History and exam

Key diagnostic factors

common

family history of GSD I

Considered a key risk factor.

frequent feedings

Infants may never have been able to sleep through the night without feeding.

hepatomegaly

A distinguishing feature of GSD I. Enlarged kidneys also occur in a majority of patients, but may only be demonstrated by abdominal ultrasonography.

distended abdomen

This sign is secondary to hepatomegaly.

Other diagnostic factors

common

hyperpnoea

Episodes of rapid breathing may be caused by metabolic acidosis.

faltering growth

Faltering growth in relation to GSD is not completely understood, but could be associated with suboptimal glycaemic control and suboptimal metabolic control, reflected by chronic metabolic acidosis.

delayed puberty

May be caused by hypoglycaemia.

lethargy

May result from hypoglycaemia, metabolic acidosis, or both.

hypotonia or muscle pain in the morning

Reduction in muscle mass.

tendency to bleed

Epistaxis, ecchymoses, and prolonged bleeding after dental surgery (or other surgery) is caused by impaired platelet function in GSD I.

uncommon

developmental delay

Only occurs if recurrent hypoglycaemic seizures have resulted in cerebral damage.

nausea and vomiting

May result from hypoglycaemia and lactic acidosis.

seizures

May be caused by hypoglycaemia.

cushingoid appearance

May be present in untreated or inadequately treated infants and children.

eruptive xanthomata

May be present on extensor surfaces in patients with extreme hyperlipidaemia.

Risk factors

strong

family history

Autosomal recessive condition. One in 4 chance of offspring being affected if there is an affected sibling.

Use of this content is subject to our disclaimer