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

GM1 Gangliosidosis: Treatment & Medication

Author: David H Tegay, DO, FACMG, Associate Professor of Medicine and Medical Genetics, New York College of Osteopathic Medicine at the New York Institute of Technology; Assistant Professor of Pediatrics, Stony Brook University Medical Center
Contributor Information and Disclosures

Updated: Jun 8, 2009

Treatment

Medical Care

  • Currently, no effective medical treatment is available for the underlying disorder in patients with G M1 gangliosidosis. Bone marrow transplantation was successful in an individual with infantile/juvenile GM1 gangliosidosis; however, no long-term benefit was reported.13 Presymptomatic cord-blood hematopoietic stem-cell transplantation has been advocated by some as a possible treatment because of success in other lysosomal storage disorders.14
  • Symptomatic treatment for some neurologic sequelae is available but does not significantly alter the clinical course.
  • Active research in the areas of enzyme replacement and gene therapy for GM1 gangliosidosis is ongoing but has not advanced to human trials.2

Consultations

  • Clinical geneticist - For initial evaluation and diagnosis, to counsel families regarding recurrence risk, and to help provide prenatal testing for future pregnancies
  • Neurologist - For symptomatic therapy of multiple neurologic sequelae
  • Cardiologist - To evaluate for cardiomyopathy
  • Orthopedist - To evaluate for dysostosis multiplex
  • Ophthalmologist - To evaluate for ocular stigmata
  • Otolaryngologist and audiologist - To assess for hearing loss15

Diet

  • No specific dietary modifications have been shown to significantly alter the clinical course.
  • Infants may ultimately require tube feeding to provide adequate intake of energy; however, nutritional support does not change the disease course, and some families may choose to forgo invasive alimentation procedures.

Activity

  • Neurologic and orthopedic sequelae may preclude adequate physical activity, and patients may benefit from physical and occupational therapy.

Medication

  • Currently, drug therapy is not a component of the standard of care for this condition.

More on GM1 Gangliosidosis

Overview: GM1 Gangliosidosis
Differential Diagnoses & Workup: GM1 Gangliosidosis
Treatment & Medication: GM1 Gangliosidosis
Follow-up: GM1 Gangliosidosis
References

References

  1. Suzuki Y, Oshima A, Nanba E. B-Galactosidase deficiency (B-Galactosidosis): GM1 gangliosidosis and Morquio B disease. In: Scriver CR, Sly WS, Valle D, et al, eds. The Metabolic and Molecular Bases of Inherited Disease. 8th ed. McGraw-Hill Professional; 2001:3775-810.

  2. Brunetti-Pierri N, Scaglia F. GM1 gangliosidosis: review of clinical, molecular, and therapeutic aspects. Mol Genet Metab. Aug 2008;94(4):391-6. [Medline].

  3. Suzuki K. Neuropathology of late onset gangliosidoses. A review. Dev Neurosci. 1991;13(4-5):205-10. [Medline].

  4. Muthane U, Chickabasaviah Y, Kaneski C, et al. Clinical features of adult GM1 gangliosidosis: report of three Indian patients and review of 40 cases. Mov Disord. Nov 2004;19(11):1334-41. [Medline].

  5. Roze E, Paschke E, Lopez N, et al. Dystonia and parkinsonism in GM1 type 3 gangliosidosis. Mov Disord. Oct 2005;20(10):1366-9. [Medline].

  6. Lenicker HM, Vassallo Agius P, Young EP, Attard Montalto SP. Infantile generalized GM1 gangliosidosis: high incidence in the Maltese Islands. J Inherit Metab Dis. Sep 1997;20(5):723-4. [Medline].

  7. Severini MH, Silva CD, Sopelsa A, et al. High frequency of type 1 GM1 gangliosidosis in southern Brazil. Clin Genet. Aug 1999;56(2):168-9. [Medline].

  8. Hanson M, Lupski JR, Hicks J, Metry D. Association of dermal melanocytosis with lysosomal storage disease: clinical features and hypotheses regarding pathogenesis. Arch Dermatol. Jul 2003;139(7):916-20. [Medline].

  9. Snow TM. Mongolian spots in the newborn: do they mean anything?. Neonatal Netw. Jan-Feb 2005;24(1):31-3. [Medline].

  10. Suzuki Y, Sakuraba H, Oshima A, et al. Clinical and molecular heterogeneity in hereditary beta-galactosidase deficiency. Dev Neurosci. 1991;13(4-5):299-303. [Medline].

  11. Chamoles NA, Blanco MB, Iorcansky S, et al. Retrospective diagnosis of GM1 gangliosidosis by use of a newborn-screening card. Clin Chem. Nov 2001;47(11):2068. [Medline][Full Text].

  12. Morrone A, Bardelli T, Donati MA, et al. Beta-galactosidase gene mutations affecting the lysosomal enzyme and the elastin-binding protein in GM1-gangliosidosis patients with cardiac involvement. Hum Mutat. 2000;15(4):354-66. [Medline].

  13. Shield JP, Stone J, Steward CG. Bone marrow transplantation correcting beta-galactosidase activity does not influence neurological outcome in juvenile GM1-gangliosidosis. J Inherit Metab Dis. 2005;28(5):797-8. [Medline].

  14. Wynn RF, Wraith JE, Mercer J, et al. Improved metabolic correction in patients with lysosomal storage disease treated with hematopoietic stem cell transplant compared with enzyme replacement therapy. J Pediatr. Apr 2009;154(4):609-11. [Medline].

  15. [Guideline] Cunningham M, Cox EO. Hearing assessment in infants and children: recommendations beyond neonatal screening. Pediatrics. Feb 2003;111(2):436-40. [Medline].

Further Reading

Keywords

GM1 gangliosidosis, acid beta-galactosidase-1 deficiency, GLB1 deficiency, Morquio disease type B, Norman-Landing disease, Landing disease, lysosomal storage disorder, ganglioside accumulation, oligosaccharide accumulation, mucopolysaccharide accumulation, keratan sulfate, dementia, coarse facial features, hepatosplenomegaly, generalized skeletal dysplasia, macular cherry-red spots, scoliosis, treatment, diagnosis

Contributor Information and Disclosures

Author

David H Tegay, DO, FACMG, Associate Professor of Medicine and Medical Genetics, New York College of Osteopathic Medicine at the New York Institute of Technology; Assistant Professor of Pediatrics, Stony Brook University Medical Center
David H Tegay, DO, FACMG is a member of the following medical societies: American College of Medical Genetics, American College of Osteopathic Internists, American College of Physicians, American Medical Association, American Osteopathic Association, American Society of Human Genetics, and Federation of American Societies for Experimental Biology
Disclosure: Nothing to disclose.

Medical Editor

Ian Krantz, MD, Department of Pediatrics, Assistant Professor, University of Pennsylvania and Children's Hospital of Philadelphia
Ian Krantz, MD is a member of the following medical societies: American Society of Human Genetics
Disclosure: Nothing to disclose.

Pharmacy Editor

Mary L Windle, PharmD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy, Pharmacy Editor, eMedicine
Disclosure: Pfizer Inc Stock Investment from financial planner; Avanir Pharma Stock Investment from financial planner ; WebMD Salary and stock Employment and investment from financial planner

Managing Editor

David Flannery, MD, FAAP, FACMG, Vice Chair of Education, Chief, Section of Medical Genetics, Professor, Department of Pediatrics, Medical College of Georgia
David Flannery, MD, FAAP, FACMG is a member of the following medical societies: American Academy of Pediatrics and American College of Medical 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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