Clinical features and rare complications in 132 patients with hepatic glycogenosis

Abstract Background Glycogen storage diseases (GSDs) with liver involvement are classified into subtypes—types 0, Ia, and Ib; III, IV, VI, IX, and XIa, XIb, and XIc, depending on the deficient enzyme. Hypoglycemia and hepatomegaly (except type 0) are hallmarks of the disease; however, muscular and r...

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Main Authors: Deniz Kor, Fatma Derya Bulut, Burcu Köşeci, Esra Kara, Ezgi Burgaç, İrem Kaplan, Nazmiye Tüzel Gündüz, Halise Neslihan Önenli Mungan
Format: Article
Language:English
Published: BMC 2025-08-01
Series:Orphanet Journal of Rare Diseases
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Online Access:https://doi.org/10.1186/s13023-025-03783-4
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author Deniz Kor
Fatma Derya Bulut
Burcu Köşeci
Esra Kara
Ezgi Burgaç
İrem Kaplan
Nazmiye Tüzel Gündüz
Halise Neslihan Önenli Mungan
author_facet Deniz Kor
Fatma Derya Bulut
Burcu Köşeci
Esra Kara
Ezgi Burgaç
İrem Kaplan
Nazmiye Tüzel Gündüz
Halise Neslihan Önenli Mungan
author_sort Deniz Kor
collection DOAJ
description Abstract Background Glycogen storage diseases (GSDs) with liver involvement are classified into subtypes—types 0, Ia, and Ib; III, IV, VI, IX, and XIa, XIb, and XIc, depending on the deficient enzyme. Hypoglycemia and hepatomegaly (except type 0) are hallmarks of the disease; however, muscular and renal tubular involvement, dyslipidemia, and osteopenia can occur. The present study was conducted to highlight the clinical differences and characteristics between types, complications, and long-term outcomes in patients with hepatic GSD. Materials and Methods The records of 132 patients with hepatic GSD, confirmed through genetic analysis, were retrospectively reviewed. Results Of the 132 patients, 55.3% were male. The consanguinity rate was 75, and 53% of the patients had a family history. The age at diagnosis was 34.36 ± 35.1 months. The frequency distribution was as follows: GSD type III (42.4%), Ia (17.4%), IXa (9.1%), Ib (9.1%), IXc (7.6%), VI (6.8%), IXb (4.5%), IV (2.3%), and 0 (0.8%). The most common presenting symptoms were abdominal distention (40.9%), elevated liver transaminases (14.4%), hepatomegaly (13.6%), hypoglycemia (12.1%), family screening (12.1%), growth retardation (4%), and others (3.8%). Hepatomegaly was found in 84.9%, splenomegaly in 20.5%, short stature in 46.2%, underweight in 14.4%, and obesity in 13.5% of the patients. Non-hepatic malignancy was detected in three patients with GSD type III. The twin rate was 6.1%. The rate of short stature was 46.2% at the time of diagnosis, while it was 15.4% in patients who reached adulthood. The number of twin patients was higher than reported in the literature, and structural anomalies such as intestinal duplication cyst, renal artery stenosis, and pulmonary stenosis, which were not previously reported in association with GSD, along with non-hepatic malignancy, were notable findings in our study. Conclusions Liver glycogenosis can present distinct and similar clinical, laboratory, and radiological features, challenging differential diagnosis between types. Our study may guide diagnosing and monitoring common GSDs with hepatic involvement.
