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Glycogen storage disease type I a: Frequency and clinical course in Turkish children

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Abstract

The aim of this study was to determine the relative frequency of type Ia in glycogen storage disease (GSD) with prominent liver involvement and to determine its clinical and laboratory findings and prognosis in Turkish children.

From 1980 to 1998, 45 out of 100 GSD patients (27 male) with liver involvement had been diagnosed for type Ia. The files were retrospectively evaluated and clinical and laboratory features were documented. In addition to routine laboratory evaluations, urine albumin, calcium excretions, and plasma biotinidase activity were measured. Breast-feeding was continued in all infants. After 6 months of age, uncooked comstarch was administered to the patients.

The relative frequency of type Ia in GSD with liver involvement was 45%. The diagnosis was made in 71% of patients before 2 years of age (median 1 year). Main complaint was abdominal protruding (57.8%), and main physical finding was, hepatomegaly (100%). Forty percent of the patients had growth retardation at diagnosis. Among laboratory parameters, hypertriglyceridemia (97.8%) and hypertransaminasemia (95.6%) were the most frequent findings following plasma biotinidase activity, which was elevated in all patients. Microalbuminuria was determined in 52.8% of the patients and hypercalciuria in 23.8%. Histopathological findings of the liver included fibrosis (75.6%), steatosis (37.8%), mosaicism (24.4%) and nuclear hyperglycogenation (15.6%). During follow-up period, the ratio of patients with growth retardation did not change. Transaminases were decreased in 48.7% of the patients. Although triglyceride and cholesterol levels decreased in the majority of the patients, they did not normalise.

The prevalence of type Ia in GSD with prominent liver involvement was found higher than the other reports. Microalbuminuria was also higher than the previous reports.

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References

  1. Roy CC, Silverman A, Alagille D. Inborn errors of metabolism. In:Pediatric Clinical Gastroenterology, 4th edn, USA; Mosby-Year Book, Inc, 1995; 816–876.

    Google Scholar 

  2. Nyhan WL, Özand PT. Glycogenosis type Ia/Von Gierke disease/Glucose-6-phosphatase deficiency. In:Atlas of Metabolic Disease, 1st edn, London: Chapman & Hall Medical, 1998; 330–340.

    Google Scholar 

  3. Hug C, Chuck G, Tsoras M. Increased serum biotinidase activity in glycogen storage disease type Ia.Pediatr Res 1994; 35: 203A.

    Google Scholar 

  4. Lee PJ, Leonard JV. The hepatic glycogen storage disease problems beyond the childhood.J Inher Metab Dis 1995; 18: 462–472.

    Article  PubMed  CAS  Google Scholar 

  5. Lei K, Shely LL, Pan C, Sidbury JB, Chou JY. Mutations in the glucose-6 phosphatase gene that cause glycogen storage disease type Ia.Science 1993; 262: 580–583.

    Article  PubMed  CAS  Google Scholar 

  6. Parvari R, Moses S, Hershkovitz E, Carmi R, Bashan N. Characterization of the mutations in the glucose-6-phosphatase gene in Israeli patients with glycogen storage disease type Ia: R83C in six Jews and a novel V166G mutation in a Muslim Arab.J Inher Metab Dis 1995; 18: 21–27.

    Article  PubMed  CAS  Google Scholar 

  7. Lei K, Chen YT, Chen Het al. Genetic basis of glycogen storage disease type Ia: Prevalent mutations at the glucose-6-phosphatase locus.Am J Hum Genet 1995; 57: 766–771.

    PubMed  CAS  Google Scholar 

  8. Okubo M, Aoyama Y, Kishimoto M, Shishiba Y, Murase T. Identification of a point mutation (G727T) in the glucose-6-phosphatase gene in Japanese patients with glycogen storage disease type Ia, and carrier screening in healthy volunteers.Clin Genet 1997; 51: 179–183.

    PubMed  CAS  Google Scholar 

  9. Lam CW, But WM, Shek CCet al. Glucose-6-phosphatase gene (727G-T) splicing mutation is prevalent in Hong Kong Chinese patients with glycogen storage disease type Ia.Clin Genet 1998; 53: 184–190.

    PubMed  CAS  Google Scholar 

  10. Keller KM, Schütz M, Med Cet al. A new mutation of the glucose-6-phosphatase gene in a 4-year-old girl with oligosymptomatic glycogen storage disease type Ia.J Pediatr 1998; 132: 361–362.

    Google Scholar 

  11. Sartorato EL, Resi FC, Norato DY, Hackel C. A novel mutation in a Brazilian patient with glycogen storage disease type Ia.J Inher Metab Dis 1998; 21: 447.

    Article  PubMed  CAS  Google Scholar 

  12. Hüner, G, Podskarbi T, Schütz M,et al. Molecular aspects of glycogen storage disease type Ia in Turkish patients: A novel mutation in the glucose-6-phosphatase gene.J Inher Metab Dis 1998; 21: 445–446.

