Glycogen storage disease type I

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Glycogen storage disease type I

Biochemistry

Biochemistry and metabolism

Glycolysis

Citric acid cycle

Electron transport chain and oxidative phosphorylation

Gluconeogenesis

Glycogen metabolism

Pentose phosphate pathway

Physiological changes during exercise

Amino acid metabolism

Nitrogen and urea cycle

Fatty acid synthesis

Fatty acid oxidation

Ketone body metabolism

Cholesterol metabolism

Metabolic disorders

Essential fructosuria

Hereditary fructose intolerance

Galactosemia

Pyruvate dehydrogenase deficiency

Glucose-6-phosphate dehydrogenase (G6PD) deficiency

Lactose intolerance

Glycogen storage disease type I

Glycogen storage disease type II (NORD)

Glycogen storage disease type III

Glycogen storage disease type IV

Glycogen storage disease type V

Leukodystrophy

Metachromatic leukodystrophy (NORD)

Krabbe disease

Gaucher disease (NORD)

Niemann-Pick disease types A and B (NORD)

Niemann-Pick disease type C

Fabry disease (NORD)

Tay-Sachs disease (NORD)

Mucopolysaccharide storage disease type 1 (Hurler syndrome) (NORD)

Mucopolysaccharide storage disease type 2 (Hunter syndrome) (NORD)

Cystinosis

Hartnup disease

Alkaptonuria

Ornithine transcarbamylase deficiency

Phenylketonuria (NORD)

Cystinuria (NORD)

Homocystinuria

Maple syrup urine disease

Abetalipoproteinemia

Familial hypercholesterolemia

Hypertriglyceridemia

Hyperlipidemia

Disorders of carbohydrate metabolism: Pathology review

Disorders of fatty acid metabolism: Pathology review

Dyslipidemias: Pathology review

Glycogen storage disorders: Pathology review

Lysosomal storage disorders: Pathology review

Disorders of amino acid metabolism: Pathology review

Assessments

Glycogen storage disease type I

Flashcards

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USMLE® Step 1 questions

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High Yield Notes

7 pages

Flashcards

Glycogen storage disease type I

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Questions

USMLE® Step 1 style questions USMLE

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A 6-month-old girl is brought to the pediatrician’s office for evaluation of an enlarged abdomen. Her parents state they have noticed a bulging, protuberant belly over the past several weeks. Her mother has also noticed she has been increasingly irritable in between her feedings, and she often wakes up crying at night and is only consoled with feedings. During her periods of irritability, the patient is often sweating, which resolves with feeding. She is exclusively breastfed. Her birth was unremarkable; however, she has not been able to sit up or crawl. Her weight is less than the 5th percentile for her age. Temperature is 36.4°C (97.5°F), pulse is 122/min, blood pressure is 86/62 mmHg, and respiratory rate is 48/min. Physical examination reveals a lethargic infant. Facial examination reveals a rounded “doll's face-like” features with enlarged cheeks. Abdominal examination reveals massive and firm hepatomegaly. Genetic testing is performed, revealing a nonsense mutation in the gene encoding the enzyme glucose-6-phosphatase. Which of the following laboratory findings can be expected in this patient, considering the most likely diagnosis? 

External References

First Aid

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Glucose-6-phosphatase

Von Gierke disease p. 85

Gout p. 477

Von Gierke disease p. 85

Hepatomegaly

Von Gierke disease p. 85

Hypoglycemia

Von Gierke disease p. 85

Triglycerides

Von Gierke disease p. 85

Uric acid

Von Gierke disease p. 85

Von Gierke disease p. 85

External Links

Transcript

Content Reviewers

Viviana Popa, MD

Contributors

Sean Watts, MD

Jung Hee Lee, MScBMC

Evan Debevec-McKenney

Salma Ladhani, MD

Glycogen storage disease type I, also called Von-Gierke’s disease, is a genetic disorder caused by a mutation in the glucose 6 phosphatase gene on chromosome 17.

The end result is that glycogen can’t be broken down into glucose in liver cells, so glucose metabolism goes awry, resulting in symptoms like low blood sugar, weakness and poor growth.

Glucose is such an important energy source, that our body stores excess glucose in liver cells and skeletal muscle cells in the form of glycogen.

Glycogen is basically an enormous molecule or polymer, that’s made up of glucose molecules linked together by glycosidic bonds.

And glycogen has a main chain, as well as multiple branches sprouting off of it.

These branches allow glycogen to be compact and also allow it to rapidly add and remove glucose to and from the big glycogen molecule.

Talk about a molecular sugar rush!

Now, glucose molecules are usually added to glycogen in response to insulin, which is secreted by the pancreas after meals.

That’s when there’s high blood sugar, or plenty of glucose floating around in the bloodstream.

So, it makes sense for some of this glucose to be stored as glycogen, right?

Now when it’s been a while after a meal, so when you’re fasting, blood sugar levels take a dip. In response, the pancreas secretes glucagon and the adrenal glands secrete epinephrine.

It turns out that glucagon tells the liver cells to break glycogen down into individual glucose molecules, and epinephrine tells skeletal muscle cells to do the same.

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