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Cerebral creatine deficiency syndrome is a collective term including different types of disease, all characterised by abnormal creatine level in central nervous system. One of the types, creatine transporter deficiency, is a common cause of X-linked intellectual disability. Typically, it is fully expressed in male patients, however females can also present some symptoms, such as mild intellectual disability, learning difficulties and behavioural problems. The patient presented in this case report is a 4-year-old girl, diagnosed by genetic testing with creatine transporter deficiency showing a novel mutation in SCL6A8 gene, and by proton magnetic resonance spectroscopy in which she presented a typical abnormality in creatine level in central nervous system. The patient presented speech and motor delay, with mild intellectual disability, behavioural problems and seizures well-controlled by valproic acid. The prognosis and therapeutic plan in a female patient with CRTR is a big clinical challenge, as there is few data about this mutation being fully expressed in women. The novel therapy methods may be a promising change in further development and symptoms control in patients with CRTR of both sexes.

SCL6A8 mutation in female patient resulting in creatine transporter deficiency