Background: Homocysteinuria is a rare metabolic disorder with a varied clinical presentation. Complications arise due to inadequate homocysteine control and include vascular, musculoskeletal and cognitive impairment. Risk is higher in the event of concurrent burns whereby the injury itself causes further metabolic derailment through hypermetabolism and catabolism.
Methodology: We present the case of an 18-year-old homocysteinuria patient who sustained a sixty-five percentage flame burn. He underwent extensive wound debridement and grafting procedures. However, despite ongoing input from the burns team, metabolic care team and a low protein diet, he developed intestinal failure, sepsis, hepatic failure, renal failure, and ultimately died. A literature search was performed using the online databases Google Scholar and Medline to identify studies pertaining to the pathogenesis, management and nutritional support required in patients sustaining major burn injuries on a background of homocysteinuria. Literature was evaluated and the care provided compared to that of the patient managed at our centre.
Results: Management of metabolic complications in both homocysteinuria and burns are complex. Vigilant monitoring of homocysteine and methionine levels is essential to ascertain the severity of ongoing derangements. There is a need for improved guidelines detailing the appropriate management of burns in patients with underlying homocystinuria as existing literature is sparse.
Conclusion: Prompt management of homocystinuria patients sustaining burn injuries at a specialist unit together with vigilant control of homocysteine and methionine levels is essential so that outcomes can be optimised.

**_Background:_** Homocysteinuria is a rare metabolic disorder with a varied clinical presentation. Complications arise due to inadequate homocysteine control and include vascular, musculoskeletal and cognitive impairment. Risk is higher in the event of concurrent burns whereby the injury itself causes further metabolic derailment through hypermetabolism and catabolism.
**_Methodology:_** We present the case of an 18-year-old homocysteinuria patient who sustained a sixty-five percentage flame burn. He underwent extensive wound debridement and grafting procedures. However, despite ongoing input from the burns team, metabolic care team and a low protein diet, he developed intestinal failure, sepsis, hepatic failure, renal failure, and ultimately died. A literature search was performed using the online databases Google Scholar and Medline to identify studies pertaining to the pathogenesis, management and nutritional support required in patients sustaining major burn injuries on a background of homocysteinuria. Literature was evaluated and the care provided compared to that of the patient managed at our centre.
**_Results:_** Management of metabolic complications in both homocysteinuria and burns are complex. Vigilant monitoring of homocysteine and methionine levels is essential to ascertain the severity of ongoing derangements. There is a need for improved guidelines detailing the appropriate management of burns in patients with underlying homocystinuria as existing literature is sparse.
**_Conclusion:_** Prompt management of homocystinuria patients sustaining burn injuries at a specialist unit together with vigilant control of homocysteine and methionine levels is essential so that outcomes can be optimised.

P.001 Adult Major Burn Injury Complicated by Classical Homocystinuria - The Undesired Outcome

Dear friends and colleagues,

We will be pleased to welcome you in Turin (Italy) for the 19th European Burns Association´s Congress in 2022. Italy is honored to hold the meeting of the European Burns Association for the second time, after Verona in 1995. Turin is easily reachable from everywhere in Europe, either travelling by car, train or choosing flight connections. During the meeting, held in the renewed industrial center of the main Italian historical automotive factory (i.e. Lingotto-FIAT), we will meet international burn specialists, focusing on standards of care, progresses in burn treatment, strategies to face disaster situations, with a special attention to education of younger colleagues. However, in your spare time, you might enjoy the sweet days of Italian late summer, simply wandering in the green parks and gardens along the two rivers which cross the city, or you might decide to discover the numerous art galleries, churches, palaces, libraries, walking across elegant squares and large boulevards, passing through centuries of art and history; finally, you may choose to immerse yourself in some of the most exciting museum experiences, such as the Cinema Museum and the Turin’s Egyptian museum.

Looking forward to seeing you all in Turin for the 19th European Association´s Congress in 2022!
Maurizio Stella, Congress President, Turin Burn Centre