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[The myocardiopathies of glycogenosis].

Thirty-three patients with glycogen abnormalities and myocardial disease were studied. 27 of them has type II glycogen disorders (Pompe's disease, with an intralysozymal deficit of acid maltase) and 6 with type III glycogen disorders Forbes disease, with a deficit in amylo-1-6-glucosidase). The picture of a type II abnormality in the infant is very standard: early onset, often neonatally; the association with asystole and muscular hypotonia and a characteristics clinical picture; invariable cardiomegaly and typical ECG findings (short PR interval, high voltage complexes). Death occurs before one year of age, treatment has limited effect, and attention is centred on the early discovery of heterozygotes and of diagnosis antenatally. The possibility of an obstructive type (4 out of 24) and a type with endocardial fibroelastosis (3 out of 24) must be emphasised. In the late onset myopathic form of type II disorder (3 cases), involvement of the myocardium is always found, but is of secondary importance in determining the clinical picture and natural history. The same can be said of type III disorders in which, despite the infrequency of asystole or significant cardiomegaly, a hypertrophic cardiomyopathy which may be obstructive can lead to sudden death in infancy (2 cases out of 6).

Angiocardiography↗

[Hepatic adenoma and hepatocellular carcinoma in 3 brothers with type I glycogenosis].

We report 2 cases of type I glycogen storage disease (Von Gierke's disease) discovered in 2 brothers at the age of 7 and 5 years, respectively. Both developed hepatic adenoma at the age of 19 and 17. Hepatocellular carcinoma occurred in the older brother the discovery of adenoma 4 years after. The frequency of these tumors in patients with type I glycogen storage disease raises problems concerning the treatment and modality of regular surveillance of the liver in these patients. The policy for the detection and treatment of these tumors, and particularly the indications for liver transplantation are discussed.

Adenoma↗

[Round liver lesions in type I glycogenosis].

We report a 24 year follow-up of a patient with type 1 glycogen storage disease with new development of adenoma of the liver. The diagnostic and therapeutic consequences are discussed.

Adult↗

[Focal peliosis of the adult liver in combination with glycogenosis type I (v.Gierke). A case report and review of the recent literature].

Peliosis hepatis is a condition characterized by blood-filled lesions in the liver that can be localized or diffuse in distribution. The predisposing factors for this condition include treatment with anabolic steroids, chemotherapeutic and oral contraceptive agents, catabolic metabolic conditions (e.g., hypoglycemia) and certain immunological disorders. This disease probably represents a non-specific immunological response to a variety of noxious agents and has been successfully induced in experimental animals. The increased tendency towards liver rupture following blunt trauma and resuscitation procedures may have important medicolegal consequences. We present a case of peliosis hepatis in a patient with type I glycogen storage disease (von Gierke).

Adult↗

[Clinical follow-up in the adult (myopathic) form of glycogenosis type II].

Adult acid maltase deficiency (AMD, glycogen storage disease type II) may involve respiratory muscles leading to severe respiratory failure even before the affection of pelvic girdle muscles has turned the patient non-ambulatory. The case of a 29-year-old woman is presented to demonstrate that long-term survival is possible even after acute respiratory failure has occurred. The examination of the patient's family revealed the diagnosis of AMD in her 24-year-old sister, so far without clinical symptoms. The comparison between the two patients of serum enzyme elevations (CK, LDH, GOT, GPT, aldolase) suggested that both physical activity and the stage of the disease may be correlated with the degree of enzyme level elevation.

Adult↗