Human pathology

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glycogenosis type 3

MIM.232400 1p21

glycogen storage disease type III, Forbe disease, limit dextrinosis, GSD type 3

Autosomal recessive metabolic disease.

Synopsis

- short stature
- growth retardation
- midface hypoplasia
- deep-set eyes
- depressed nasal bridge
- broad upturned nasal tip
- bow-shaped lips
- thin vermillion border
- cardiomyopathy
- ventricular hypertrophy on ECG

- hepatic anomalies

  • hepatomegaly
  • hepatic fibrosis
  • glycogen hepatocytic overload
  • rarefied cytoplasm
  • pyknotic anc eccentrically-located nuclei
  • mosaic appearance
  • hepatocytic steaosis
  • cirrhosis (adults)

- muscle weakness (increases with age)
- distal muscle wasting
- myopathy
- hypoglycemia

LABORATORY ABNORMALITIES

- Amylo-1,6-glucosidase deficiency
- Hypoglycemia
- Hyperlipidemia
- Normal blood lactate
- Normal uric acid
- Elevated transaminases

Subtypes

- GSD 3a (GSD type IIIa): both liver and muscle involvement
- GSD 3b (GSD type IIIb): liver involvement only (15% of all cases)

Etiology

- germline mutations in the amylo-1,6-glucosidase, 4-alpha-glucoanotransferase gene (AGL) (MIM.232400)