Von Gierke disease
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(Glycogen storage disease type Ia)
Prevalence: 1/100.000. Autosomal recessive transmission of a mutation of the G6PC1 gene (17q21.31) causing a deficiency in glucose-6-phosphatase in the liver, kidneys and small bowel. Early onset (first months of life).
Clinical signs:
- hepatomegaly without splenomegaly, risk of liver adenomas and hepatomas
- muscular hypotrophy, chubby facies
- hypoglycemia with hyperlactacidemia; convulsions, coma, and mental retardation if medical treatment is not followed
- short stature,
- tendency to bleeding despite a normal or increased platelet count
- hyperuricemia with risk of urinary lithiasis
- hypertriglyceridemia (xanthomas)
- nephromegaly
- osteoporosis.
Treatments: continuous glucose intake (night gavage with starch solutions); liver transplantation.
Anesthetic implications:
insure supply of glucose and measure blood glucose levels. Check the clotting parameters (platelets count). One case of pancreatitis secondary to hypertriglyceridemia following a continuous infusion of propofol has been reported.
References :
Updated: June 2019