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Glycogen storage disease type III

Glycogen storage disease type III (GSD III) is an autosomal recessive metabolic disorder and inborn error of metabolism (specifically of carbohydrates) characterized by a deficiency in glycogen debranching enzymes.[3] It is also known as Cori's disease in honor of the 1947 Nobel laureates Carl Cori and Gerty Cori. Other names include Forbes disease in honor of clinician Gilbert Burnett Forbes (1915–2003), an American physician who further described the features of the disorder, or limit dextrinosis, due to the limit dextrin-like structures in cytosol.[2] Limit dextrin is the remaining polymer produced after hydrolysis of glycogen. Without glycogen debranching enzymes to further convert these branched glycogen polymers to glucose, limit dextrinosis abnormally accumulates in the cytoplasm.[5]

Not to be confused with Cori cycle.

Glycogen storage disease type III

Cori Disease, Debrancher Deficiency, Forbes Disease[1]

Hypotonia[2]

AGL gene mutation[3]

Biopsy, Elevated transaminases[4]

Currently no cure, Diet regime[4]

Glycogen is a molecule the body uses to store carbohydrate energy. Symptoms of GSD-III are caused by a deficiency of the enzyme amylo-1,6 glucosidase, or debrancher enzyme. This causes excess amounts of an abnormal glycogen to be deposited in the liver, muscles and, in some cases, the heart.

Signs and symptoms[edit]

Glycogen storage disease type III presents during infancy with hypoglycemia and failure to thrive. Clinical examination usually reveals hepatomegaly. Muscular disease, including hypotonia and cardiomyopathy, usually occurs later. The liver pathology typically regresses as the individual enter adolescence, as does splenomegaly, should the individual so develop it.[2]

(muscle or liver)

Biopsy

CBC

Ultrasound

mutation analysis (helps ascertain GSD III subtype)

DNA

IV (if oral route is inadvisable)

glucose

Nutritional specialist

(for osteoporosis/secondary complication)

Vitamin D

transplant (if complication occurs)

Hepatic

Treatment for glycogen storage disease type III may involve a high-protein diet, in order to facilitate gluconeogenesis. Additionally the individual may need:[2][1][10]

Mayorandan, Sebene; Meyer, Uta; Hartmann, Hans; Das, Anibh Martin (1 January 2014). . Orphanet Journal of Rare Diseases. 9: 196. doi:10.1186/s13023-014-0196-3. ISSN 1750-1172. PMC 4302571. PMID 25431232.

"Glycogen storage disease type III: modified Atkins diet improves myopathy"

Sentner, Christiaan P.; Hoogeveen, Irene J.; Weinstein, David A.; Santer, René; Murphy, Elaine; McKiernan, Patrick J.; Steuerwald, Ulrike; Beauchamp, Nicholas J.; Taybert, Joanna; Laforêt, Pascal; Petit, François M.; Hubert, Aurélie; Labrune, Philippe; Smit, G. Peter A.; Derks, Terry G. J. (22 April 2016). . Journal of Inherited Metabolic Disease. 39 (5): 697–704. doi:10.1007/s10545-016-9932-2. ISSN 0141-8955. PMC 4987401. PMID 27106217.

"Glycogen storage disease type III: diagnosis, genotype, management, clinical course and outcome"

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