Maple syrup urine disease
Branched-Chain Amino Acid Discard Disease (MSUD) is an intricate metabolic disorder of genetic origin in which there are mutations in the genes coding for BCKD enzymes, which are critical for the degradation of branched-chain amino acids and whose malfunctioning results in their toxic accumulation in the body. This accumulation, mainly of leucine, isoleucine and valine, usually leads to severe damage to the nervous system, causing symptoms ranging from feeding difficulties to neurological problems. A peculiar aspect of MSUD is the characteristic odor of urine, often described as "acrid" or "sweetish." This peculiarity is due to the accumulation of these amino acids which, unable to be broken down, are eliminated through the urine, which then appears a reddish-brown color characteristic of the disease, which in association with the sweetish odor has led to the coining of the name "Maple Syrup Urine Disease." Clinically, symptoms vary depending on the specificity of the genetic mutations and the extent of amino acid accumulation. MSUD can manifest with developmental delay, seizures, and behavioral problems, reflecting the neurological damage that occurs due to the accumulation of toxic substances in the body. There is currently no cure for the disease, which is, however, treated through a low-protein diet that limits protein intake and consequently the amino acids responsible. The use of special amino acid formulations may be necessary to ensure adequate nutritional intake.