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Journal of Inherited Metabolic Disease

, Volume 34, Issue 2, pp 399–407 | Cite as

Features and outcome of galactokinase deficiency in children diagnosed by newborn screening

  • Julia B. Hennermann
  • Peter Schadewaldt
  • Barbara Vetter
  • Yoon S. Shin
  • Eberhard Mönch
  • Jeannette Klein
Galactosemia

Abstract

Galactokinase deficiency (GALK-D), an autosomal recessive disorder in the Leloir pathway, results in accumulation of galactose, galactitol, and galactonate and leads to early onset of juvenile bilateral cataract. Highest incidence of GALK-D is found in Romani populations. The migration wave due to the Yugoslavian civil war has changed the spectrum of inborn errors of metabolism within Europe. Hence, newborn screening (NBS) in the Berlin region, performed from 1991 until 2010 in 683,675 neonates, revealed an increased incidence of GALK-D of 1:40,000, comparable to that of galactose-1-phosphate-uridyltransferase deficiency. A total of 44% of GALK-D patients were of Romani origin. All patients of Bosnian or Serbian origin were homozygous for the Romani founder mutation p.P28T. Detection of GALK-D by NBS and early start of galactose-restricted diet resulted in regression or prevention of cataracts. Slight cataracts without visual impairment occurred in 50% of the patients, 56% of whom were noncompliant. Further clinical symptoms, e.g., hypoglycemia, mental retardation, microcephaly, and failure to thrive, were associated with noncompliance. With treatment, galactose in blood decreased from 8,892 ± 5,243 to 36.5 ± 49.3 μmol/l, galactose in urine from 31,820 ± 32,103 to 30.0 ± 36.1 μmol/mmol creatinine, galactitol in RBC from 1,584 ± 584 to 12.3 ± 9.4 μmol/l, and galactitol in urine from 11,724 ± 4,496 to 236 ± 116 μmol/mmol creatinine. This is the first presentation of outcome and clinical features in GALK-D patients diagnosed by NBS. As our data suggest, GALK-D should be considered for inclusion in NBS in populations expected to have substantial numbers of GALK-D carriers, e.g., Yugoslavian immigrants.

Keywords

Cataract Galactosemia Galactitol GALT Activity Galactose Concentration 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Abbreviations

GALK

Galactokinase

GALK-D

Galactokinase deficiency

GALT

Galactose-1-phosphate-uridyltransferase

NBS

Newborn screening

RBC

Red blood cells

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Copyright information

© SSIEM and Springer 2011

Authors and Affiliations

  • Julia B. Hennermann
    • 1
  • Peter Schadewaldt
    • 2
  • Barbara Vetter
    • 1
  • Yoon S. Shin
    • 3
  • Eberhard Mönch
    • 1
  • Jeannette Klein
    • 1
  1. 1.Department of PediatricsCharité Universitätsmedizin BerlinBerlinGermany
  2. 2.Diabetes ForschungsinstitutHeinrich Heine UniversityDuesseldorfGermany
  3. 3.Ludwig Maximilian UniversityMunichGermany

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