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IEMbase 0007: GCH1-related GTP cyclohydrolase I deficiency, autosomal dominant

Scope

Field Value
IEMbase ID 7
Nosology 21.1.03.01
Gene GCH1
External IDs OMIM:600225
Generated mapping UNMAPPED; weak candidate Dopa-Responsive Dystonia score 0.762
Likely DisMech targets kb/disorders/Autosomal_Dominant_Dopa_Responsive_Dystonia.yaml; umbrella kb/disorders/Dopa_Responsive_Dystonia.yaml
Review date 2026-07-07

IEMbase phenotype signal

Characteristic clinical features are diurnal fluctuation, dystonia, hypokinesia, parkinsonism, and rigidity. Additional features include bradykinesia, dyskinesia, dysphagia, hypertonia, hypotonia, pes equinovarus, scoliosis, spasticity, increased tendon reflexes, and tremor.

Biochemical entries include phenylalanine, CSF 5-HIAA and homovanillic acid, phenylalanine loading, and CSF biopterin/neopterin. Treatment is levodopa.

DisMech phenotype coverage

The generated crosswalk is a false negative. DisMech has a specific Autosomal Dominant Dopa-Responsive Dystonia entry with GCH1 genetics, autosomal dominant inheritance, BH4 cofactor limitation, childhood dystonia, diurnal fluctuation, parkinsonism, and low-dose levodopa response. The broader Dopa-Responsive Dystonia umbrella also captures limb/focal dystonia, parkinsonism, gait disturbance, decreased CSF homovanillic acid, transient hyperphenylalaninemia, and levodopa therapy.

Concordance and completeness

Judgement: mapping false negative; phenotype concordance is high once the specific AD-DRD entry is selected.

IEMbase has some orthopedic or pyramidal/motor secondary terms not explicit in the local entry, including pes equinovarus, scoliosis, spasticity, and increased tendon reflexes. DisMech has stronger mechanism and treatment modeling than the IEMbase row.

Curation actions

  • Add synonyms such as Segawa disease, GTPCH-DRD, and GTP cyclohydrolase I deficiency autosomal dominant to the local target or mapping normalization.
  • Prefer the specific Autosomal Dominant Dopa-Responsive Dystonia entry as the canonical crosswalk target, with the umbrella as parent context.
  • Consider secondary musculoskeletal/pyramidal features only with supporting phenotype evidence.