Glycogen Storage Disease Type Ia, Different Clinical Manifestations and Outcome: A Case Series

Document Type : Case Report

Authors

1 Children Growth Disorder Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

2 Department of Pediatrics, Shahid Sadoughi Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

3 Mother and Newborn Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

4 Department of Biology, Faculty of Science, Yazd University, Yazd, Iran

Abstract

Background: Conversion of glucose-6-phosphate to glucose is the final step in both glycogenolysis and gluconeogenesis. In glycogen storage disease type Ia (GSD type Ia), decreased activity of the enzyme glucose-6-phosphatase leads to an increased concentration of glucose-6-phosphate within the hepatocytes and shunting into alternative pathway with the following consequences: hyperlactatemia, hyperuricemia and hypertriglyceridemia. Patients develop hypoglycemia within 3 to 4 hours after a meal.
Case Report: We reported four patients with GSD type Ia with different clinical manifestations such as hypoglycemia, hepatomegaly, lactic acidosis, hyperchylomicronemia, and hyperuricemia and also described their prognosis.
Conclusion: Previously, many children with GSD Ia died in infancy or early childhood. Recurrent severe hypoglycemia can cause brain damage, but the prognosis has improved dramatically with early diagnosis and long term maintenance of optimal metabolic control.

Keywords


  1. Parikh NS, Ahlawat R. Glycogen storage disease type I. [Online]. [cited 2022 Jan]; Available from: URL:
    https://pu/bmed.ncbi.nlm.nih.gov/30480935/
  2. Cederbaum SD, Berry GT. Inborn errors of carbohydrate, ammonia, amino acid, and organic acid metabolism. In: Avery ME, editor. Avery’s diseases of the newborn. Philadelphia, PA: W.B. Saunders; 2012. p. 215-38.
  3. Saudubray JM, Baumgartner MR, Walter JH. Inborn metabolic diseases. 5th ed. Berlin/Heidelberg, Germany: Springer; 2011. p. 117-26.
  4. Derks TGJ, Rodriguez-Buritica DF, Ahmad A, de Boer F, Couce ML, Grünert SC, et al. Glycogen storage disease type Ia: Current management options, burden and unmet needs. Nutrients 2021; 13(11): 3828.
  5. Kliegman RM, Geme JW. Nelson textbook of pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2019. p. 778-81.
  6. Niba ETE, Wijaya YOS, Awano H, Taniguchi N, Takeshima Y, Nishio H, et al. DBS screening for glycogen storage disease type 1a: Detection of c.648G>T mutation in G6PC by combination of modified competitive oligonucleotide priming-PCR and melting curve analysis. Int J Neonatal Screen 2021; 7(4): 79.
  7. Li X, Jing H, Cheng L, Xia J, Wang J, Li Q, et al. A case study of glycogen storage disease type Ia presenting with multiple hepatocellular adenomas: an analysis by gadolinium ethoxybenzyl-diethylenetriamine-pentaacetic acid magnetic resonance imaging. Quant Imaging Med Surg 2021; 11(6): 2785-91.
  8. Sarafoglou K, Hoffmann GF, Roth KS. Pediatric endocrinology and inborn errors of metabolism. 2nd ed. Philadelphia, PA: McGraw Hill; 2017.