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Priestley JR, Pace LM, Sen K, Aggarwal A, Alves CAP, Campbell IM, Cuddapah SR, Engelhardt NM, Eskandar M, Jolín García PC, Gropman A, Helbig I, Hong X, Gowda VK, Lusk L, Trapane P, Srinivasan VM, Suwannarat P, Ganetzky RD. Malate dehydrogenase 2 deficiency is an emerging cause of pediatric epileptic encephalopathy with a recognizable biochemical signature. Mol Genet Metab Rep 2022; 33:100931. [DOI: 10.1016/j.ymgmr.2022.100931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 10/21/2022] [Indexed: 11/18/2022] Open
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Albokhari D, Ng BG, Guberinic A, Daniel EJP, Engelhardt NM, Barone R, Fiumara A, Garavelli L, Trimarchi G, Wolfe L, Raymond KM, Morava E, He M, Freeze HH, Lam C, Edmondson AC. ALG8-CDG: Molecular and phenotypic expansion suggests clinical management guidelines. J Inherit Metab Dis 2022; 45:969-980. [PMID: 35716054 PMCID: PMC9474684 DOI: 10.1002/jimd.12527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 05/26/2022] [Accepted: 06/15/2022] [Indexed: 11/06/2022]
Abstract
Congenital disorders of glycosylation are a continuously expanding group of monogenic disorders of glycoprotein and glycolipid glycan biosynthesis. These disorders mostly manifest with multisystem involvement. Individuals with ALG8-CDG commonly present with hypotonia, protein-losing enteropathy, and hepatic involvement. Here, we describe seven unreported individuals diagnosed with ALG8-CDG based on biochemical and molecular testing and we identify nine novel variants in ALG8, bringing the total to 26 individuals with ALG8-CDG in the medical literature. In addition to the typical multisystem involvement documented in ALG8-CDG, our cohort includes the two oldest patients reported and further expands the phenotype of ALG8-CDG to include stable intellectual disability, autism spectrum disorder and other neuropsychiatric symptoms. We further expand the clinical features in a variety of organ systems including ocular, musculoskeletal, dermatologic, endocrine, and cardiac abnormalities and suggest a comprehensive evaluation and monitoring strategy to improve clinical management.
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Affiliation(s)
- Daniah Albokhari
- Department of Pediatrics, Division of Human Genetics, Section of Metabolism, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Pediatrics, Taibah University College of Medicine, Medina, Saudi Arabia
| | - Bobby G Ng
- Human Genetics Program, Sanford Burnham Prebys, La Jolla, California, USA
| | - Alis Guberinic
- Department of Clinical Genomics, Mayo Clinic, Rochester, Minnesota, USA
| | - Earnest James Paul Daniel
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Nicole M Engelhardt
- Department of Pediatrics, Division of Human Genetics, Section of Metabolism, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Rita Barone
- Department of Clinical and Experimental Medicine, Division of Child Neurology and Psychiatry, University of Catania, Catania, Italy
| | - Agata Fiumara
- Department of Clinical and Experimental Medicine, Pediatric Clinic, University of Catania, Catania, Italy
| | - Livia Garavelli
- Medical Genetics Unit, Mother and Child Department, Local Health Authority (AUSL) of Reggio Emilia Research Unit (IRCCS), Arcispedale Santa Maria Nuova, Reggio Emilia, Italy
| | - Gabriele Trimarchi
- Medical Genetics Unit, Mother and Child Department, Local Health Authority (AUSL) of Reggio Emilia Research Unit (IRCCS), Arcispedale Santa Maria Nuova, Reggio Emilia, Italy
| | - Lynne Wolfe
- NIH Undiagnosed Diseases Program, Common Fund, Office of the Director, National Institutes of Health, Bethesda, Maryland, USA
| | - Kimiyo M Raymond
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Eva Morava
- Department of Clinical Genomics, Mayo Clinic, Rochester, Minnesota, USA
| | - Miao He
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Hudson H Freeze
- Human Genetics Program, Sanford Burnham Prebys, La Jolla, California, USA
| | - Christina Lam
- Division of Genetic Medicine, Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA
- Center of Integrated Brain Research, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Andrew C Edmondson
- Department of Pediatrics, Division of Human Genetics, Section of Metabolism, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
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Alsharhan H, Ng BG, Daniel EJP, Friedman J, Pivnick EK, Al-Hashem A, Faqeih EA, Liu P, Engelhardt NM, Keller KN, Chen J, Mazzeo PA, Rosenfeld JA, Bamshad MJ, Nickerson DA, Raymond KM, Freeze HH, He M, Edmondson AC, Lam C. Expanding the phenotype, genotype and biochemical knowledge of ALG3-CDG. J Inherit Metab Dis 2021; 44:987-1000. [PMID: 33583022 PMCID: PMC8282734 DOI: 10.1002/jimd.12367] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 01/15/2021] [Accepted: 02/10/2021] [Indexed: 12/11/2022]
Abstract
Congenital disorders of glycosylation (CDGs) are a continuously expanding group of monogenic disorders of glycoprotein and glycolipid biosynthesis that cause multisystem diseases. Individuals with ALG3-CDG frequently exhibit severe neurological involvement (epilepsy, microcephaly, and hypotonia), ocular anomalies, dysmorphic features, skeletal anomalies, and feeding difficulties. We present 10 unreported individuals diagnosed with ALG3-CDG based on molecular and biochemical testing with 11 novel variants in ALG3, bringing the total to 40 reported individuals. In addition to the typical multisystem disease seen in ALG3-CDG, we expand the symptomatology of ALG3-CDG to now include endocrine abnormalities, neural tube defects, mild aortic root dilatation, immunodeficiency, and renal anomalies. N-glycan analyses of these individuals showed combined deficiencies of hybrid glycans and glycan extension beyond Man5 GlcNAc2 consistent with their truncated lipid-linked precursor oligosaccharides. This spectrum of N-glycan changes is unique to ALG3-CDG. These expanded features of ALG3-CDG facilitate diagnosis and suggest that optimal management should include baseline endocrine, renal, cardiac, and immunological evaluation at the time of diagnosis and with ongoing monitoring.
