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IEMbase 0028: CTH-related cystathionine gamma-lyase deficiency

Scope

Field Value
IEMbase ID 28
Nosology 1.5.07.01
Gene CTH
External IDs OMIM:219500
Generated mapping UNMAPPED; best fuzzy candidate Homocystinuria.yaml
Candidate DisMech targets none currently valid
Review date 2026-07-07

IEMbase phenotype signal

IEMbase represents cystathionine gamma-lyase deficiency/cystathioninuria as a biochemical condition with no clinical significance. The only characteristic clinical row is No clinical significance across all age bands.

The biochemical signal is high plasma cystathionine, very high plasma/urinary cystathionine, low methionine-to-cystathionine ratio, normal cysteine, and normal-to-mildly high total homocysteine. No treatments are listed and treatability is unknown.

DisMech phenotype coverage

There is no current DisMech entry for CTH deficiency or cystathioninuria. The best fuzzy candidate, Homocystinuria.yaml, should be rejected. CBS-deficient homocystinuria has low cystathionine, marked hyperhomocystinemia, elevated or variable methionine, and a severe ocular/skeletal/vascular phenotype. CTH deficiency has the opposite cystathionine signal and is represented by IEMbase as clinically insignificant.

Concordance and completeness

Judgement: generated status is correctly unmapped. The fuzzy homocystinuria candidate is mechanistically misleading despite pathway proximity.

There is no local DisMech coverage to compare for phenotype completeness. If a future entry is created, it should be framed as a mostly biochemical cystathioninuria record unless stronger clinical evidence is added.

Curation actions

  • Do not map this record to Homocystinuria.yaml.
  • If curated, preserve the low-clinical-significance judgement and avoid importing CBS-deficiency complications.
  • The key differentiator is high cystathionine in CTH deficiency versus low cystathionine in CBS deficiency.