Maple syrup urine disease is due to deficiency of
**Core Concept**
Maple syrup urine disease (MSUD) is a metabolic disorder caused by a deficiency of an enzyme involved in the breakdown of certain amino acids. It is an example of an organic acidemia, a group of disorders that result from the accumulation of organic acids in the body due to a defect in their metabolism.
**Why the Correct Answer is Right**
The correct answer is a branched-chain alpha-keto acid dehydrogenase complex (BCKDC), which is responsible for breaking down the branched-chain amino acids leucine, isoleucine, and valine. The BCKDC is a multienzyme complex that catalyzes the conversion of these amino acids to their corresponding alpha-keto acids, which are then further metabolized. A deficiency of this enzyme leads to the accumulation of branched-chain amino acids and their toxic byproducts in the body, resulting in the characteristic symptoms of MSUD.
**Why Each Wrong Option is Incorrect**
* **Option A:** This option is incorrect because the enzyme responsible for breaking down methionine is methionine adenosyltransferase, not related to MSUD.
* **Option B:** This option is incorrect because the enzyme responsible for breaking down phenylalanine is phenylalanine hydroxylase, not related to MSUD.
* **Option C:** This option is incorrect because the enzyme responsible for breaking down tyrosine is tyrosine aminotransferase, not related to MSUD.
**Clinical Pearl / High-Yield Fact**
Maple syrup urine disease is a classic example of a metabolic disorder that can be diagnosed by the characteristic sweet odor of the urine, which resembles maple syrup. This is due to the accumulation of branched-chain amino acids and their toxic byproducts, which are volatile and give the urine its distinctive odor.
**Correct Answer: D. Branched-chain alpha-keto acid dehydrogenase complex**