Summary
Polyglucosan body diseases in adults, contrary to infantile cases (Andersen's disease or type IV glycogenosis or amylopectinosis), are usually not associated with a significant deficiency of the branching enzyme (=amylo-1,4-1,6 transglucosidase). We, therefore, report on a 19-year-old male with complete branching enzyme deficiency presenting with severe myopathy, dilative cardiomyopathy, heart failure, dysmorphic features, and subclinical neuropathy. His 14-year-old brother had similar symptoms and was erroneously classified by a previous muscle biopsy as having central core disease but could later be identified as also having polyglucosan body myopathy. The skeletal muscle, endomyocardiac, and sural nerve biopsies as well as the autopsy revealed extraordinarily severe deposits of polyglucosan bodies not only in striated and smooth muscle fibers, but also in histiocytes, fibroblasts, perineurial cells, axons and astrocytes. Occasional paracrystalline mitochondrial inclusions were also noted. Thus, this patient represents to our knowledge the first juvenile, familial case of polyglucosan body disease with total branching enzyme deficiency and extensive polyglucosan body storage.
This is a preview of subscription content,log in via an institution to check access.
Access this article
Subscribe and save
- Get 10 units per month
- Download Article/Chapter or eBook
- 1 Unit = 1 Article or 1 Chapter
- Cancel anytime
Buy Now
Price includes VAT (Japan)
Instant access to the full article PDF.
Similar content being viewed by others
References
Andersen DH (1950) Studies on glycogen disease with report of a case in which the glycogen was abnormal. In: Najjar VA (ed) Carbohydrate metabolism. Johns Hopkins Press. Baltimore, pp 28–42
Baudrimont M, Gheradi R, Gray F, Lajarde S, Poirier J (1986) Adult polyglucosan body disease (APBD). Report of 3 cases. J Neuropathol Exp Neurol 45:366
Brown BI, Brown DH (1966) Lack of an alpha-1,4-glucan: alpha-1,4-glucan 6-glycosyl transferase in a case of type IV glycogenosis. Proc Natl Acad Sci USA 56:725–729
Busard HLSM, Gabreëls-Festen AAWM, Renier WO, Gabreëls FJM, Joosten EMG, van't Hof MA, Rensing JBM (1991) Adult polyglucosan body disease: the diagnostic value of axilla skin biopsy. Ann Neurol 29:448–451
Cafferty MS, Lovelace RE, Hays AP, Servidei S, DiMauro S, Rowland LP (1991) Polyglucosan body disease. Muscle Nerve 14:102–107
Carpenter S, Karpati G, Andermann F, Jacob JC, Andermann E (1974) Lafora's disease: peroxisomal storage in skeletal muscle. Neurology 24:531–538
Cornelio F, DiDonato S (1985) Myopathies due to enzyme deficiencies. J Neurol 232:329–340
Craig JM, Uzman LL (1958) A familial metabolic disorder with storage of unusual polysaccharide complex. Pediatrics 22:20–32
DiMauro S, Eastwood AB (1977) Disorders of glycogen and lipid-metabolism. Adv Neurol 17:123–142
Ferguson IT, Mahon M, Cumming WJK (1983) Adult case of Andersen's disease — Type IV glycogenosis. A clinical, histochemical, ultrastructural and biochemical study. J Neurol Sci 60:337–351
Ferrans VJ, Hibbs RG, Walsh JJ, Burch GE (1966) Cardiomyopathy, cirrhosis of the liver and deposits of a fibrillar polysaccharide. Report of a case with histochemical and electron microscopic studies. Am J Cardiol 17:457–469
Gallen CC, Schultz P, Thomas CS, Jones M, Brown BI (1986) Glycogenosis IV: clinical and pathological findings in siblings. Ann Neurol 20:404
Goebel HH, Reusche E, Aksu F, Voit T, Yokota T (1990) Morphological analysis of polyglucosan bodies in familial chilhood myopathy. Brain Dev 12:645
Goebel HH, Shin YS, Gullota F, Yokota T, Alroy J, Voit T, Haller P, Schulz A (1992) Adult polyglucosan body myopathy. J Neuropathol Exp Neurol 51:24–35
Gray F, Gherardi R, Marshall A, Janota I, Poirier J (1988) Adult polyglucosan body disease (APBD). J Neuropathol Exp Neurol 47:459–474
