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3-methylglutaconic aciduria (3-MGA) type I is an inborn error of leucine metabolism with a variable clinical phenotype ranging from mildly delayed speech to psychomotor retardation, coma, failure to thrive, metabolic acidosis and dystonia.
Features include always present findings: Reduced tissue 3-methylglutaconyl-CoA hydratase activity and 3-Methylglutaconic aciduria; and common findings: Ataxia, Delayed speech and language development, and Abnormal brain white matter (abnormal cerebral white matter morphology). 24 total HPO annotations.
Organ System | Phenotype Count | Example Features |
|---|---|---|
Brain and nerves | 14 | Dystonia, Ataxia, Difficulty with thinking and memory (cognitive impairment) |
Muscles | 2 | Brain shrinkage (cerebral atrophy), Damage to the optic nerve (optic atrophy) |
Kidneys and urinary system | 1 | Urinary incontinence |
Growth and development | 1 | Failure to thrive |
Metabolism | 1 | Metabolic acidosis |
Eyes | 1 | Damage to the optic nerve (optic atrophy) |
Age of onset: adulthood.
AUH encodes AU RNA binding methylglutaconyl-CoA hydratase (339 aa). Catalyzes the fifth step in the leucine degradation pathway, the reversible hydration of 3-methylglutaconyl-CoA (3-MG-CoA) to 3-hydroxy-3-methylglutaryl-CoA (HMG-CoA). Highest expression in Adrenal Gland (45.6 TPM) and Brain Cerebellar Hemisphere (29.1 TPM).
3-methylglutaconic aciduria type 1 is caused by mutations in the AUH gene on chromosome 9.
The AUH protein participates in mutant AUH hexamer, AUH mutants don't synthesize 3-hydroxy-methylglutaryl-CoA, and beta-methylglutaconyl-CoA + H2O beta-hydroxy-beta-methylglutaryl-CoA pathways.
AUH is classified as a druggable target (Enzyme category) with score 52.2.
Genetic testing for AUH is available. Testing is considered confirmatory for diagnosis.
Phenotype severity distribution: 2 always present features, 3 common features.
Estimated prevalence: <1 in 1,000,000 (VERY_RARE).
No clinical trials have been registered for 3-methylglutaconic aciduria type 1.
3 publications have been identified in PubMed for 3-methylglutaconic aciduria type 1. Research spans Case Report / Case Series (67%) and Review / Meta-Analysis (33%).
Mróz D (2025). [PMID: 40194906](https://pubmed.ncbi.nlm.nih.gov/40194906/). *Journal of inherited metabolic disease*. [Case Report / Case Series]
Demetriadou A (2025). [PMID: 40255048](https://pubmed.ncbi.nlm.nih.gov/40255048/). *Journal of inherited metabolic disease*. [Review / Meta-Analysis]
Marchante Pita R (2025). [PMID: 40365324](https://pubmed.ncbi.nlm.nih.gov/40365324/). *JIMD reports*. [Case Report / Case Series]
Data assembled from 7 of 12 sources · Last updated Sep 19, 2026, 2:53 PM UTC
Online Mendelian Inheritance in Man
European rare disease database
Genetic and Rare Diseases Info Center
AI-curated news mentioning 3-methylglutaconic aciduria type 1
Updated Aug 25, 2026
The FDA approved Genglycos (pariglasgene brecaparvovec-opnr) to reduce daily cornstarch intake in patients aged 8 years and older with glycogen storage disease type Ia. Known as Von Gierke disease, GSDIa is a rare metabolic disorder caused by a mutation in the G6PC gene. This genetic variation leads to a deficiency in glucose-6-phosphatase (G6Pase), an enzyme needed to release glucose into the bloodstream. Without this enzyme, the body cannot properly maintain blood glucose levels, causing severe hypoglycemia and other serious metabolic complications · Pariglasgene brecaparvovec is an adeno-associated virus (AAV) serotype 8 based gene therapy that delivers a functional copy of the G6PC gene into liver cells, enabling the production of normally functioning G6Pase. Ultragenyx stated that as part of its postmarketing commitments to the FDA, the Company will provide 2 years of clinical data from open-label commercial treatment of 50 patients and 20 control patients through its existing GSDIa Disease Monitoring Program. ... Ultragenyx announces US FDA approval of Genglycos™ gene therapy, the first-ever FDA-approved treatment designed to treat the underlying cause of glycogen storage disease type Ia (GSDIa). “The reduced reliance on cornstarch, experienced by patients in our clinical studies, demonstrates this gene therapy’s ability to establish the normal breakdown of glycogen to produce glucose during fasting or episodes of metabolic stress. This ability to regulate glucose has alleviated the disease burden and has the potential to mitigate the risk of severe or life-threatening hypoglycemia for these patients.” Close more info about First Gene Therapy Approved for Glycogen Storage Disease Type la