Vomiting, weakness and glyceroluria after eating dessert
10.3760/cma.j.issn.2095-428X.2018.20.012
- VernacularTitle:进食甜点后呕吐、乏力,伴甘油尿
- Author:
Rui KOU
1
;
Ying ZHANG
;
Ke LEI
;
Fei TIAN
;
Jing LIU
;
Hongxiu YANG
;
Zhihong CHEN
Author Information
1. 266003,青岛大学附属医院神经内分泌儿科
- Keywords:
Fructose-1,6-bisphosphatase deficiency;
Glyceroluria;
Hypoglycemia;
Acidosis
- From:
Chinese Journal of Applied Clinical Pediatrics
2018;33(20):1573-1577
- CountryChina
- Language:Chinese
-
Abstract:
During 2 years,a 6-year-old girl was hospitalized for 2 times with recurrent onset of episodes of vomiting,weakness and fever after eating dessert at the Department of Neurology & Endocrine Pediatrics,the Affiliated Hospital of Qingdao University.The arterial blood gas analysis revealed severe hypoglycemia,lacticacidemia and metabolic acidosis,the urine ketone body was positive.After intravenous infusion of glucose,bicarbonate and antibiotics,there was a dramatic clinical improvement in a short time.Physical examination showed tachypnea and mild hepatomegaly,and she had normal physical and mental development.The laboratory findings revealed transient hyperuricacidemia.Urine organic acids analysis repeatedly showed an elevation of lactic acid,ketone and glycerol.Glyceroluria was a very distinctive trait.The literatures in PubMed was searched with glyceroluria as keyword.Three related diseases were identified:FBPase deficiency,glycerol kinase (GK) deficiency and complex GK deficiency.Further reading of related literatures to understand the characteristics of diseases and laboratory tests,the clinical diagnosis of GK deficiency and complex GK deficiency was excluded.The mutation analysis of FBPase gene (FBP1) was performed by Sanger sequencing and a novel compound heterozygous mutations of c.355G ＞A and c.960delG was discovered.Full analysis of disease-related traits and targeted gene testing is one of the effective methods for accurate diagnosis and treatment of inherited metabolic disorders.
