[Clinical heterogeneity in fructose intolerance]

Insights

Hereditary fructose intolerance (HFI) in infants often presents with vomiting and failure to thrive, requiring early diagnosis. A fructose-free diet is crucial for survival, highlighting the need for pediatrician awareness.

Area of Science:

  • Biochemistry
  • Pediatrics
  • Genetics

Context:

  • Hereditary fructose intolerance (HFI) is a rare metabolic disorder.
  • Diagnosis in infants is often delayed, leading to severe health consequences.
  • This study focuses on eight infants diagnosed with HFI.

Purpose:

  • To describe the clinical presentation and diagnostic challenges of HFI in infants.
  • To emphasize the importance of early diagnosis and dietary management.
  • To report a co-occurring case of Fructose-1,6-diphosphatase deficiency.

Summary:

  • Eight infants diagnosed with HFI via fructose tolerance tests and liver aldolase assays presented with vomiting and failure to thrive.
  • Hepatomegaly and abnormal liver function tests were common; hypoglycemia occurred in 3 patients.
  • Two infants died, while six survived and are well on a fructose-free diet.

Impact:

  • Highlights the critical role of pediatricians in recognizing HFI symptoms and understanding infant nutrition.
  • Stresses the danger of fructose-containing solutions in infusion therapy.
  • Underscores the necessity of prompt diagnosis and lifelong dietary adherence for HFI management.

Related Concept Videos

Glucose Transporters01:27

Glucose Transporters

Glucose transporters facilitate the transport of glucose across the cell membrane. In addition to glucose, some glucose transporters can also aid the movement of other hexoses such as fructose, mannose, and galactose.
Facilitated diffusion-glucose transporters (GLUTs) are encoded by the solute-linked carrier (SLC) family 2, subfamily A gene family, or SLC2A. The 14 GLUT protein members are distributed into three classes:
Glucose Absorption Into the Small Intestine01:26

Glucose Absorption Into the Small Intestine

Complex carbohydrates consumed cannot be absorbed into the small intestine in their original form. First, they must be hydrolyzed to a monosaccharide form such as glucose or galactose. These monosaccharides are then transported across the intestinal membrane and into the blood via transcellular transport. The intestinal epithelial cells allow the movement of these monosaccharides with a defined 'entry' through membrane transporter proteins present on their apical membrane and 'exit' via the...
Cystic Fibrosis: Pathogenesis01:23

Cystic Fibrosis: Pathogenesis

Cystic fibrosis (CF), an autosomal recessive disorder, significantly affects the function of exocrine glands. This genetically inherited disease is characterized by the production of thick and sticky mucus, which can severely affect various organs and systems in the body.
CF is primarily caused by a genetic mutation in a chromosome 7 gene coding for the cystic fibrosis transmembrane conductance regulator (CFTR) protein. The most common gene mutation leading to CF is the ΔF508 mutation, but...
Overview of Carbohydrate Metabolism01:19

Overview of Carbohydrate Metabolism

Carbohydrate metabolism is a fundamental biochemical process that ensures a constant supply of energy to living cells. The most important carbohydrate is glucose, which can be broken down via glycolysis to enter into the Krebs cycle and eventually lead to the production of ATP through oxidative phosphorylation.
Glucose transport into cells is facilitated by a family of transport proteins called GLUT (Glucose Transporters). GLUT4 is the primary glucose transporter for insulin-stimulated glucose...
Inborn Errors of Metabolism01:20

Inborn Errors of Metabolism

Phenylketonuria (PKU) is a protein metabolism disorder characterized by high blood levels of the amino acid phenylalanine. This results from a mutation in the gene responsible for phenylalanine hydroxylase, an enzyme that converts phenylalanine into tyrosine. When this enzyme is deficient, phenylalanine builds up in the blood, leading to symptoms such as vomiting, rashes, seizures, growth deficiency, and severe mental retardation. An early diagnosis and a diet restricting phenylalanine intake...
Pathophysiology of Diabetes01:20

Pathophysiology of Diabetes

Diabetes mellitus is a chronic metabolic disorder characterized by hyperglycemia. The four categories of diabetes are type 1 diabetes, type 2 diabetes, other specific types of diabetes, and gestational diabetes.
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility, suggesting a...