Defective galactose oxidation in a patient with glycogen storage disease and Fanconi syndrome

Carbohydrate metabolism was studied in a child with atypical glycogen storage disease and Fanconi syndrome. Massive glucosuria, partial resistance to glucagon and abnormal responses to carbohydrate loads, mainly in the form of major impairment of galactose utilization were found, as reported in previous cases. Increased blood lactate to pyruvate ratios, observed in a few cases of idiopathic Fanconi syndrome, were not present. [1-14C]Galactose oxidation was normal in erythrocytes, but reduced in fresh minced liver tissue, despite normal activities of hepatic galactokinase, uridyltransferase, and UDP-glucose 4-epimerase in homogenates of frozen liver. These data suggest a defect in hepatic galactose metabolism not so far identified.