Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Perinatal/Neonatal Case Presentation
  • Published:

Perinatal/Neonatal Case Presentation

Neonatal presentation of lethal neuromuscular glycogen storage disease type IV

Abstract

A total of 11 types of glycogen storage disorders have been recognized with variable clinical presentations. Type IV, also known as Andersen disease, represents a rare subtype that can induce severe clinical findings early in life. We report on a patient with early fetal onset of symptoms with severe neuromuscular findings at birth. The pregnancy was further complicated by polyhydramnios and depressed fetal movement. At birth severe hypotonia was noticed requiring active resuscitation and then mechanical ventilation. His lack of expected course for hypoxic ischemic encephalopathy prompted genetic testing, including a muscle biopsy, which confirmed the diagnosis of glycogen storage disease IV (GSD IV). Mutation analysis of the glycogen branching enzyme 1 gene demonstrated a previously unrecognized mutation. We review recent information on early presentation of GSD IV with particular interest in the presentation of the neonatal lethal neuromuscular form of this rare disorder.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Figure 1

Similar content being viewed by others

References

  1. Akman HO, Karadimas C, Gyftodimou Y, Grigoriadou M, Kokotas H, Konstantinidou A et al. Prenatal diagnosis of glycogen storage disorder type IV. Prenat Diagn 2006; 26: 951–955.

    Article  CAS  Google Scholar 

  2. Willot S, Marchand V, Rasquin A, Alvarez F, Martin SR . Systemic progression of type IV glycogen storage disease after liver transplantation. J Pediatr Gastroenterol Nutr 2010; 51: 661–664.

    Article  Google Scholar 

  3. Moses SW, Pavari R . The variable presentations of glycogen storage disease type IV: a review of clinical, enzymatic and molecular studies. Curr Mol Med 2002; 2: 177–188.

    Article  CAS  Google Scholar 

  4. Asserto A, van Diggelen OP, Diogo L, Morava E, Cassandrini D, Carreira I et al. Null mutations and lethal congenital form of glycogen storage disease type IV. BBRC 2007; 361: 445–450.

    Google Scholar 

  5. L’hermine-Coulomb A, Beuzen F, Bouvier R, Rolland MO, Froissart R, Menez F et al. Fetal type IV glycogen storage disease: clinical, enzymatic and genetic data of a pure muscular form with variable and early antenatal manifestations in the same family. Am J Med Genet 2005; 139A: 118–122.

    Article  Google Scholar 

  6. Konstantinidou AE, Anninos H, Gyftodimou Y, Petersen MB, Karadimas C, Fotopoulos S et al. Neonatal neuromuscular variant of glycogen storage disease type IV: histopathological findings leading to the diagnosis. Histopathology 2006; 48: 869–886.

    Article  Google Scholar 

  7. Janecke AR, Dertinger S, Ketelsen UP, Bereuter L, Simma B, Müller T et al. Neonatal type IV glycogen storage disease associated with “null” mutations in glycogen branching enzyme 1. J Pediatr 2004; 145: 705–709.

    Article  CAS  Google Scholar 

  8. Van Noort G, Straks W, Van Diggelen OP, Hennekam RCM . A congenital variant of glycogenesis type IV. Padiatr Path 1993; 13: 685–698.

    Article  CAS  Google Scholar 

  9. Giuffre B, Parini R, Rizzuti T, Morandi L, van Diggelen OP, Bruno C et al. Severe neonatal onset of glycogenesis type IV: clinical and laboratory findings leading to diagnosis in two siblings. J Inherit Metab Disord 2004; 27: 609–619.

    Article  CAS  Google Scholar 

  10. Maruyama K, Suzuki T, Koizumi T, Sugie H, Fukuda T, Ito M et al. Congenital form of glycogen storage disease type IV: a case report and a review of the literature. Pediatr Int 2004; 46: 474–477.

    Article  Google Scholar 

  11. Tang TT, Segura AD, Chen YT, Ricci LM, Franciosi RA, Splaingard ML et al. Neonatal hypotonia and cardiomyopathy secondary to type IV glycogenosis. Acta Neuropathol 1994; 87: 531–536.

    Article  CAS  Google Scholar 

  12. Nambu M, Kawabe K, Fukuda T, Okuno TB, Ohta S, Nonaka I et al. A neonatal form of glycogen storage disease type IV. Neurology 2003; 61: 392–394.

    Article  CAS  Google Scholar 

  13. Zellweger H, Mueller S, Ionasescu V, Schochet SS, McCormick WF . Glycogenosis IV: a new cause of infantile hypotonia. J Pediatr 1972; 80: 5.

    Article  Google Scholar 

  14. Alegria A, Martins E, Dias M, Cunha A, Cardoso ML, Maire I . Glycogen storage disease type IV presenting as hydrops fetalis. J Inher Metab Disord 1999; 22: 330–332.

    Article  CAS  Google Scholar 

  15. Cox PM, Brueton LA, Murphy KW, Worthington VC, Bjelogrlic P, Lazda EJ et al. Early-onset fetal hydrops and muscle degeneration in siblings due to a novel variant of type IV glycogenosis. Am J Med Genet 1999; 86: 187–193.

    Article  CAS  Google Scholar 

  16. Nolte KW, Janecke AR, Vorgerd M, Weis J, Schroder JM . Congenital type IV glycogenosis: the spectrum of pleiomorphic polyglucosan bodies in muscle, nerve and spinal cord with two novel mutations in the GBE1 gene. Acta Neuropathol 2008; 116: 491–506.

    Article  CAS  Google Scholar 

  17. Raju GP, Li HC, Bali DS, Chen YT, Urion DK, Lidov HG et al. A case of congenital glycogen storage disease type IV with a novel GBE1 mutation. J Child Neurol 2008; 23: 349–352.

    Article  Google Scholar 

  18. Tay SKH, Akman HO, Chung WK, Pike MG, Muntoni F, Hays AP et al. Fatal infantile neuromuscular presentation of glycogen storage disease type IV. Neuromuscul Disord 2004; 14: 253–260.

    Article  Google Scholar 

  19. Konstantinidou AS, Anninos H, Dertinger S, Nonni A, Petersen M, Karadimas C et al. Placental involvement in glycogen storage disease type IV. Placenta 2008; 29: 378–381.

    Article  CAS  Google Scholar 

  20. Shin YS, Steiguber H, Klemm P, Endres W, Schwab O, Wolff G . Branching enzyme in erythrocytyes. Detection of type IV glycogenosis homozygotes and heterozygotes. J Inher Metab Disord 1988; 11 (Suppl 2): 252–254.

    Article  Google Scholar 

Download references

Acknowledgements

We would like to thank Dr David Weaver for reviewing this manuscript and for his excellent advice.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to L F Escobar.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Escobar, L., Wagner, S., Tucker, M. et al. Neonatal presentation of lethal neuromuscular glycogen storage disease type IV. J Perinatol 32, 810–813 (2012). https://doi.org/10.1038/jp.2011.178

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/jp.2011.178

Keywords

Search

Quick links