Neutropenia, neutrophil dysfunction, and inflammatory bowel disease in glycogen storage disease type Ib: Results of the European Study on Glycogen Storage Disease Type I

• Published in: The Journal of pediatrics Vol. 137; no. 2; pp. 187 - 191
• Main Authors: Visser, Gepke, Rake, Jan-Peter, Fernandes, John, Labrune, Philippe, Leonard, James V., Moses, Shimon, Ullrich, Kurt, Smit, G.Peter A.
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01-08-2000; Elsevier
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Biological and medical sciences; Carbohydrates (enzymatic deficiencies). Glycogenosis; Child; Child, Preschool; Comorbidity; Disease Progression; Errors of metabolism; Europe - epidemiology; Female; Glycogen Storage Disease Type I - epidemiology; Humans; Infant; Infant, Newborn; Inflammatory Bowel Diseases - epidemiology; Inflammatory Bowel Diseases - physiopathology; Male; Medical sciences; Metabolic diseases; Middle Aged; Neutropenia - epidemiology; Neutropenia - physiopathology; Neutrophils - metabolism; Retrospective Studies; Severity of Illness Index; Europe; PMA; GSD; IBD; Human; Leukopenia; Enzyme; Deficiency; Phosphoric monoester hydrolases; Metabolic diseases; Esterases; Hemopathy; Enzymopathy; Genetic disease; Incidence; Inflammatory disease; Clinical stage; Glycogenosis; Digestive diseases; Hydrolases; Complication; Intestinal disease; Carbohydrate; Glucose-6-phosphatase; Neutropenia
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1067/mpd.2000.105232

Objective: To investigate the incidence, the severity, and the course of neutropenia, neutrophil dysfunction, and inflammatory bowel disease (IBD) in glycogen storage disease (GSD) type Ib. Method: As part of a collaborative European Study on GSD type I, a retrospective registry was established in 12 European countries that included all patients with GSD-I who were known at the centers and were born from 1960 to 1995. Of a total of 288 patients with GSD-I, 57 who had GSD-Ib form the basis of this study. Results: Neutropenia (defined as an absolute neutrophil count <1 × 109/L) was found in 54 patients. In 64% of the patients neutropenia was documented before the age of 1 year, but in 18% of the patients neutropenia was first noted between the ages of 6 and 9 years. Neutropenia was persistent in 5 patients and intermittent without any clear cyclical course in 45. Neutrophil function was investigated in 18 patients with neutropenia and was abnormal in all. Perioral infections were reported in 37 patients, perianal infections in 27 patients, and protracted diarrhea in 23 patients. Findings on colonoscopy and radiologic studies in 10 of 20 patients suspected to have IBD were abnormal in all. All patients with IBD, perioral infections, and perianal infections had neutropenia. Conclusions: Intermittent severe neutropenia is frequently found in patients with GSD-Ib. The study also indicates that IBD in GSD-Ib is underdiagnosed; up to 77% of the patients studied had evidence of IBD, all of whom had neutropenia. IBD was not detected in those with normal neutrophil counts. These findings support the notion that neutropenia and/or neutrophil dysfunction in GSD-Ib and IBD are causally related. (J Pediatr 2000;137:187-91)