Martínez M, Romero MG, Guereta LG, Cabrera M, Regojo RM, Albajara L, Couce ML, de Pipaon MS. Infantile-onset Pompe disease with neonatal debut: A case report and literature review.
Medicine (Baltimore) 2017;
96:e9186. [PMID:
29390460 PMCID:
PMC5758162 DOI:
10.1097/md.0000000000009186]
[Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE
Infantile-onset Pompe disease, also known as glycogen storage disease type II, is a progressive and fatal disorder without treatment. Enzyme replacement therapy with recombinant human acid alpha-glucosidase (GAA) enhances survival; however, the best outcomes have been achieved with early treatment.
PATIENT CONCERNS
We report a case of a newborn with infantile-onset Pompe disease diagnosed in the first days of life who did not undergo universal neonatal screening. The patient was asymptomatic, with a general physical examination revealing only a murmur. The clinical presentation was dominated by the neonatal detection of hypertrophic cardiomyopathy, without hypotonia or macroglossia.
DIAGNOSES
Pompe disease was confirmed in the first week of life by GAA activity in dried blood spots, and a GAA genetic study showed the homozygous mutation p.Arg854X.
INTERVENTIONS
Parents initially refused replacement therapy.
OUTCOMES
The patient experienced recurrent episodes of ventricular fibrillation during central line placement and could not be resuscitated.
LESSONS
Although Pompe disease is rare, and universal screening has not been established, neonatologists should be alerted to the diagnosis of Pompe in the presence of hypertrophic cardiomyopathy. Diagnosis is achieved in a few days with the aid of dried blood spots.
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