A patient with glycogen storage disease type Ia combined with chronic hepatitis B infection: a case report

BMC Medical Genetics

Jie Xia¹  Wenying Wang²  Yunjie Dan²  Guohong Deng²  Wenting Tan²  Rentao Yu³ 

[1] 0000 0004 1757 2259, grid.416208.9, Department of Infectious Diseases, Southwest Hospital, Army Medical University, 400038, Chongqing, China;0000 0004 1757 2259, grid.416208.9, Department of Infectious Diseases, Southwest Hospital, Army Medical University, 400038, Chongqing, China;0000 0004 1757 2259, grid.416208.9, Chongqing Key Laboratory of Infectious Diseases, Southwest Hospital, Army Medical University, 400038, Chongqing, China;0000 0004 1757 2259, grid.416208.9, Department of Infectious Diseases, Southwest Hospital, Army Medical University, 400038, Chongqing, China;0000 0004 1757 2259, grid.416208.9, Chongqing Key Laboratory of Infectious Diseases, Southwest Hospital, Army Medical University, 400038, Chongqing, China;Department of Respiratory, the General Hospital of Western Theater Command, 460000, Chengdu, China;

关键词: GSD Ia;    G6PC gene;    Growth retardation;    Chronic hepatitis B;   

DOI  :  10.1186/s12881-019-0816-9

来源: publisher

【 摘 要 】

BackgroundGlycogen storage disease type I (GSD I), also known as von Gierk disease, is a metabolic disorder leading to the excessive accumulation of glycogen and fat in organs, characterized by hepatomegaly, hypoglycemia, lactic acidemia, hyperlipidemia, hyperuricemia, puberty delay and growth retardation, which can be indicated by height, weight, blood glucose and blood lipids.Case presentationHere we present a 16-year-old male patient with GSD Ia complicated with hepatic adenoma and combined with hepatitis B. As a chronic hepatitis B patient, the patient was admitted to hospital in order to further clarify the nature of hepatic space occupancy because of suspicion of hepatocellular carcinoma. However, the imaging studies did not support hepatocellular carcinoma certainly. And by tracing his clinical history, we suggested that he might suffer from GSD I. Finally the diagnosis was confirmed by MRI (Gd-EOB-DTPA), liver biopsy and whole exome sequencing (WES).The WES discovered a homozygous point mutation at the exon 5 of G6PC gene at 17th chromosome, c.G648 T (p.L216 L, NM_000151, rs80356484). This pathogenic mutation causes CTG changing to CTT at protein 216. Though both codons encode leucine, this silent mutation creates a new splicing site 91 bp downstream of the authentic splice site. According to previous research, this mutation is a disease causal variant for GSD Ia, and has a high frequency among GSD patients in China and Japan.This patient was finally diagnosed as GSD Ia complicated with hepatic adenoma and combined with chronic hepatitis B, and received corn starch therapy immediately after GSD was suspected.After receiving corn starch therapy, the height and weight of the patient were increased, and the secondary sexual characteristics were developed, including beard, pubic hair and seminal emission. Unexpectedly, the liver adenomas were still increasing, and we did not find any cause to explain this phenomenon.ConclusionThis patient was diagnosed as GSD Ia combined with chronic hepatitis B, who responded to corn starch intervention. For childhood patients with hypoglycaemia, hyperlipidemia, puberty delay and growth retardation, GSD should be considered. Gene sequencing is valuable for the quick identification of GSD subtypes.

【 授权许可】

CC BY