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A clinical case of galactosemia type I in a child with a compound heterozygous mutation in the gene: C.267CG (p. Tyr89Term), C.563A (p.Gln188Arg)

https://doi.org/10.33667/2078-5631-2025-6-22-25

Abstract

Galactosemia is an orphan metabolic disease, the late diagnosis of which can lead to severe liver damage. A clinical case of galactosemia type I is presented. The disease manifested itself in the late neonatal period with vomiting, cholestatic liver damage, coagulopathy with hemorrhagic syndrome, and weight loss. A differential diagnosis was performed with necrotic enterocolitis and intestinal obstruction. The residual activity of the GALT enzyme corresponded to the biochemical variant, and did not correlate with the severe clinical picture. Against the background of lactose-free formula feeding, the child's condition improved. Genetic examination revealed two pathological mutations in the heterozygous state in exons 3 and 6 of the GALT gene. Catamnestic observation showed the formation of a delay in static-motor development in the child by the end of the first year of life.

About the Authors

A. V. Dmitriev
Ryazan State Medical University named after academician I.P. Pavlov
Russian Federation

Dmitriev Andrey V., DM Sci (habil.), Professor, Head of Pediatric Diseases with a Course in Hospital Pediatrics,

Ryazan.



N. V. Fedina
Ryazan State Medical University named after academician I.P. Pavlov
Russian Federation

Fedina Natalia V., PhD Med, Associate Professor at Dept of Pediatric Diseases with a Course in Hospital Pediatrics,

Ryazan.



R. A. Gudkov
Ryazan State Medical University named after academician I.P. Pavlov
Russian Federation

Gudkov Roman A., PhD Med, Associate Professor at Dept of Pediatric Diseases with a Course in Hospital Pediatrics,

Ryazan.



V. I. Petrova
Ryazan State Medical University named after academician I.P. Pavlov
Russian Federation

Petrova Valeria I., PhD Med, Associate Professor at Dept of Pediatric Diseases with a Course in Hospital Pediatrics,

Ryazan.



L. V. Bozhenova
Regional Children's Clinical Hospital named after N. V. Dmitrieva
Russian Federation

Bozhenova Larisa V., neonatologist at Dept of Pathology of Newborns, Premature Infants and Young Children,

Ryazan.



References

1. Kikuchi A., Voda Yu., Ahura T., Kure S. Discovery of GALM deficiency (galactosemia type IV) and the newborn screening system for galactosemia in Japan. Int. J. Neonatal screening. 2021; 7: 68. DOI: 10.3390/ijns7040068

2. Demirbas D., Coelho A. I., Rubio-Gozalbo M.E., Berry GT. Hereditary galactosemia. Metabolism. 2018; 83: 188–196. https://doi.org/10.1016/j.metabol.2018.01.025

3. Gudkov R. A., Dmitriyev A. V., Fedina N. V., Petrova V. I., Teryokhina T. A., Sologub A. E. Differential Diagnosis of Conjugated Hyperbilirubinemia in Infancy (Literature Review. I. P. Pavlov Russian Medical Biological Herald. 2024; 32 (2): 315–328. (In Russ.). DOI: 10.17816/PAVLOVJ188846

4. Squires R. H. Jr. Acute liver failure in children. Semin Liver Dis. 2008; 28 (2):153–166. DOI: 10.1055/s-2008–1073115.

5. Rokaitė R., Traberg R., Dženkaitis M., Kučinskienė R., Labanauskas L. Two Lithuanian Cases of Classical Galactosemia with a Literature Review: A Novel GALT Gene Mutation Identified. Medicina (Kaunas). 2020; 56 (11): 559. DOI: 10.3390/medicina56110559

6. Applebaum MN, Thaler MM. Reversibility of extensive liver damage in galactosemia. Gastroenterology. 1975; 69 (2): 496–502.

7. Vitiello L, De Bernardo M, Guercio Nuzio S, Mandato C, Rosa N, Vajro P. Pediatric liver diseases and ocular changes: What hepatologists and ophthalmologists should know and share with each other. Dig Liver Dis. 2020; 52 (1): 1–8. DOI: 2019.11.009

8. Koss K., Doran., Ovoye S. et al. Classical galactosemia in Ireland: morbidity, complications and treatment results. J Inherit Metab Dis. 2013; 36:21–27.

9. Porta F., Pagliardini S., Pagliardini V. et al. Newborn screening for galactosemia: 30 years of experience in one center. The world of J. Pediatrician. 2015; 11: 160–164. DOI: 10.1007/S12519-015-0017-3

10. Demirbas D., Coelho A. I., Rubio-Gozalbo M.E., Berry G. T. Hereditary galactosemia. Metabolism. 2018 Jun; 83: 188–196. DOI: 10.1016/j.metabol.2018.01.025

11. Voskoboeva E. Yu., Baidakova G. V., Denisenkov A. I. et al. Galactosemia in Russia: molecular genetic features, neonatal screening, confirmatory diagnosis. Medical genetics. 2009; 6 (84): 25–33.