Greene GM, Weldon DC, Ferrans VJ (1987) Juvenile polysaccharidosis with cardioskeletal myopathy. Arch Pathol Lab Med 111:977–982
Greene HL, Brown BI, McClenathan DT, Agostini RM Jr, Taylor SR (1988) A new variant of type IV glycogenosis: deficiency of branching enzyme activity without apparent progressive liver disease. Hepathology 8:302–306
Guerra AS, van Diggelen OP, Carneiro F, Tsou RM, Simoes S, Santos NT (1986) A juvenile variant of glycogenosis IV (Andersen's disease). Eur J Pediatr 145:179–181
Holmes JM, Houghton CR, Woolf AL (1960) A myopathy presenting in adult life with features suggestive of glycogen storage disease. J Neurol Neurosurg Psychiatry 23:302–311
Howell RR, Kabach MM, Brown BI (1971) Type IV glycogen storage disease: branching enzyme deficiency in skin fibroblasts and possible heterozygote detection. J Pediatr 78:638–642
Hübner G, Pongratz D, Gokel M, Wiebecke B, Remberger K, Deufel T (1986) Glykogenose Typ II (M. Pompe) und Typ IV (M. Andersen) bei Jugendlichen und Erwachsenen. Verh Dtsch Ges Pathol 70:623
Huijing F (1975) Glycogen metabolism and glycogen-storage diseases. Physiol Rev 55:609–658
Ishihara T, Yokota T, Yamashita Y, Takahashi M, Kawano H, Uchino F, Kamei T, Matsumoto N, Kusunose Y, Yamada M (1987) Comparative study of the intracytoplasmic inclusions in Lafora's disease and type IV glycogenosis by electron microscopy. Acta Pathol Jpn 37:1591–1601
Karpati G, Carpenter S, Wolfe LS, Sherwin A (1969) A peculiar polysaccharide accumulation in muscle in a case of cardioskeletal myopathy. Neurology 19:553–564
Komure O, Ichikawa K, Tsutsumi A, Hiyama Fujioka A (1985) Intraaxonal polysaccharide storage myopathy. Acta neuropathol (Berl) 65:300–304
Lossos A, Barash V, Soffer D, Argov Z, Gomori M, Ben-Nariah Z, Abramsky O, Steiner I (1991) Hereditary branching enzyme dysfunction in adult polyglucosan body disease: a possible metabolic cause in two patients. Ann Neurol 30:655–662
MacAdams AJ, Hug G, Bove KE (1974) Glycogen storage disease types I to X. Criteria for morphologic diagnosis. Hum Pathol 5:463–487
McMaster KR, Powers JM, Hennigar GR, Wohltmann HJ, Farr GH (1979) Nervous system involvement in type IV glycogenosis. Arch Pathol Lab Med 103:105–111
Mercier C, Whelan WJ (1970) The fine structure of glycogen from Type IV glycogen-storage disease. Eur J Biochem 16:579–583
Nase-Hüppmeier S, Kunze KP, Sigmund M, Schröder JM, May R, Shin Y (1991) Demonstration of branching enzyme deficiency of cardiac muscle in type IV glycogenosis. Circulation 84 [Suppl]:1117
Okamoto K, Klena JF, Hirano A (1982) A type of adult polyglucosan body disease. Acta Neuropathol (Berl) 58:73–77
Pellissier JF, De Barsy T, Serratrice G, Toga M (1981) Polysaccharide (amylopectin-like) storage myopathy. Histochemical, ultrastructural and biochemical studies. Acta Neuropathol (Berl) [Suppl] VII:292–296
Peress NS, DiMauro S, Roxburgh VA (1979) Adult polysaccharidosis. Clinical, ultrastructural, and biochemical findings. Arch Neurol 36:840–845
Ramsey HJ (1965) Ultrastructure of corpora amylacea. J Neuropathol Exp Neurol 24:25–39
Reed GB, Dixon JF, Neustern HB, Donnell GB, Landing BH (1968) Type IV glycogenosis: patient with absence of a branching enzyme alpha-1,4-glucan:alpha-1,4-glucan 6-glycosyl transferase. Lab Invest 19:546–547
Reusche E, Aksu F, Goebel HH, Shin YS, Yokota T, Reichmann H (1992) A mild juvenile variant of type IV glycogenosis. Brain Dev 14:36–43
Robitaille Y, Carpenter S, Karpati G, DiMauro S (1980) A distinct form of adult polyglucosan body disease with massive involvement of central and peripheral neuronal processes and astrocytes. A report of four cases and a review of the occurrence of polyglucosan bodies in other conditions such as Lafora's disease and normal ageing. Brain 103:315–336
