TY - JOUR
T1 - Successful liver transplantation and long-term follow-up in a patient with MPI-CDG
AU - Janssen, Mirian C.H.
AU - De Kleine, Ruben H.
AU - Van Den Berg, Arie P.
AU - Heijdra, Yvonne
AU - Van Scherpenzeel, Monique
AU - Lefeber, Dirk J.
AU - Morava, Eva
PY - 2014/7
Y1 - 2014/7
N2 - Hepatopathy is the most common feature in the Congenital Disorders of Glycosylation (CDG). More than 70 subtypes have been identified in this growing group of inborn errors. Most defects present as multisystem disease, whereas phosphomannose isomerase deficiency (MPI-CDG) presents with exclusive hepato-intestinal phenotype. MPI-CDG has been considered as one of the very few treatable disorders of glycosylation; several patients showed significant improvement of their life-threatening protein-losing enteropathy and coagulation disorder on oral mannose supplementation therapy. However, patients who have MPI-CDG develop progressive liver insufficiency during a later course of disease. A patient who had MPI-CDG developed progressive liver fibrosis, despite oral mannose supplementation and repeated fractionated heparin therapy. She showed mannose therapy-associated hemolytic jaundice. She developed severe dyspnea and exercise intolerance owing to pulmonary involvement, necessitating liver transplant. After transplantation her physical exercise tolerance, pulmonary functions, and metabolic parameters became fully restored. She is still doing well 2 years after transplantation now. In conclusion, we here report on the first successful liver transplantation in CDG.
AB - Hepatopathy is the most common feature in the Congenital Disorders of Glycosylation (CDG). More than 70 subtypes have been identified in this growing group of inborn errors. Most defects present as multisystem disease, whereas phosphomannose isomerase deficiency (MPI-CDG) presents with exclusive hepato-intestinal phenotype. MPI-CDG has been considered as one of the very few treatable disorders of glycosylation; several patients showed significant improvement of their life-threatening protein-losing enteropathy and coagulation disorder on oral mannose supplementation therapy. However, patients who have MPI-CDG develop progressive liver insufficiency during a later course of disease. A patient who had MPI-CDG developed progressive liver fibrosis, despite oral mannose supplementation and repeated fractionated heparin therapy. She showed mannose therapy-associated hemolytic jaundice. She developed severe dyspnea and exercise intolerance owing to pulmonary involvement, necessitating liver transplant. After transplantation her physical exercise tolerance, pulmonary functions, and metabolic parameters became fully restored. She is still doing well 2 years after transplantation now. In conclusion, we here report on the first successful liver transplantation in CDG.
KW - Congenital disorder of glycosylation
KW - Liver transplantation
KW - MPI-CDG
UR - http://www.scopus.com/inward/record.url?scp=84904100059&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84904100059&partnerID=8YFLogxK
U2 - 10.1542/peds.2013-2732
DO - 10.1542/peds.2013-2732
M3 - Article
C2 - 24982104
AN - SCOPUS:84904100059
SN - 0031-4005
VL - 134
SP - e279-e283
JO - Pediatrics
JF - Pediatrics
IS - 1
ER -