Galactokinase deficiency: lessons from the GalNet registry

M. Estela Rubio-Gozalbo, Britt Derks, Anibh Martin Das, Uta Meyer, Dorothea Möslinger, M. Luz Couce, Aurélie Empain, Can Ficicioglu, Natalia Juliá Palacios, Mariela M. De Los Santos De Pelegrin, Isabel A. Rivera, Sabine Scholl-Bürgi, Annet M. Bosch, David Cassiman, Didem Demirbas, Matthias Gautschi, Ina Knerr, Philippe Labrune, Anastasia Skouma, Patrick VerlooSaskia B. Wortmann, Eileen P. Treacy, David J. Timson, Gerard T. Berry

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Abstract

Purpose: Galactokinase (GALK1) deficiency is a rare hereditary galactose metabolism disorder. Beyond cataract, the phenotypic spectrum is questionable. Data from affected patients included in the Galactosemias Network registry were collected to better characterize the phenotype. Methods: Observational study collecting medical data of 53 not previously reported GALK1 deficient patients from 17 centers in 11 countries from December 2014 to April 2020. Results: Neonatal or childhood cataract was reported in 15 and 4 patients respectively. The occurrence of neonatal hypoglycemia and infection were comparable with the general population, whereas bleeding diathesis (8.1% versus 2.17–5.9%) and encephalopathy (3.9% versus 0.3%) were reported more often. Elevated transaminases were seen in 25.5%. Cognitive delay was reported in 5 patients. Urinary galactitol was elevated in all patients at diagnosis; five showed unexpected Gal-1-P increase. Most patients showed enzyme activities ≤1%. Eleven different genotypes were described, including six unpublished variants. The majority was homozygous for NM_000154.1:c.82C>A (p.Pro28Thr). Thirty-five patients were diagnosed following newborn screening, which was clearly beneficial. Conclusion: The phenotype of GALK1 deficiency may include neonatal elevation of transaminases, bleeding diathesis, and encephalopathy in addition to cataract. Potential complications beyond the neonatal period are not systematically surveyed and a better delineation is needed.

Original languageEnglish
JournalGenetics in Medicine
DOIs
Publication statusPublished - 18 Aug 2020

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Keywords

  • cataract
  • galactokinase 1 deficiency
  • GALK1 gene variants
  • galactosemias registry
  • neonatal complications

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    Rubio-Gozalbo, M. E., Derks, B., Das, A. M., Meyer, U., Möslinger, D., Couce, M. L., Empain, A., Ficicioglu, C., Juliá Palacios, N., De Los Santos De Pelegrin, M. M., Rivera, I. A., Scholl-Bürgi, S., Bosch, A. M., Cassiman, D., Demirbas, D., Gautschi, M., Knerr, I., Labrune, P., Skouma, A., ... Berry, G. T. (2020). Galactokinase deficiency: lessons from the GalNet registry. Genetics in Medicine. https://doi.org/10.1038/s41436-020-00942-9