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Wilke MVMB, de Oliveira BM, Starosta RT, Shinawi M, Lu L, He M, Ma Y, Stoll J, de Souza CFM, de Siqueira ACM, Vieira SMG, Cerski CT, Refosco LF, Schwartz IVD. A Broad Characterization of Glycogen Storage Disease IV Patients: A Clinical, Genetic, and Histopathological Study. Biomedicines 2023; 11:biomedicines11020363. [PMID: 36830903 PMCID: PMC9953126 DOI: 10.3390/biomedicines11020363] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/05/2023] [Accepted: 01/12/2023] [Indexed: 01/28/2023] Open
Abstract
Glycogen storage disease type IV (GSD IV) is an ultra-rare autosomal recessive disease caused by variants in the GBE1 gene, which encodes the glycogen branching enzyme (GBE). GSD IV accounts for approximately 3% of all GSD. The phenotype of GSD IV ranges from neonatal death to mild adult-onset disease with variable hepatic, muscular, neurologic, dermatologic, and cardiac involvement. There is a paucity of literature and clinical and dietary management in GSD IV, and liver transplantation (LT) is described to correct the primary hepatic enzyme defect. Objectives: We herein describe five cases of patients with GSD IV with different ages of onset and outcomes as well as a novel GBE1 variant. Methods: This is a descriptive case series of patients receiving care for GSD IV at Reference Centers for Rare Diseases in Brazil and in the United States of America. Patients were selected based on confirmatory GBE1 genotypes performed after strong clinical suspicion. Results: Pt #1 is a Latin male with the chief complaints of hepatosplenomegaly, failure to thrive, and elevated liver enzymes starting at the age of 5 months. Before LT at the age of two, empirical treatment with corn starch (CS) and high protein therapy was performed with subjective improvement in his overall disposition and liver size. Pt #2 is a 30-month-old Afro-American descent patient with the chief complaints of failure to gain adequate weight, hypotonia, and hepatosplenomegaly at the age of 15 months. Treatment with CS was initiated without overall improvement of the symptoms. Pt #3.1 is a female Latin patient, sister to pt #3.2, with onset of symptoms at the age of 3 months with bloody diarrhea, abdominal distention, and splenomegaly. There was no attempt of treatment with CS. Pt #4 is an 8-year-old male patient of European descent who had his initial evaluation at 12 months, which was remarkable for hepatosplenomegaly, elevated ALT and AST levels, and a moderate dilatation of the left ventricle with normal systolic function that improved after LT. Pt #1, #3.2 and #4 presented with high levels of chitotriosidase. Pt #2 was found to have the novel variant c.826G > C p.(Ala276Pro). Conclusions: GSD IV is a rare disease with different ages of presentation and different cardiac phenotypes, which is associated with high levels of chitotriosidase. Attempts of dietary intervention with CS did not show a clear improvement in our case series.
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Affiliation(s)
- Matheus Vernet Machado Bressan Wilke
- Medical Genetics Service, Hospital de Clínicas de Porto Alegre, Ramiro Barcelos St., 2350, 3rd Floor, Porto Alegre 90035-903, Brazil
- Post Graduation Program Ciências da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre 90035-903, Brazil
| | - Bibiana Mello de Oliveira
- Medical Genetics Service, Hospital de Clínicas de Porto Alegre, Ramiro Barcelos St., 2350, 3rd Floor, Porto Alegre 90035-903, Brazil
- Post Graduation Program in Genetics and Molecular Biology, Universidade Federal do Rio Grande do Sul, Porto Alegre 90035-903, Brazil
| | - Rodrigo Tzovenos Starosta
- Division of Medical Genetics and Genomics, Washington University in Saint Louis, Saint Louis, MO 63130, USA
| | - Marwan Shinawi
- Division of Medical Genetics and Genomics, Washington University in Saint Louis, Saint Louis, MO 63130, USA
| | - Liang Lu
- Department of Pathology and Immunology, Washington University in Saint Louis, Saint Louis, MO 63130, USA
| | - Mai He
- Department of Pathology and Immunology, Washington University in Saint Louis, Saint Louis, MO 63130, USA
| | - Yamin Ma
- Department of Pathology and Immunology, Washington University in Saint Louis, Saint Louis, MO 63130, USA
| | - Janis Stoll
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Washington University in Saint Louis, Saint Louis, MO 63130, USA
| | - Carolina Fischinger Moura de Souza
- Medical Genetics Service, Hospital de Clínicas de Porto Alegre, Ramiro Barcelos St., 2350, 3rd Floor, Porto Alegre 90035-903, Brazil
- Postgraduate Program in Child and Adolescent Health, Universidade Federal do Rio Grande do Sul, Porto Alegre 90035-903, Brazil
- Correspondence:
| | - Ana Cecilia Menezes de Siqueira
- Treatment Center of Inborn Errors of Metabolism, Instituto de Medicina Integral Professor Fernando Figueira, Recife 50070-902, Brazil
| | | | - Carlos Thadeu Cerski
- Pathology Service, Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-903, Brazil
| | - Lilia Farret Refosco
- Medical Genetics Service, Hospital de Clínicas de Porto Alegre, Ramiro Barcelos St., 2350, 3rd Floor, Porto Alegre 90035-903, Brazil
| | - Ida Vanessa Doederlein Schwartz
- Medical Genetics Service, Hospital de Clínicas de Porto Alegre, Ramiro Barcelos St., 2350, 3rd Floor, Porto Alegre 90035-903, Brazil
- Post Graduation Program Ciências da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre 90035-903, Brazil
- Post Graduation Program in Genetics and Molecular Biology, Universidade Federal do Rio Grande do Sul, Porto Alegre 90035-903, Brazil
- Department of Genetics, Universidade Federal do Rio Grande do Sul, Porto Alegre 90035-903, Brazil
- BRAIN Laboratory, Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-903, Brazil
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Sreekantam S, Rizvi H, Brown R, Santra S, Raiman J, Vijay S, Mckiernan PJ, Gupte GL. An uncommon cause of early infantile liver disease and raised chitotriosidase. JIMD Rep 2020; 54:22-24. [PMID: 32685346 PMCID: PMC7358662 DOI: 10.1002/jmd2.12123] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 04/05/2020] [Accepted: 04/07/2020] [Indexed: 11/06/2022] Open
Abstract
Our subject presented at 11 months of age, following a varicella zoster infection, with acute on chronic liver disease and was found to have raised serum chitotriosidase. White cell enzyme analysis for Gaucher, Niemann Pick A, B and lysosomal acid lipase deficiency were normal. Niemann Pick type C (NPC) disease was considered as a provisional diagnosis and liver transplantation assessment deferred until recovery from varicella and results of mutational analysis of NPC gene were available. Liver biopsy at a later date showed findings suggestive of glycogen storage disease (GSD) type IV but he was too unstable for an urgent liver transplantation and sadly passed away at the age of 13 months. The classic hepatic subtype of glycogen storage disorder type IV (GSD IV) is a rare metabolic cause of early-onset liver disease and raised chitotriosidase. There are very few reports of raised chito in GSD IV. Liver transplantation has a favourable outcome for the hepatic subtype of GSD IV and early diagnosis in our subject could have potentially altered the outcome.
