Congenital Disorder of Glycosylation Id Presenting with Hyperinsulinemic Hypoglycemia and Islet Cell Hyperplasia

Context: Inborn errors in protein glycosylation, such as the congenital disorders of glycosylation (CDGs), generate multifaceted syndromes that impair many organ systems. We here report the diagnosis of the third known patient with CDG-Id. Results: The patient’s phenotype was extremely severe, and s...

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Published in:The journal of clinical endocrinology and metabolism 2005-07, Vol.90 (7), p.4371-4375
Main Authors: Sun, Liangwu, Eklund, Erik A., Chung, Wendy K., Wang, Chao, Cohen, Jason, Freeze, Hudson H.
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
Cells, Cultured
Endocrinopathies
Female
Fundamental and applied biological sciences. Psychology
Glycosylation
Humans
Hyperinsulinism - genetics
Hyperplasia
Hypoglycemia - genetics
Immunohistochemistry
Infant, Newborn
Islets of Langerhans - pathology
Mannosyltransferases - genetics
Medical sciences
Metabolism, Inborn Errors - genetics
Pregnancy
Vertebrates: endocrinology
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Summary:Context: Inborn errors in protein glycosylation, such as the congenital disorders of glycosylation (CDGs), generate multifaceted syndromes that impair many organ systems. We here report the diagnosis of the third known patient with CDG-Id. Results: The patient’s phenotype was extremely severe, and she succumbed at 19 d of age. Leading features included hyperinsulinemic hypoglycemia, and autopsy revealed islet cell hyperplasia with increased β-cell mass. Other features were a Dandy-Walker malformation, facial dysmorphisms, and profound hypotonia. The patient carried a novel homozygous point mutation (512G>A) in the hALG3 gene, which encodes a mannosyltransferase. Lentiviral complementation with wild-type hALG3 corrects the biochemical defect in the patient’s fibroblasts. Conclusions: Our findings underscore the importance of proper glycosylation in several major organ systems and emphasize that CDG should be ruled out in patients with persistent hyperinsulinemic hypoglycemia of unknown etiology.
ISSN:0021-972X
1945-7197
DOI:10.1210/jc.2005-0250