    Article  PubMed  Google Scholar 

  13. Koçak N, Özsoylu S, Ciliv G. Type I Von Gierke Glycogenosis (Clinical and laboratory findings of 45 cases).Çocuk Sagligi ve Hastaliklari Dergisi 1989; 32: 209–214.

    Google Scholar 

  14. Lee PJ, Dalton RN, Shah V, Hindmarsh PC, Leonard JV. Glomerular and tubular function in glycogen storage disease.Pediatr Nephrol 1995; 9: 705–710.

    Article  PubMed  CAS  Google Scholar 

  15. Kher KK. Urinary stone disease. In: Kher KK, Makker SP, eds.Clinical Pediatric Nephrology. New York; McGraw-Hill Inc., 1992; 699–719.

    Google Scholar 

  16. Burlina AB, Sherwood JW, Marchioro MV, Dalla Bernardina B, Gaburro D. Neonatal screening for biotinidase in North East Italy.Eur J Pediatr 1988; 147: 317–318.

    Article  PubMed  CAS  Google Scholar 

  17. Lee P, Mather S, Owens C, Leonard J, Dick-Mireaux C. Hepatic ultrasound findings in the glycogen storage disease.Br J Radiol 1994; 67: 1062–1066.

    Article  PubMed  CAS  Google Scholar 

  18. Smit GPA. The long-term outcome of patients with glycogen storage disease type Ia.Eur J Pediatr 1993; 152 (Suppl 1): 52–55.

    Article  Google Scholar 

  19. Talente GM, Coleman RA, Alter Cet al. Glycogen storage disease in adults.Ann Intern Med 1994; 120: 218–226.

    PubMed  CAS  Google Scholar 

  20. Chen Y-T, Burchell A. Glycogen storage disease. In: Scriver CR, Beaudet AL, Sly WS, Valle D, eds.The Metabolic and Molecular Basis of Inherited Disease, 7th edn. New York; McGraw-Hill, 1995; 935–965.

    Google Scholar 

  21. Moses SW. Pathophysiology and dietary treatment of the glycogen storage diseases.J Pediatr Gastroenterol Nutr 1990; 11: 155–174.

    Article  PubMed  CAS  Google Scholar 

  22. Wakid N, Bitar J, Allam C. Glycogen storage disease type I: Laboratory data and diagnosis.Clin Chem 1987; 33: 2008–2010.

    PubMed  CAS  Google Scholar 

  23. Reitsma-Bierens W, Smit G, Troelstra JA. Renal function and kidney size in glycogen storage disease type I.Pediatr Nephrol 1992; 6: 236–238.

    Article  PubMed  CAS  Google Scholar 

  24. Wolfsdorf JI, Laffel LMB, Crigler JF. Metabolic control and renal dysfunction in type I glycogen storage disease.J Inher Metab Dis 1997; 20: 559–568.

    Article  PubMed  CAS  Google Scholar 

  25. Chen Y-T. Type I glycogen storage disease: kidney involvement, pathogenesis and its treatment.Pediatr Nephrol 1991; 5: 71–76.

    Article  PubMed  CAS  Google Scholar 

  26. Yüce A, Coskun T, Koçak N, Özsoylu S, Özalpí, Gögçs S. Type I glycogenosis with renal tubular dysfunction (presentation of two cases).Turk J Pediatr 1993; 35: 201–204.

    PubMed  Google Scholar 

  27. Jevon GP, Finegold MJ. Reability of histological criteria in glycogen storage disease of the liver.Pediatr Pathol 1994; 14: 709–721.

    Article  PubMed  CAS  Google Scholar 

  28. Parker PH, Ballew M, Greene HL. Nutritional management of glycogen storage disease.Annu Rev Nutr 1993; 13: 83–109.

    Article  PubMed  CAS  Google Scholar 

  29. Wolfsdorf JI, Keller RJ, Landy H, Crigler JF. Glucose therapy for glycogenosis type I in infants: Comparison of intermittent uncooked cornstarch and continuous overnight glucose feedings.J Pediatr 1990; 117: 384–391.

    Article  PubMed  CAS  Google Scholar 

  30. Wolfsdorf JI, Rudlin CR, Crigler JF. Physical growth and development of children with type I glycogen storage disease: comparison of the effects of long-term use of dextrose and uncooked cornstarch.Am J Clin Nutr 1990; 52: 1051.

    PubMed  CAS  Google Scholar 

  31. Chen YT, Bazzarre CH, Lee MM, Sidbury JB, Coleman RA. Type I glycogen storage disease: Nine years of management with cornstarch.Eur J Pediatr 1993; 152 (Suppl 1): 56–59.

    Article  Google Scholar 

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Saltik, I.N., Özen, H., Ciliv, G. et al. Glycogen storage disease type I a: Frequency and clinical course in Turkish children. Indian J Pediatr 67, 497–501 (2000). https://doi.org/10.1007/BF02760476

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