title: Extended phenotype description and new molecular findings in late onset glycogen storage disease type II: a northern Italy population study and review of the literature.
abstract: Glycogen storage disease type II (GSDII) is a lysosomal storage disorder caused by acid alpha-1,4-glucosidase deficiency and associated with recessive mutations in its coding gene GAA. Few studies have provided so far a detailed phenotypical characterization in late onset GSDII (LO-GSDII) patients. Genotype-phenotype correlation has been previously attempted with controversial results. We aim to provide an in-depth description of a cohort (n = 36) of LO-GSDII patients coming from the north of Italy and compare our population's findings to the literature. We performed a clinical record-based retrospective and prospective study of our patients. LO-GSDII in our cohort covers a large variability of phenotype including subtle clinical presentation and did not differ significantly from previous data. In all patients, molecular analysis disclosed GAA mutations, five of them being novel. To assess potential genotype-phenotype correlations we divided IVS1-32-13T>G heterozygous patients into two groups following the severity of the mutations on the second allele. Our patients harbouring "severe" mutations (n = 21) presented a strong tendency to have more severe phenotypes and more disability, more severe phenotypes and more disability, higher prevalence of assisted ventilation and a shorter time of evolution to show it. The determination of prognostic factors is mandatory in order to refine the accuracy of prognostic information, to develop follow-up strategy and, more importantly, to improve the decision algorithm for enzyme replacement therapy administration. The demonstration of genotype-phenotype correlations could help to reach this objective. Clinical assessment homogeneity is required to overcome limitations due to the lack of power of most studies.
authors.affiliation: Fonds Erasme pour la Recherche Médicale, Université Libre de Bruxelles (ULB), Brussels, Belgium, gauthier.remiche@erasme.ulb.ac.be.
authors.forename: Gauthier
authors.initials: G
authors.lastname: Remiche
authors.forename: Dario
authors.initials: D
authors.lastname: Ronchi
authors.forename: Francesca
authors.initials: F
authors.lastname: Magri
authors.forename: Costanza
authors.initials: C
authors.lastname: Lamperti
authors.forename: Andreina
authors.initials: A
authors.lastname: Bordoni
authors.forename: Maurizio
authors.initials: M
authors.lastname: Moggio
authors.forename: Nereo
authors.initials: N
authors.lastname: Bresolin
authors.forename: Giacomo P
authors.initials: GP
authors.lastname: Comi
mesh_terms: D000328:Adult; D017668:Age of Onset; D015331:Cohort Studies; D018672:Community Health Planning; D004252:DNA Mutational Analysis; D005260:Female; D005838:Genotype; D006009:Glycogen Storage Disease Type II / Q000453:epidemiology* / Q000235:genetics* / Q000473:pathology / Q000503:physiopathology*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000201:enzymology / Q000473:pathology; D009154:Mutation / Q000235:genetics*; D010641:Phenotype; D013223:Statistics as Topic; D000520:alpha-Glucosidases / Q000235:genetics*; D001617:beta-Glucosidase
chemical_list: C509951:GAA protein, human; D000520:alpha-Glucosidases; C424266:GBA3 protein, human; D001617:beta-Glucosidase