October - December 2019, Volume 15, Issue 4

Matei L, Teodorescu MI, Kozma A, Iordan Dumitru AD, Stoicescu SM, Carniciu S

Persistent Asymptomatic Severe Hypoglycaemia Due to Type 0A Glycogenosis - General and Oro-Dental Aspects

Acta Endo (Buc) 2019, 15 (4): 526-530
doi: 10.4183/aeb.2019.526

Background. Type 0 glycogenosis is a genetic metabolic disorder characterized by the absence of glycogen synthesis of hepatic synthase and hence of liver glycogen stores in normal amounts. It is an extremely rare condition. Case study. This case is a 5-year and 11-monthold female child with asymptomatic severe hypoglycemia in the last two years. During the admission and afterwards, an extensive panel of paraclinical and imaging investigations was carried out to diagnose and document the case, which led to the specific genetic test. The result was positive for 2 heterozygous mutations in the GYS2 gene (hepatic glycogen synthase), the p.547C> T mutation was pathogenic (class 1) and c.465del, frameshift likely pathogenic (class 2). In order to integrate the clinical picture of patients with this condition and to establish potential correlations regarding the specific aspects with the general development and the phenotype, the oro-dental status was investigated. Conclusion. The investigations showed a positive correlation with literature data in several respects: low stature, hypoglycemia with hyperketonemia but normal plasma lactate, postprandial and contradictory hyperglycemia, delayed bone development, etc. Oro-buco-maxillary aspects showed a slight delay in the dental eruption. Dietary therapy and stricter dental care and additional prophylaxis are required.

Keywords: Glycogen Storage Disease, GSD0a, glycogen-deficiency, hypoglycemia, dentistry, rare metabolic diseases.

Correspondence: Andrei Kozma MD, “Alessandrescu – Rusescu” National Institute for Mother and Child Health - Research Department in Social Pediatrics and Obstetrics, Bucharest, Romania, E-mail: dr.ka.mailbox@gmail.com