S-Adenosylhomocysteine (SAH) hydrolase deficiency typically presents in infancy.
Here we describe a woman with SAH hydrolase deficiency who presented in adulthood.
The proband had two healthy sons, one of whom was asymptomatic at 7 years of age despite being SAH hydrolase deficient.
SAH hydrolase deficiency can be associated with early-onset hepatocellular carcinoma.