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Novel heterozygous mutations in the PGAM2 gene with negative exercise testing
M Sidhu1, L Brady1, G D Vladutiu2
1Department of Pediatrics, McMaster University, Hamilton, ON, Canada.
This study identifies two new PGAM2 gene variants in a patient with glycogen storage disease type X (GSDX). Despite typical GSDX symptoms, the patient showed normal post-exercise lactate levels.
Area of Science:
- Genetics
- Biochemistry
- Neuromuscular Disorders
Background:
- Glycogen storage disease type X (GSDX) is linked to pathogenic variants in the PGAM2 gene.
- GSDX typically presents with exercise-induced muscle issues like cramping, weakness, and myoglobinuria, often with skeletal muscle tubular aggregates.
Observation:
- A 52-year-old patient was diagnosed with GSDX.
- This patient exhibited typical GSDX symptoms but maintained normal post-exercise lactate levels during both anaerobic and aerobic exercise.
Findings:
- Genetic analysis revealed two previously unidentified PGAM2 gene variants: c.426C>A (p.Tyr142Ter) and c.533delG (p.Gly178Alafs*31).
- These novel variants are associated with the patient's GSDX diagnosis.
Implications:
- This expands the known spectrum of PGAM2 variants causing GSDX.
- The findings suggest that normal post-exercise lactate response does not exclude GSDX.
- Further research into PGAM2 variants and their metabolic consequences is warranted.
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