What is already known on this topic?Glycerol Kinase Deficiency (GKD) [OMIM 307030] is a rare X-linked recessive metabolic disorder, which is characterized biochemically by hyperglycerolaemia and glyceroluria. Mutations in the GK gene are the major causes of isolate GKD.
What this study adds?We report a novel splice-site mutation (c.1340 -2A>G) identified at GK gene analysis.
IntroductionGlycerol Kinase Deficiency (GKD) [OMIM 307030] is a rare X-linked recessive metabolic disorder, which is characterized biochemically by hyperglycerolemia and glyceroluria [1]. The clinical spectrum varies from asymptomatic and Central Nervous System (CNS) deterioration to severe developmental delay, and is found to be related with GK gene mutation. The gene (GK) is located on Xp21 and encodes a key enzyme in regulation of glycerol uptake and metabolism that catalyzes the phosphorylation of glycerol [2].GKD can be categorized into three types: Infantile GKD, Juvenile GKD and Adult GKD. The Infantile GKD, also called the complex GKD or Xp21 contiguous gene deletion syndrome, is the most common type of GK mutation, which is caused by a deletion of GK gene or the neighboring genes, the clinical manifestations depends on the deletion of the genes [3]. The juvenile GKD is called symptomatic GKD, with symptoms like episodic vomiting, acidemia and Central Nervous System (CNS) deterioration. The adult GKD is called asymptomatic GKD, which detected incidentally with pseudohypertriglyceridemia. The juvenile and adult GKD are also called isolated GKD, which mainly caused by point mutations in GK gene.In this case report, a Chinese patient clinically diagnosed with isolated glycerol kinase deficiency is detected to have a novel splice-site mutation in the GK gene, which leads to a skip of exon 17.
Case Report
General information and clinical manifestationsA 3-month-old male term infant was referred to hospital due to no weight gain for three months. He was born with uterine-incision delivery route due to malpresentation after a first pregnancy of a 27-year-old mother at 38 weeks of uncomplicated gestation. His Apgar score was 9 points at 5min, with birth weight 3250g and head circumference 32cm. The parents were nonconsanguineous.
Laboratory testsThe infant's serum triglyceride was 11.17mmol/l (normal range: 0.52-1.56mmol/l), and his urine analysis revealed increased urine glycerol. His serum cortisol level was 1.00μg/dl (normal range: 3.7-19.4μg/dl (8 am); 2.9-17.3μg/dl (4 pm)), testosterone was 1.02ng/ml (normal range:1.42-9.23ng/ml), lactate dehydrogenase was 275.5U/l (normal range: 109-245U/l), and creatine kinase was 77.0U/l (normal range: 24-190U/l).
Molecular studiesThe clinical and laboratory findings were consistent with the clinical diagnosis of isolated glycerol kinase deficiency. The proband and his mother were recruited at the Hunan Jiahui genetics hospital. The study was approved by the Ethics Committee of the State Key
AbstractGlycerol Kinase Deficiency (GKD) is a rare X-linked recessive metabolic disorder. Mutations in the G...