A novel mutation of the GAA gene in a Finnish late-onset Pompe disease patient: clinical phenotype and follow-up with enzyme replacement therapy

Muscle Nerve. 2009 Jul;40(1):143-8. doi: 10.1002/mus.21291.

Abstract

Pompe disease is a rare, progressive disease leading to skeletal muscle weakness due to deficiency of the acid alpha-glucosidase (GAA) enzyme. Herein we report the first diagnosed Finnish patient with a phenotype compatible with the late-onset form of Pompe disease. Molecular genetic analysis of the GAA gene revealed a novel missense mutation, 1725C>A (Y575X), combined with a previously reported mutation, 1634C>T (P545L). Human recombinant alpha-glucosidase enzyme (alglucosidase-alpha) treatment was initiated for this patient at age 20 years. After 12 months she was no longer fully wheelchair-bound, and muscle strength had improved. No disease progression was visible on muscle magnetic resonance imaging of the lower limbs, and the energy state of the muscle cells increased by 46% on phosphorus magnetic resonance spectroscopy. Overall, our findings suggest that enzyme replacement therapy is indicated, even in patients with late-onset Pompe disease, to halt disease progression and improve the quality of daily life.

Publication types

  • Case Reports

MeSH terms

  • DNA Mutational Analysis
  • Electrocardiography
  • Electromyography / methods
  • Electrons
  • Female
  • Finland / ethnology
  • Follow-Up Studies
  • Glycogen Storage Disease Type II / diagnosis
  • Glycogen Storage Disease Type II / drug therapy*
  • Glycogen Storage Disease Type II / genetics*
  • Glycogen Storage Disease Type II / physiopathology
  • Humans
  • Magnetic Resonance Imaging / methods
  • Magnetic Resonance Spectroscopy / methods
  • Muscle, Skeletal / diagnostic imaging
  • Muscle, Skeletal / pathology
  • Muscle, Skeletal / physiopathology
  • Mutation / genetics
  • Radionuclide Imaging
  • Recombinant Proteins / therapeutic use
  • Tyrosine / genetics
  • Young Adult
  • alpha-Glucosidases / genetics*
  • alpha-Glucosidases / therapeutic use*

Substances

  • Recombinant Proteins
  • Tyrosine
  • alpha-Glucosidases