We present the case of a Spanish man with late-onset Pompe disease and a novel allelic variant of GAA in heterozygosis
Case: Male, Spanish, onset at 57yo with pelvic weakness
CasePresentingHPOs: HP:0003236, HP:0002522, HP:0003184, HP:0012515, HP:0003749, HP:0003700, HP:0005144, HP:0002151, HP:0030232, HP:0009058
HPOsFreeText: weakness of hip adduction and shoulder abduction, abolished lower limb reflexes. CK = 500-800 U/L, lactate = 27.0 U/L, GOT = 50 U/L, GPT = 69 U/L, LDH = 449 U/L, aldolase = 8.7 U/L, myopathic motor unit action potentials with early recruitment and spontaneous activity (mainly in quadriceps), asymmetric septal left ventricular hypertrophy with preserved ventricular function, atrophy of both biceps and deltoid muscles, fibrillary deposits in cytoplasm, focal disorganization of sarcomeres, decrease in GAA inhibitory activity (0.64-0.68 μmol/L/h)
CaseNotHPOs: HP:0001283, HP:0002093, HP:0003326, HP:0002487
NotHPOsFreeText:
CaseAddInfo: daughter also underwent genetic testing which showed she was a heterozygous carrier for the same variant. She presented with decreased GAA activity in DBS and isolated lymphocytes.
CasePreviousTesting: blood laboratory exams, electromyography study, echocardiogram, biopsy of biceps and deltoid muscles, histochemical staining which showed no abnormalities, electron microscopy, DBS, enzyme activity analyzed in isolated lymphocytes (confirmed decreased GAA activity)
CaseGenotypingMethod: n/a
Variant: NM_000152.3:c.1249A>C
CAID: CA401365271, http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/by_caid?caid=CA401365271
gnomAD: n/a