eMedicine Specialties > Pediatrics: Genetics and Metabolic Disease > Metabolic Diseases

Glycogen-Storage Disease Type VI: Follow-up

Author: Lynne Ierardi-Curto, MD, PhD, Medical Geneticist, Laboratory Corporation of America (LabCorp), Northeast Division, Genetics Services
Contributor Information and Disclosures

Updated: Aug 4, 2008

Follow-up

Further Outpatient Care

  • Perform follow-up evaluation to assess physical growth and to prevent hypoglycemic episodes by adjusting diet, as needed.

Deterrence/Prevention

  • Instruct patients who exhibit episodes of fasting hypoglycemia to avoid prolonged fasts exceeding 5-7 hours.
  • During an acute illness with decreased oral intake, maintain normoglycemia with intravenous infusion of glucose-containing solution.

Prognosis

  • Patients have an excellent prognosis for normal stature and development, even without dietary management during childhood.
  • Most patients exhibit resolution of hepatomegaly, hypotonia, muscle weakness, risk of fasting hypoglycemia, and abnormal biochemical parameters before or at puberty.
  • The overall prognosis of rare variants with associated muscle or cardiac involvement depends on the severity of organ dysfunction.

Patient Education

  • Educate patients and parents about proper diet management and fasting avoidance techniques.
  • Parents and primary physicians of an affected child with episodes of fasting hypoglycemia should know how to administer intravenous glucose solutions during periods of acute illness with decreased oral intake.

Miscellaneous

Medicolegal Pitfalls

  • Failure to educate the family about the effects of fasting and decreased oral intake during acute illness in those patients with episodes of fasting hypoglycemia
 


More on Glycogen-Storage Disease Type VI

Overview: Glycogen-Storage Disease Type VI
Differential Diagnoses & Workup: Glycogen-Storage Disease Type VI
Treatment & Medication: Glycogen-Storage Disease Type VI
Follow-up: Glycogen-Storage Disease Type VI
References

References

  1. Chang S, Rosenberg MJ, Morton H. Identification of a mutation in liver glycogen phosphorylase in glycogen storage disease type VI. Hum Mol Genet. May 1998;7(5):865-70. [Medline].

  2. Burwinkel B, Rootwelt T, Kvittingen EA. Severe phenotype of phosphorylase kinase-deficient liver glycogenosis with mutations in the PHKG2 gene. Pediatr Res. 2003;54(6):834-839. [Medline].

  3. Burwinkel B, Amat L, Gray RG. Variability of biochemical and clinical phenotype in X-linked liver glycogenosis with mutations in the phosphorylase kinase PHKA2 gene. Hum Genet. Apr 1998;102(4):423-9. [Medline].

  4. Bashan N, Iancu TC, Lerner A. Glycogenosis due to liver and muscle phosphorylase kinase deficiency. Pediatr Res. Apr 1981;15(4 Pt 1):299-303. [Medline].

  5. Beauchamp NJ, Taybert J, Champion MP et al. High frequency of missense mutations in glycogen storage disease type VI. J Inherit Metab Dis. Oct 2007;30:722-734. [Medline].

  6. Burwinkel B, Bakker HD, Herschkovitz E. Mutations in the liver glycogen phosphorylase gene (PYGL) underlying glycogenosis type VI. Am J Hum Genet. Apr 1998;62(4):785-91. [Medline].

  7. Burwinkel B, Bakker HD, Herschkovitz E, et al. Mutations in the liver glycogen phosphorylase gene (PYGL) underlying glycogenosis type VI. Am J Hum Genet. Apr 1998;62(4):785-91. [Medline].

  8. Chen Y-T, Burchell A. Glycogen storage diseases. In: The Metabolic and Molecular Bases of Inherited Disease. Vol 1. 1995:935-65.

  9. Goldberg T, Slonim AE. Nutrition therapy for hepatic glycogen storage diseases. J Am Diet Assoc. Dec 1993;93(12):1423-30. [Medline].

  10. Hendrickx J, Bosshard NU, Willems P. Clinical, biochemical and molecular findings in a patient with X-linked liver glycogenosis followed for 40 years. Eur J Pediatr. Nov 1998;157(11):919-23. [Medline].