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spelling doaj-art-3f8dbdb42b90450f94e898f362afd81f2025-08-20T03:42:03ZengBMCOrphanet Journal of Rare Diseases1750-11722025-08-0120111510.1186/s13023-025-03783-4Clinical features and rare complications in 132 patients with hepatic glycogenosisDeniz Kor0Fatma Derya Bulut1Burcu Köşeci2Esra Kara3Ezgi Burgaç4İrem Kaplan5Nazmiye Tüzel Gündüz6Halise Neslihan Önenli Mungan7Department of Pediatric Metabolism and Nutrition, Çukurova UniversityDepartment of Pediatric Metabolism and Nutrition, Çukurova UniversityPediatric Metabolism Clinic, Adana City HospitalCengiz Gökçek Gynecology and Pediatrics Hospital, Pediatric Metabolism ClinicPediatric Metabolism Clinic, Adana City HospitalDepartment of Pediatric Metabolism and Nutrition, Çukurova UniversityDepartment of Pediatric Metabolism and Nutrition, Çukurova UniversityDepartment of Pediatric Metabolism and Nutrition, Çukurova UniversityAbstract Background Glycogen storage diseases (GSDs) with liver involvement are classified into subtypes—types 0, Ia, and Ib; III, IV, VI, IX, and XIa, XIb, and XIc, depending on the deficient enzyme. Hypoglycemia and hepatomegaly (except type 0) are hallmarks of the disease; however, muscular and renal tubular involvement, dyslipidemia, and osteopenia can occur. The present study was conducted to highlight the clinical differences and characteristics between types, complications, and long-term outcomes in patients with hepatic GSD. Materials and Methods The records of 132 patients with hepatic GSD, confirmed through genetic analysis, were retrospectively reviewed. Results Of the 132 patients, 55.3% were male. The consanguinity rate was 75, and 53% of the patients had a family history. The age at diagnosis was 34.36 ± 35.1 months. The frequency distribution was as follows: GSD type III (42.4%), Ia (17.4%), IXa (9.1%), Ib (9.1%), IXc (7.6%), VI (6.8%), IXb (4.5%), IV (2.3%), and 0 (0.8%). The most common presenting symptoms were abdominal distention (40.9%), elevated liver transaminases (14.4%), hepatomegaly (13.6%), hypoglycemia (12.1%), family screening (12.1%), growth retardation (4%), and others (3.8%). Hepatomegaly was found in 84.9%, splenomegaly in 20.5%, short stature in 46.2%, underweight in 14.4%, and obesity in 13.5% of the patients. Non-hepatic malignancy was detected in three patients with GSD type III. The twin rate was 6.1%. The rate of short stature was 46.2% at the time of diagnosis, while it was 15.4% in patients who reached adulthood. The number of twin patients was higher than reported in the literature, and structural anomalies such as intestinal duplication cyst, renal artery stenosis, and pulmonary stenosis, which were not previously reported in association with GSD, along with non-hepatic malignancy, were notable findings in our study. Conclusions Liver glycogenosis can present distinct and similar clinical, laboratory, and radiological features, challenging differential diagnosis between types. Our study may guide diagnosing and monitoring common GSDs with hepatic involvement.https://doi.org/10.1186/s13023-025-03783-4Glycogen storage diseaseLiver involvementNon-hepatic malignancy
spellingShingle Deniz Kor
Fatma Derya Bulut
Burcu Köşeci
Esra Kara
Ezgi Burgaç
İrem Kaplan
Nazmiye Tüzel Gündüz
Halise Neslihan Önenli Mungan
Clinical features and rare complications in 132 patients with hepatic glycogenosis
Orphanet Journal of Rare Diseases
Glycogen storage disease
Liver involvement
Non-hepatic malignancy
title Clinical features and rare complications in 132 patients with hepatic glycogenosis
title_full Clinical features and rare complications in 132 patients with hepatic glycogenosis
title_fullStr Clinical features and rare complications in 132 patients with hepatic glycogenosis
title_full_unstemmed Clinical features and rare complications in 132 patients with hepatic glycogenosis
title_short Clinical features and rare complications in 132 patients with hepatic glycogenosis
title_sort clinical features and rare complications in 132 patients with hepatic glycogenosis
topic Glycogen storage disease
Liver involvement
Non-hepatic malignancy
url https://doi.org/10.1186/s13023-025-03783-4
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