy, recurrent rhabdomyolysis, and sensorimotor axonal neuropathy. These patients tend to survive into adolescence and adulthood.

Incidence in the US 2001-2010: 13 in 23.7 million screens (0.5 cases per million).

Implicated genes:
Hydroxyacyl-Coenzyme A dehydrogenase/3-ketoacyl-Coenzyme A thiolase/ enoyl-Coenzyme A hydratase (trifunctional protein), alpha subunit, HADHA
Hydroxyacyl-Coenzyme A dehydrogenase/3-ketoacyl-Coenzyme A thiolase /enoyl-Coenzyme A hydratase (trifunctional protein), beta subunit, HADHB


Variants in HADHA (see gnomAD page):
total variable positions: 606
rare variants: 0
common variants: 0
Allele frequency of rare (<0.001) variants and the implied number of homozygotes and compound heterozygotes, per million births (under the naive assumption that gnomAD captures all variants present in the human population; PSC = premature stop codon):

Population All rare variants Rare, resulting in PSC Rare, not intronic and not silent Known disease related All presumably detrimental
all 0 => 0 0 => 0 0 => 0 0 => 0 0 => 0
afr 0 => 0 0 => 0 0 => 0 0 => 0 0 => 0
amr 0 => 0 0 => 0 0 => 0 0 => 0 0 => 0
asj 0 => 0 0 => 0 0 => 0 0 => 0 0 => 0
eas 0 => 0 0 => 0 0 => 0 0 => 0 0 => 0
fin 0 => 0 0 => 0 0 => 0 0 => 0 0 => 0
nfe 0 => 0 0 => 0 0 => 0 0 => 0 0 => 0
oth 0 => 0 0 => 0 0 => 0 0 => 0 0 => 0
sas 0 => 0 0 => 0 0 => 0 0 => 0 0 => 0


Expected number of homozygotes/compound heterozygotes in a demographic profile close to the US, using all known (as in, listed in gnomAD) rare nontrivial variants as causative variants: 0.

Expected number of homozygotes/compound heterozygotes in a demographic profile close to the US, using all presumably harmful variants as causative variants: 0.



Variants in HADHB (see gnomAD page):
total variable positions: 442
rare variants: 0
common variants: 0
Allele frequency of rare (<0.001) variants and the implied number of homozygotes and compound heterozygotes, per million births (under the naive assumption that gnomAD captures all variants present in the human population; PSC = premature stop codon):
Population All rare variants Rare, resulting in PSC Rare, not intronic and not silent Known disease related All presumably detrimental
all 0 => 0 0 => 0 0 => 0 0 => 0 0 => 0
afr 0 => 0 0 => 0 0 => 0 0 => 0 0 => 0
amr 0 => 0 0 => 0 0 => 0 0 => 0 0 => 0
asj 0 => 0 0 => 0 0 => 0 0 => 0 0 => 0
eas 0 => 0 0 => 0 0 => 0 0 => 0 0 => 0
fin 0 => 0 0 => 0 0 => 0 0 => 0 0 => 0
nfe 0 => 0 0 => 0 0 => 0 0 => 0 0 => 0
oth 0 => 0 0 => 0 0 => 0 0 => 0 0 => 0
sas 0 => 0 0 => 0 0 => 0 0 => 0 0 => 0


Expected number of homozygotes/compound heterozygotes in a demographic profile close to the US, using all known (as in, listed in gnomAD) rare nontrivial variants as causative variants: 0.

Expected number of homozygotes/compound heterozygotes in a demographic profile close to the US, using all presumably harmful variants as causative variants: 0.



Total estimated number of casses per million (all presumably harmful variants): 0.

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