“…In general, the most diagnosed patients of inborn errors of metabolism (IEMs) including HT-1, were born from consanguineous married parents. As HT-1 is a rare inherited autosomal recessive disorder, it explains why it is more common in population with a high rate of consanguineous marriages, such as in United Arab Emirates, Oman, Kuwait, and Saudi Arabia, in which the rate of consanguineous marriages reaches up to approximately 60% [33,[77][78][79][80], and even the first reported case of HT-1 in Japan (1957) was a child from parents of consanguineous marriage [13,14]. Furthermore, in our study, the reported three family cases are also born from a consanguineous married parent.…”