# Incidental Finding of MEGDEL Syndrome at a Tertiary Care Center in Saudi Arabia

## TL;DR

This case report describes an 11-year-old boy diagnosed with MEGDEL syndrome in Saudi Arabia, highlighting the importance of genetic testing and multidisciplinary care for rare genetic disorders.

## Contribution

The report adds a new case of MEGDEL syndrome in Saudi Arabia and emphasizes the role of genetic testing in diagnosis.

## Key findings

- A homozygous deletion variant in the SERAC1 gene was identified through whole exome sequencing.
- The patient exhibited brain atrophy, tracheal stenosis, laryngomalacia, and skeletal abnormalities.
- The case highlights the diagnostic challenges and the need for genetic counseling in consanguineous families.

## Abstract

MEGDEL syndrome, a rare autosomal recessive disorder characterized by 3-methylglutaconic aciduria, deafness, encephalopathy, and Leigh-like syndrome, results from mutations in the SERAC1 gene. This case report explores the clinical presentation, diagnostic challenges, and genetic findings of an 11-year-old boy with MEGDEL syndrome at a tertiary care center in Saudi Arabia.

The patient, born to consanguineous parents, presented with developmental delay, cerebral palsy, intellectual disability, and seizures. Diagnostic evaluation at 15 months revealed 3-methylglutaconic aciduria, and subsequent genetic testing through whole exome sequencing confirmed a rare homozygous deletion variant in the SERAC1 gene. The patient exhibited brain atrophy, tracheal stenosis, laryngomalacia, and skeletal abnormalities. The complexity of MEGDEL syndrome manifestations and the challenge of distinguishing it from other metabolic disorders are discussed, emphasizing the significance of genetic testing in confirming the diagnosis.

This case underscores the occurrence of MEGDEL syndrome in a child with cerebral palsy, highlighting the importance of a multidisciplinary approach for diagnosis and the need for genetic counseling in consanguineous families. Although the management remains primarily supportive, the report calls for more comprehensive epidemiological studies to determine the prevalence and incidence of MEGDEL syndrome. The findings contribute to the growing understanding of this rare disorder, thus emphasizing the necessity for ongoing research to enhance diagnostic accuracy and management strategies.