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IEMbase 0656: CA5A-related carbonic anhydrase VA deficiency

Scope

Field Value
IEMbase ID 656
Nosology 1.1.09.01
Nosology code IEM0064
Gene CA5A
External IDs OMIM:615751; ORPHA:401948
Generated mapping UNMAPPED; weak candidate Carbamoyl_Phosphate_Synthetase_I_Deficiency.yaml
Candidate DisMech targets No exact local target; broad hyperammonemia/UCD context only
Review date 2026-07-07

IEMbase phenotype signal

IEMbase represents autosomal recessive CA5A-related carbonic anhydrase VA deficiency, also labeled hyperammonemia due to carbonic anhydrase VA deficiency.

Clinical rows emphasize neonatal/infantile metabolic decompensation: coma, temperature instability, vomiting, encephalopathy, feeding difficulties, and hypoglycemia. Biochemical rows include increased ammonia, low glucose, normal-to-increased lactate, low-to-normal arginine and citrulline, normal-to-high glutamine, normal urinary orotic acid, and multiple organic acid/acylglycine abnormalities including 3-methylcrotonylglycine, propionylglycine, ketones, 2-ketoglutaric acid, 3-hydroxybutyric acid, 3-hydroxyisovaleric acid, 3-hydroxypropionic acid, adipic acid, fumaric acid, sebacic acid, and suberic acid.

DisMech phenotype coverage

Carbamoyl_Phosphate_Synthetase_I_Deficiency.yaml is a mechanistically related but gene-specific false exact candidate. It models CPS1 loss at the urea-cycle entry step, with hyperammonemia, low citrulline, high glutamine, normal/low orotic acid, encephalopathy, coma, and ammonia neurotoxicity. Those are useful shared decompensation features, but the file does not model CA5A, mitochondrial carbonic anhydrase VA, bicarbonate supply to multiple mitochondrial enzymes, or the IEMbase organic-acid/acylglycine pattern.

No local CA5A or carbonic anhydrase VA deficiency disease entry was found.

Concordance and completeness

Judgement: broad hyperammonemia context only; true CA5A disease-level gap.

The CPS1 entry should not be treated as exact coverage, but it is a useful neighbor for shared acute hyperammonemic encephalopathy. The IEMbase row needs a separate CA5A mechanism to preserve the combined urea-cycle, pyruvate carboxylase, and organic-acid signature.

Curation actions

  • Keep this row unmapped until a CA5A target exists.
  • Do not map to Carbamoyl_Phosphate_Synthetase_I_Deficiency.yaml as exact.
  • Preserve ammonia, glucose, lactate, glutamine, arginine/citrulline, normal orotic acid, organic acids, acylglycines, hypoglycemia, vomiting, encephalopathy, coma, feeding, and temperature-instability prompts.