12. Berry G. T. Classical galactosemia and the clinical variant of galactosemia. In: Adam M., Mirza G. M., et al. Reviews of genes. University of Washington; Seattle, Washington, USA: 2000. PP. 1993–2022.

13. Calderon F. R., Phansalkar A. R., Crockett D. K., Miller M., Mao R. Mutation database for the galactose-1-phosphate uridyltransferase (GALT) gene. Hum Mutat. 2007; 28 (10): 939–943.

14. Bosch AM. Galactosaemia – should it be screened in newborns? Dev Period Med. 2018; 22 (3): 221–224. DOI: 10.34763/devperiodmed.20182203.221224

15. Almenabawy N., Bahl S., Ostlund A. L., Ghai-Jain S., Sosova I., Chan A., Mercimek-Andrews S. Clinical and biochemical phenotypes, genotypes, and long-term outcomes of individuals with galactosemia type I from a single metabolic genetics center in Alberta. Mol Genet Metab Rep. 2024; 38: 101055. https://doi.org/10.1016/j.ymgmr.2024.101055.

16. Kotb M. A., Mansour L., William Shaker Basanti C., El Garf W, Ali GIZ, Mostafa El Sorogy S. T., Kamel IE.M, Kamal N. M. Pilot study of classic galactosemia: Neurodevelopmental impact and other complications urge neonatal screening in Egypt. JAdvRes. 2018; Feb 23; 12: 39–45. https://doi.org/10.1016/j.jare.2018.02.001

17. Therrell B. L. Jr., Lloyd-Puryear M.A., Camp K. M., Mann MY. Inborn errors of metabolism identified via newborn screening: ten-year incidence data and costs of nutritional interventions for research agenda planning. MolGenetMetab 2014; 113: 14–26.

18. Petrova E. I. Health of pregnant women, women in labor, women in labor and newborns (based on materials from the Ryazan region. Science of the young (Eruditio Juvenium). 2013; 2: 53–58.

19. Choi R., Jo K.I., Ko D.H. et al. Novel GALT variations and mutation spectrum in the Korean population with decreased galactose-1-phosphate uridyltransferase activity. BMC Med Genet 15, 94 (2014). https://doi.org/10.1186/s12881-014-0094-5

20. Rokaitė R, Traberg R, Dženkaitis M, Kučinskienė R, Labanauskas L. Two Lithuanian Cases of Classical Galactosemia with a Literature Review: A Novel GALT Gene Mutation Identified. Medicina (Kaunas). 2020 Oct 25; 56 (11): 559. DOI: 10.3390/medicina56110559. PMID: 33113773; PMCID: PMC 7693318.

21. Ohlsson A, Hunt M, Wedell A, von Döbeln U. Heterogeneity of disease-causing variants in the Swedish galactosemia population: Identification of 16 novel GALT variants. J Inherit Metab Dis. 2019 Sep; 42 (5): 1008–1018. DOI: 10.1002/jimd.12136. Epub 2019 Aug 12. PMID: 31194895.

22. Maroulis V, Agathangelidis A, Skouma A, Sdogou T, Papadakis MN, Papakonstantinou E, Girginoudis P, Vorgias CE, Aleporou V, Kollia P. Molecular characterization of novel and rare DNA variants in patients with galactosemia. Front Genet. 2023 Nov 27; 14: 1266353. DOI: 10.3389/fgene.2023.1266353. PMID: 38090149; PMCID: PMC 10711677.

23. Voskoboeva E. Y., Baidakova G. V., Denisenkov A. I. et al. Galactosemia in Russia: the molecular genetic characteristics, neonatal screening, confirming the diagnosis. Med gen 2009; 8 (6): 25–33. (In Russ.).

24. Clinical guidelines. Galactose metabolism disorders (Galactosemia). Year of approval: 2021. IDKR 375/3. Approved by the Scientific and Practical Council of the Ministry of Health of the Russian Federation. (In Russ.). http://cr.rosminzdrav.ru/recomend/375_3 (date of access: 08/31/2021).


Review

For citations:


Dmitriev A.V., Fedina N.V., Gudkov R.A., Petrova V.I., Bozhenova L.V. A clinical case of galactosemia type I in a child with a compound heterozygous mutation in the gene: C.267CG (p. Tyr89Term), C.563A (p.Gln188Arg). Medical alphabet. 2025;(6):22-25. (In Russ.) https://doi.org/10.33667/2078-5631-2025-6-22-25

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ISSN 2078-5631 (Print)
ISSN 2949-2807 (Online)