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IEMbase 0011: CPS1-related carbamoyl phosphate synthetase I deficiency

Scope

Field Value
IEMbase ID 11
Nosology 1.1.02.01
Gene CPS1
External IDs OMIM:237300
Generated mapping AMBIGUOUS by alias_exact:carbamoyl phosphate synthetase i deficiency
Candidate DisMech targets Carbamoyl_Phosphate_Synthetase_I_Deficiency.yaml; Urea_Cycle_Disorder.yaml#Carbamoyl Phosphate Synthetase I Deficiency
Review date 2026-07-07

IEMbase phenotype signal

Characteristic clinical features are coma, developmental delay, encephalopathy, and vomiting, with stronger neonatal/infantile intensity for acute decompensation. Additional features include failure to thrive, feeding difficulty/protein aversion, seizures, and neonatal temperature instability.

The biochemical profile is urea-cycle proximal: increased ammonia, increased glutamine, low arginine, very low citrulline, normal argininosuccinic acid, and low/normal urinary orotic acid. IEMbase also lists mild/variable urinary 3-methylglutaconic acid.

Treatments include protein-defined diet, arginine or citrulline, nitrogen-scavenger drugs, carglumic acid, hemodialysis, peritoneal dialysis, and liver transplantation.

DisMech phenotype coverage

The standalone DisMech disease is the best curation target. It captures hyperammonemia, episodic ammonia intoxication, respiratory insufficiency, aminoaciduria, hypoargininemia, encephalopathy, seizures, coma, developmental delay, intellectual disability, hypotonia, vomiting, lethargy, microcephaly, cerebral edema, abnormal white matter, and atypical behavior. Biochemical entries cover plasma ammonia, citrulline, glutamine, urinary orotic acid, and alanine. Treatments cover diet, nitrogen scavengers, citrulline/arginine, carglumic acid, dialysis, liver transplantation, and genetic counseling.

The Urea Cycle Disorder umbrella also includes a subtype with the same name, which explains the generated ambiguous match.

Concordance and completeness

Judgement: phenotype concordance is high, but mapping should prefer the standalone disease over the umbrella subtype for one-to-one IEMbase crosswalks.

IEMbase adds feeding difficulty/protein aversion and neonatal temperature instability, which are not explicit in the standalone DisMech entry. DisMech adds respiratory insufficiency, hypotonia, lethargy, microcephaly, cerebral edema, white matter abnormalities, and broader neurologic sequelae.

Curation actions

  • Resolve crosswalk ambiguity by treating Carbamoyl_Phosphate_Synthetase_I_Deficiency.yaml as the canonical target.
  • Consider whether umbrella subtype aliases should be de-prioritized in generated exact-alias mapping.
  • Consider adding feeding difficulty/protein aversion if supported by evidence.