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Affiliation(s)
- Hind Alsharhan
- Department of Pediatrics, Division of Human Genetics,
Section of Metabolism, The Children’s Hospital of Philadelphia, Philadelphia,
Pennsylvania
- Department of Pathology and Laboratory Medicine,
Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
- Department of Pediatrics, Faculty of Medicine, Kuwait
University, Kuwait City, Kuwait
| | - Bobby G. Ng
- Human Genetics Program, Sanford Burnham Prebys Medical
Discovery Institute, La Jolla, California
| | - Earnest James Paul Daniel
- Department of Pathology and Laboratory Medicine,
Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Jennifer Friedman
- Division of Neurosciences and Pediatrics, University of
California San Diego and Rady Children’s Hospital, San Diego,
California
| | - Eniko K. Pivnick
- Department of Pediatrics, Division of Medical Genetics,
University of Tennessee Health Science Center (UTHSC), Memphis, Tennessee
| | - Amal Al-Hashem
- Department of Pediatrics, Prince Sultan Military Medical
City, Riyadh, Saudi Arabia
- College of Medicine, Alfaisal University, Riyadh, Saudi
Arabia
| | - Eissa Ali Faqeih
- Section of Medical Genetics, Children’s Specialist
Hospital King Fahad Medical City, Riyadh, Saudi Arabia
| | - Pengfei Liu
- Department of Molecular and Human Genetics, Baylor
College of Medicine, Houston, Texas
- Baylor Genetics Laboratories, Houston, Texas
| | - Nicole M. Engelhardt
- Department of Pediatrics, Division of Human Genetics,
Section of Metabolism, The Children’s Hospital of Philadelphia, Philadelphia,
Pennsylvania
| | - Kierstin N. Keller
- Department of Pediatrics, Division of Human Genetics,
Section of Metabolism, The Children’s Hospital of Philadelphia, Philadelphia,
Pennsylvania
| | - Jie Chen
- Department of Pathology and Laboratory Medicine,
Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Pamela A. Mazzeo
- Department of Pediatrics, The Children’s Hospital
of Philadelphia, Philadelphia, Pennsylvania
| | | | - Jill A. Rosenfeld
- Department of Molecular and Human Genetics, Baylor
College of Medicine, Houston, Texas
- Baylor Genetics Laboratories, Houston, Texas
| | - Michael J. Bamshad
- Division of Genetic Medicine, Department of Pediatrics,
University of Washington School of Medicine, Seattle, Washington
- Department of Genome Sciences, University of Washington,
Seattle, Washington
- Brotman-Baty Institute, Seattle, Washington
| | - Deborah A. Nickerson
- Department of Genome Sciences, University of Washington,
Seattle, Washington
- Brotman-Baty Institute, Seattle, Washington
| | - Kimiyo M. Raymond
- Department of Laboratory Medicine and Pathology, Mayo
Clinic, Rochester, Minnesota
| | - Hudson H. Freeze
- Human Genetics Program, Sanford Burnham Prebys Medical
Discovery Institute, La Jolla, California
| | - Miao He
- Department of Pathology and Laboratory Medicine,
Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Andrew C. Edmondson
- Department of Pediatrics, Division of Human Genetics,
Section of Metabolism, The Children’s Hospital of Philadelphia, Philadelphia,
Pennsylvania
| | - Christina Lam
- Division of Genetic Medicine, Department of Pediatrics,
University of Washington School of Medicine, Seattle, Washington
- Center of Integrated Brain Research, Seattle
Children’s Research Institute, Seattle, Washington
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