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Affiliation(s)
- Srividya Sreekantam
- Department of Clinical Inherited Metabolic DisordersBirmingham Women's and Children's Hospital NHS TrustUK
| | - Hina Rizvi
- Department of HepatologyBirmingham Women's and Children's Hospital NHS TrustUK
| | - Rachel Brown
- Department of HistopathologyBirmingham Women's and Children's Hospital NHS TrustUK
| | - Saikat Santra
- Department of Clinical Inherited Metabolic DisordersBirmingham Women's and Children's Hospital NHS TrustUK
| | - Julian Raiman
- Department of Clinical Inherited Metabolic DisordersBirmingham Women's and Children's Hospital NHS TrustUK
| | - Suresh Vijay
- Department of Clinical Inherited Metabolic DisordersBirmingham Women's and Children's Hospital NHS TrustUK
| | - Patrick J. Mckiernan
- Department of Gastroenterology, Hepatology, and NutritionChildren's Hospital of PittsburghPittsburghPennsylvaniaUSA
| | - Girish L. Gupte
- Department of HepatologyBirmingham Women's and Children's Hospital NHS TrustUK
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Szymańska E, Szymańska S, Truszkowska G, Ciara E, Pronicki M, Shin YS, Podskarbi T, Kępka A, Śpiewak M, Płoski R, Bilińska ZT, Rokicki D. Variable clinical presentation of glycogen storage disease type IV: from severe hepatosplenomegaly to cardiac insufficiency. Some discrepancies in genetic and biochemical abnormalities. Arch Med Sci 2018; 14:237-247. [PMID: 29379554 PMCID: PMC5778435 DOI: 10.5114/aoms.2018.72246] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Accepted: 06/26/2017] [Indexed: 12/20/2022] Open
Affiliation(s)
- Edyta Szymańska
- Department of Pediatrics, Nutrition and Metabolic Disorders, the Children’s Memorial Health Institute, Warsaw, Poland
| | - Sylwia Szymańska
- Department of Pathology, the Children’s Memorial Health Institute, Warsaw, Poland
| | - Grażyna Truszkowska
- Department of Medical Biology, Molecular Biology Laboratory, Institute of Cardiology, Warsaw, Poland
| | - Elżbieta Ciara
- Department of Medical Genetics, the Children’s Memorial Health Institute, Warsaw, Poland
| | - Maciej Pronicki
- Department of Pathology, the Children’s Memorial Health Institute, Warsaw, Poland
| | - Yoon S. Shin
- University Children’s Hospital and Molecular Genetics and Metabolism Laboratory, Munich, Germany
| | | | - Alina Kępka
- Department of Biochemistry, Radioimmunology and Experimental Medicine, the Children’s Memorial Health Institute, Warsaw, Poland
| | - Mateusz Śpiewak
- Cardiac Magnetic Resonance Unit, Institute of Cardiology, Warsaw, Poland
| | - Rafał Płoski
- Department of Medical Genetics, Centre of Biostructure, Medical University of Warsaw, Warsaw, Poland
| | - Zofia T. Bilińska
- Unit for Screening Studies in Inherited Cardiovascular Diseases, Institute of Cardiology, Warsaw, Poland
| | - Dariusz Rokicki
- Department of Pediatrics, Nutrition and Metabolic Disorders, the Children’s Memorial Health Institute, Warsaw, Poland
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Sharma A, Varghese AM, Vijaylakshmi K, Sumitha R, Prasanna VK, Shruthi S, Chandrasekhar Sagar BK, Datta KK, Gowda H, Nalini A, Alladi PA, Christopher R, Sathyaprabha TN, Raju TR, Srinivas Bharath MM. Cerebrospinal Fluid from Sporadic Amyotrophic Lateral Sclerosis Patients Induces Mitochondrial and Lysosomal Dysfunction. Neurochem Res 2015; 41:965-84. [DOI: 10.1007/s11064-015-1779-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2015] [Revised: 10/15/2015] [Accepted: 11/17/2015] [Indexed: 12/14/2022]
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