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Jerves Serrano T, Gold J, Cooper JA, Church HJ, Tylee KL, Wu HY, Kim SY, Stepien KM. Hepatomegaly and Splenomegaly: An Approach to the Diagnosis of Lysosomal Storage Diseases. J Clin Med 2024; 13:1465. [PMID: 38592278 PMCID: PMC10932313 DOI: 10.3390/jcm13051465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 02/28/2024] [Accepted: 02/29/2024] [Indexed: 04/10/2024] Open
Abstract
Clinical findings of hepatomegaly and splenomegaly, the abnormal enlargement of the liver and spleen, respectively, should prompt a broad differential diagnosis that includes metabolic, congestive, neoplastic, infectious, toxic, and inflammatory conditions. Among the metabolic diseases, lysosomal storage diseases (LSDs) are a group of rare and ultrarare conditions with a collective incidence of 1 in 5000 live births. LSDs are caused by genetic variants affecting the lysosomal enzymes, transporters, or integral membrane proteins. As a result, abnormal metabolites accumulate in the organelle, leading to dysfunction. Therapeutic advances, including early diagnosis and disease-targeted management, have improved the life expectancy and quality of life of people affected by certain LSDs. To access these new interventions, LSDs must be considered in patients presenting with hepatomegaly and splenomegaly throughout the lifespan. This review article navigates the diagnostic approach for individuals with hepatosplenomegaly particularly focusing on LSDs. We provide hints in the history, physical exam, laboratories, and imaging that may identify LSDs. Additionally, we discuss molecular testing, arguably the preferred confirmatory test (over biopsy), accompanied by enzymatic testing when feasible.
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Affiliation(s)
| | - Jessica Gold
- Division of Genetics, Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA;
| | - James A. Cooper
- Willink Biochemical Genetics Laboratory, St Mary’s Hospital, Manchester University NHS Foundation Trust, Manchester M13 9WL, UK; (J.A.C.); (H.J.C.); (K.L.T.); (H.Y.W.)
| | - Heather J. Church
- Willink Biochemical Genetics Laboratory, St Mary’s Hospital, Manchester University NHS Foundation Trust, Manchester M13 9WL, UK; (J.A.C.); (H.J.C.); (K.L.T.); (H.Y.W.)
| | - Karen L. Tylee
- Willink Biochemical Genetics Laboratory, St Mary’s Hospital, Manchester University NHS Foundation Trust, Manchester M13 9WL, UK; (J.A.C.); (H.J.C.); (K.L.T.); (H.Y.W.)
| | - Hoi Yee Wu
- Willink Biochemical Genetics Laboratory, St Mary’s Hospital, Manchester University NHS Foundation Trust, Manchester M13 9WL, UK; (J.A.C.); (H.J.C.); (K.L.T.); (H.Y.W.)
| | - Sun Young Kim
- Division of Human Genetics, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati, Cincinnati, OH 45219, USA;
| | - Karolina M. Stepien
- Salford Royal Organization, Northern Care Alliance NHS Foundation Trust, Adult Inherited Metabolic Diseases Department, Salford M6 8HD, UK
- Division of Cardiovascular Sciences, University of Manchester, Manchester M13 9PL, UK
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Sheth J, Shah S, Datar C, Bhatt K, Raval P, Nair A, Jain D, Shah J, Sheth F, Sheth H. Late infantile form of multiple sulfatase deficiency with a novel missense variant in the SUMF1 gene: case report and review. BMC Pediatr 2023; 23:133. [PMID: 36959582 PMCID: PMC10037891 DOI: 10.1186/s12887-023-03955-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 03/15/2023] [Indexed: 03/25/2023] Open
Abstract
BACKGROUND Multiple sulfatase deficiency (MSD) is a rare lysosomal storage disorder caused due to pathogenic variants in the SUMF1 gene. The SUMF1 gene encodes for formylglycine generating enzyme (FGE) that is involved in the catalytic activation of the family of sulfatases. The affected patients present with a wide spectrum of clinical features including multi-organ involvement. To date, almost 140 cases of MSD have been reported worldwide, with only four cases reported from India. The present study describes two cases of late infantile form of MSD from India and the identification of a novel missense variant in the SUMF1 gene. CASE PRESENTATION In case 1, a male child presented to us at the age of 6 years. The remarkable presenting features included ichthyosis, presence of irritability, poor social response, thinning of corpus callosum on MRI and, speech regression. Clinical suspicion of MSD was confirmed by enzyme analysis of two sulfatase enzymes followed by gene sequencing. We identified a novel missense variant c.860A > T (p.Asn287Ile) in exon 7 of the SUMF1 gene. In case 2, a two and a half years male child presented with ichthyosis, leukodystrophy and facial dysmorphism. We performed an enzyme assay for two sulfatases, which showed significantly reduced activities thereby confirming MSD diagnosis. CONCLUSION Overall, present study has added to the existing data on MSD from India. Based on the computational analysis, the novel variant c.860A > T identified in this study is likely to be associated with a milder phenotype and prolonged survival.
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Affiliation(s)
- Jayesh Sheth
- FRIGE's Institute of Human Genetics, FRIGE House, Jodhpur Gam Road, Satellite, Ahmedabad, India.
| | - Siddharth Shah
- Royal Institute of Child Neurosciences, Vastrapur, Ahmedabad, India
| | - Chaitanya Datar
- Bharati Hospital and Research Centre, Dhankawadi, Pune, India
- KEM Hospital, Rasta Peth, Pune, India
| | - Kaveri Bhatt
- FRIGE's Institute of Human Genetics, FRIGE House, Jodhpur Gam Road, Satellite, Ahmedabad, India
| | - Pooja Raval
- FRIGE's Institute of Human Genetics, FRIGE House, Jodhpur Gam Road, Satellite, Ahmedabad, India
| | - Aadhira Nair
- FRIGE's Institute of Human Genetics, FRIGE House, Jodhpur Gam Road, Satellite, Ahmedabad, India
| | - Deepika Jain
- Shishu Child Development and Early Intervention Centre, Ahmedabad, India
| | - Jhanvi Shah
- FRIGE's Institute of Human Genetics, FRIGE House, Jodhpur Gam Road, Satellite, Ahmedabad, India
| | - Frenny Sheth
- FRIGE's Institute of Human Genetics, FRIGE House, Jodhpur Gam Road, Satellite, Ahmedabad, India
| | - Harsh Sheth
- FRIGE's Institute of Human Genetics, FRIGE House, Jodhpur Gam Road, Satellite, Ahmedabad, India
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Asiimwe N, Al Mazid MF, Jeong YT, Lee J, Lee JS. The discovery of penta-peptides inhibiting the activity of the formylglycine-generating enzyme and their potential antibacterial effects against Mycobacterium tuberculosis. RSC Adv 2022; 12:18884-18888. [PMID: 35873338 PMCID: PMC9241360 DOI: 10.1039/d2ra03379h] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 06/16/2022] [Indexed: 11/21/2022] Open
Abstract
The formylglycine-generating enzyme is a key regulator that converts sulfatase into an active form. Despite its key role in many diseases, enzyme activity inhibitors have not yet been reported. In this study, we investigated penta-peptide ligands for FGE activity inhibition and discovered two hit peptides. In addition, the lead peptides also showed potential antibacterial effects in a Mycobacterium tuberculosis model.
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Affiliation(s)
| | | | - Yong Taek Jeong
- Department of Pharmacology, Korea University College of Medicine South Korea
| | - Juyong Lee
- Department of Chemistry, Kangwon National University South Korea
| | - Jun-Seok Lee
- Department of Pharmacology, Korea University College of Medicine South Korea
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