Disorders of Carbohydrate Metabolism

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What enzyme deficiency leads to hereditary fructose intolerance?

Aldolase B

When do symptoms of hereditary fructose intolerance commonly present?

Midinfancy

What is a characteristic initial symptom of hereditary fructose intolerance?

Nausea

Which disorder is characterized by an elevated level of plasma galactose-1-phosphate combined with galactosuria?

Galactosemia

What are common symptoms of classic galactosemia in infants?

Vomiting, diarrhea, jaundice

Which condition is differentiated from hereditary fructose intolerance by the gastrointestinal symptoms following large amounts of fructose ingestion?

Fructose malabsorption

At what point do glycogen storage diseases typically present?

When feedings are spaced and hypoglycemia appears

What nutritional therapy is essential for managing hereditary fructose intolerance?

Restriction of dietary sources of fructose and certain sugar alcohols

Study Notes

Disorders of Carbohydrate Metabolism

  • Disorders of carbohydrate metabolism vary in presentation, clinical course, and outcome.
  • Early and aggressive nutritional therapy is required for these disorders.

Hereditary Fructose Intolerance (HFI)

  • Results from a deficiency of the liver enzyme aldolase B.
  • Typically presents in infancy and toddlerhood, when dietary sources of sucrose and fructose are introduced.
  • Initial symptoms include nausea, bloating, and vomiting.
  • Untreated, liver and kidney damage can occur, along with growth restriction.
  • Incidence of about 1 in 20,000 to 30,000 in Europe.
  • Different from fructose malabsorption, which is a more common condition where individuals experience gastrointestinal symptoms after ingesting large amounts of fructose.

Galactosemia

  • Characterized by an elevated level of plasma galactose-1-phosphate combined with galactosuria.
  • Found in two autosomal recessive metabolic disorders: galactokinase deficiency and galactose-1-phosphate uridyltransferase (GALT) deficiency, also known as "classic galactosemia."
  • Illness generally occurs within the first 2 weeks of life.
  • Symptoms include vomiting, diarrhea, lethargy, failure to thrive, jaundice, hepatomegaly, and cataracts.
  • Infants with galactosemia may be hypoglycemic and susceptible to infection from gram-negative organisms.
  • If left untreated, death frequently ensues secondarily to septicemia.

Learn about various disorders of carbohydrate metabolism, including galactosemia, hereditary fructose intolerance, and glycogen storage diseases, and their different presentations and outcomes.

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