eMedicine Specialties > Pediatrics: Genetics and Metabolic Disease > Metabolic Diseases
Galactokinase Deficiency: Differential Diagnoses & Workup
Updated: Sep 2, 2009
- Overview
- Differential Diagnoses & Workup
- Treatment & Medication
- Follow-up
- Multimedia
Differential Diagnoses
Galactose-1-Phosphate Uridyltransferase
Deficiency (Galactosemia)
Hypoparathyroidism
Oculocerebrorenal Dystrophy (Lowe
Syndrome)
Osteogenesis Imperfecta
Wilson Disease
Other Problems to Be Considered
Fabry disease
Myotonic dystrophy
Steroid administration
Workup
Laboratory Studies
- Clinitest
- Most hospitals use Clinitest in the diagnosis of galactokinase deficiency, the simplest laboratory test available to detect reducing sugars (eg, glucose, lactose, or fructose, which reduce copper salts in Clinitest tablets) in the urine.
- Always correlate a positive Clinitest result with a test specific for glucose, such as Clinistix. Alternatively, galactose may be identified directly with paper or gas chromatography. If galactose is found, galactose-1-phosphate concentration should also be measured to conclusively exclude transferase-deficient galactosemia.
- Definitive biochemical diagnosis is based on assessment of red cell galactokinase activity.
Imaging Studies
- No imaging studies are required.
Other Tests
- Once a definitive diagnosis is established, no further testing is needed.
Procedures
- No diagnostic procedures are required.
Histologic Findings
- No histologic findings are associated with galactokinase deficiency. Cataracts bear no distinguishing features that identify their etiology.
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| Overview: Galactokinase Deficiency |
Differential Diagnoses & Workup: Galactokinase Deficiency |
| Treatment & Medication: Galactokinase Deficiency |
| Follow-up: Galactokinase Deficiency |
| Multimedia: Galactokinase Deficiency |
| References |
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References
Cuthbert C, Klapper H, Elsas L. Diagnosis of inherited disorders of galactose metabolism. Curr Protoc Hum Genet. Jan 2008;Chapter 17:Unit 17.5. [Medline].
Park HD, Kim YK, Park KU, Kim JQ, Song YH, Song J. A novel c.-22T>C mutation in GALK1 promoter is associated with elevated galactokinase phenotype. BMC Med Genet. Mar 24 2009;10:29. [Medline].
Berry GT. The role of polyols in the pathophysiology of hypergalactosemia. Eur J Pediatr. 1995;154(7 Suppl 2):S53-64. [Medline].
Beutler E, Matsumoto F, Kuhl W, Krill A, Levy N, Sparkes R, et al. Galactokinase deficiency as a cause of cataracts. N Engl J Med. Jun 7 1973;288(23):1203-6. [Medline].
Bosch AM, Bakker HD, van Gennip AH, van Kempen JV, Wanders RJ, Wijburg FA. Clinical features of galactokinase deficiency: a review of the literature. J Inherit Metab Dis. Dec 2002;25(8):629-34. [Medline].
Gitzelmann R. Hereditary galactokinase deficiency, a newly recognized cause of juvenile cataracts. Pediatr Res. 1967;1:14-23.
Hunter M, Heyer E, Austerlitz F. The P28T mutation in the GALK1 gene accounts for galactokinase deficiency in Roma(Gypsy) patients across Europe. Pediatr Res. 2002;51:602-606.
Kerr MM, Logan RW, Cant JS, Hutchison JH. Galactokinase deficiency in a newborn infant. Arch Dis Child. Dec 1971;46(250):864-6. [Medline].
Levy NS, Krill AE, Beutler E. Galactokinase deficiency and cataracts. Am J Ophthalmol. Jul 1972;74(1):41-8. [Medline].
Pickering WR, Howell RR. Galactokinase deficiency: clinical and biochemical findings in a new kindred. J Pediatr. Jul 1972;81(1):50-5. [Medline].
Reich S, Hennerman J, Vetter B. An unexpectedly high frequency of hypergalactosemia in an immigrant Bosnian population revealed by newborn screening. Pediatr Res. 2002;51:598-601.
Sangiuolo F, Magnani M, Stambolian D. Biochemical characterization of two GALK1 mutations in patients with galactokinase deficiency. Hum Mutat. 2004;23:396.
Thalhammer O, Gitzelmann R, Pantlitschko M. Hypergalactosemia and galactosuria due to galactokinase deficiency in a newborn. Pediatrics. Sep 1968;42(3):441-5. [Medline].
Further Reading
Keywords
galactosemia II, GALK deficiency, cataracts, galactosuria, hexose sugar, galactose, glucose, hexokinase, galactosemia, galactose-1-phosphate uridyltransferase galactosemias, hexokinase, galactokinase deficiency, transferase-deficient galactosemia, galactose-related cataracts
Differential Diagnoses & Workup: Galactokinase Deficiency