  11. Hendrickx J, Lee P, Keating JP. Complete genomic structure and mutational spectrum of PHKA2 in patients with x-linked liver glycogenosis type I and II. Am J Hum Genet. Jun 1999;64(6):1541-9. [Medline].

  12. Kotb MA, Abdallah HK, Kotb A. Liver glycogenoses: are they a possible cause of polyneuropathy? A cross-sectional study. J Trop Pediatr. Aug 2004;50(4):196-202. [Medline].

  13. Newgard CB, Fletterick RJ, Anderson LA. The polymorphic locus for glycogen storage disease VI (liver glycogen phosphorylase) maps to chromosome 14. Am J Hum Genet. Apr 1987;40(4):351-64. [Medline].

  14. Ozen H. Glycogen storage diseases: new perspectives. World J Gastroenterol. May 2007;13:2541-2553. [Medline].

  15. Tang NL, Hui J, Young E, et al. A novel mutation (G233D) in the glycogen phosphorylase gene in a patient with hepatic glycogen storage disease and residual enzyme activity. Mol Genet Metab. Jun 2003;79(2):142-5. [Medline].

  16. Willems PJ, Gerver WJ, Berger R. The natural history of liver glycogenosis due to phosphorylase kinase deficiency: a longitudinal study of 41 patients. Eur J Pediatr. Jan 1990;149(4):268-71. [Medline].

Further Reading

Keywords

glycogen storage disease type VI, Hers disease, Hers' disease, GSD, GSD VI, glycogenosis, liver phosphorylase deficiency, glycogen phosphorylase, liver phosphorylase, hepatic phosphorylase kinase, X-linked liver glycogenosis, type 6 glycogenosis, hepatophosphorylase deficiency glycogenosis, hypoglycemia, hyperketosis, growth retardation, hepatomegaly, hyperlacticacidemia, hyperuricemia, hyperlipidemia, renal tubule acidosis, phosphorylase kinase deficiency, severe cardiomyopathy, short stature

Contributor Information and Disclosures

Author

Lynne Ierardi-Curto, MD, PhD, Medical Geneticist, Laboratory Corporation of America (LabCorp), Northeast Division, Genetics Services
Disclosure: Nothing to disclose.

Medical Editor

Edward Kaye, MD, Vice President of Clinical Research, Genzyme Corporation
Edward Kaye, MD is a member of the following medical societies: American Academy of Neurology, American Society of Gene Therapy, American Society of Human Genetics, Child Neurology Society, and Society for Inherited Metabolic Disorders
Disclosure: Nothing to disclose.

Pharmacy Editor

Mary L Windle, PharmD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy, Pharmacy Editor, eMedicine.com, Inc
Disclosure: Pfizer Inc Stock Investment from broker recommendation; Avanir Pharma Stock Investment from broker recommendation

Managing Editor

Hagop Youssoufian, MD, MSc, Vice President of Clinical Research, ImClone Systems Incorporated
Hagop Youssoufian, MD, MSc is a member of the following medical societies: American Society for Clinical Investigation, American Society of Clinical Oncology, American Society of Hematology, and American Society of Human Genetics
Disclosure: Nothing to disclose.

CME Editor

Paul D Petry, DO, FACOP, FAAP, Consulting Staff, Freeman Pediatric Care, Freeman Health System
Paul D Petry, DO, FACOP, FAAP is a member of the following medical societies: American Academy of Osteopathy, American Academy of Pediatrics, American College of Osteopathic Pediatricians, and American Osteopathic Association
Disclosure: Nothing to disclose.

Chief Editor

Bruce Buehler, MD, Professor, Department of Pediatrics, Pathology and Microbiology, Executive Director, Hattie B Munroe Center for Human Genetics and Rehabilitation, University of Nebraska Medical Center
Bruce Buehler, MD is a member of the following medical societies: American Academy for Cerebral Palsy and Developmental Medicine, American Academy of Pediatrics, American Association on Mental Retardation, American College of Medical Genetics, American College of Physician Executives, American Medical Association, and Nebraska Medical Association
Disclosure: Nothing to disclose.

 
 
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