Rosai J, Lascano EF (1970) Basophilic (mucoid) degeneration of myocardium. A disorder of glycogen metabolism. Am J Pathol 61:99–112
Schochet SS, McCormick WF, Zellweger H (1970) Type IV glycogenosis (amylopectinosis). Light and electron microscopic observations. Arch pathol 10:354–363
Schochet SS, McCormick WF, Kovarsky K (1971) Light and electron microscopy of skeletal muscle in type IV glycogenosis. Acta Neuropathol (Berl) 19:137–144
Schröder JM, May R, Shin Y, Sommer C, Kunze KP, Nase-Hüppmeier S (1991) New variant of polyglucosan body disease: late juvenile hereditary myopathy with complete brancher enzyme deficiency. Neuropathol Appl Neurobiol 17:517–518
Servidei S, Riepe RE, Langston C, Tani LY, Bricker JT, Crisp-Lindgren N, Travers H, Armstrong D, DiMauro S (1987) Severe cardiopathy in branching enzyme deficiency. J Pediatr 111:51–56
Shin YS (1990) Diagnosis of glycogen storage disease. J Inherited Metab Dis 13:419–434
Shin YS, Steigüber H, Klemm P, Endres W, Schwab O, Wolff G (1988) Branching enzyme in erythrocytes. Detection of type IV glycogenosis homozygotes and heterozygotes. J Inherited Metab Dis 11 [Suppl 2]:252–254
Sidbury JB, Mason J, Burns WB, Ruebner BH (1964) Type IV glycogenosis: report of a case proven by characterization of glycogen and studied at necropsy. Bull Johns Hopkins Hosp 111:157–181
Suzuki K, David E, Kutschmann B (1971) Presenile dementia with “Lafora-like” intraneural inclusions. Arch Neurol 25:69–80
Thompson AJ, Swash M, Cox EL, Ingram DA, Schwartz MS (1988) Polysaccharide storage myopathy. Muscle Nerve 2:349–355
Torvik A, Dietrichson P, Svaar H, Hudgson P (1975) Myopathy with tremor and dementia: a metabolic disorder? Case report and postmortem study. J Neurol Sci 21:181–190
Tunón T, Bengoechea O, Narbona J (1983) Glycogenosis with amylopectinoid deposits in a 13-year-old girl. Clin Neuropathol 7:100–104
Vos AJM, Joosten EMG, Gabreëls-Festen AAWM (1983) Adult polyglucosan body disease: clinical and nerve biopsy findings in two cases. Ann Neurol 13:440–444
Weis J, Schröder JM (1988) Adult polyglucosan body myopathy with subclinical peripheral neuropathy: case report and review of diseases associated with polyglucosan body accumulation. Clin Neuropathol 7:271–279
Yokota T, Ishihara T, Kawano H, Yamishata Y, Uchino F, Kamei T, Kusunose Y, Matsumoto N (1987) Immunological homogeneity of Lafora body, corpora amylacea, basophilic degeneration in heart, and intracytoplasmic inclusions of liver and heart in type IV glycogenosis. Acta Pathol Jpn 37:941–946
Zellweger H, Mueller S, Ionasescu V, Schochet SS, McCormick WF (1982) Glycogenosis IV: a new cause of infantile hypotonia. J Pediatr 80:842–844
Author information
Authors and Affiliations
Institut für Neuropathologie, Rheinisch-Westfälische Technische Hochschule Aachen, Pauwelsstrasse 30, W-5100, Aachen, Germany
J. M. Schröder & R. May
Medizinische Klinik I, Rheinisch-Westfälische Technische Hochschule Aachen, Pauwelsstrasse 30, W-5100, Aachen, Germany
M. Sigmund & S. Nase-Hüppmeier
Kinderklinik der Universität München, Germany
Y. S. Shin
- J. M. Schröder
You can also search for this author inPubMed Google Scholar
- R. May
You can also search for this author inPubMed Google Scholar
- Y. S. Shin
You can also search for this author inPubMed Google Scholar
- M. Sigmund
You can also search for this author inPubMed Google Scholar
- S. Nase-Hüppmeier
You can also search for this author inPubMed Google Scholar
Rights and permissions
About this article
Cite this article
Schröder, J.M., May, R., Shin, Y.S.et al. Juvenile hereditary polyglucosan body disease with complete branching enzyme deficiency (type IV glycogenosis).Acta Neuropathol85, 419–430 (1993). https://doi.org/10.1007/BF00334454
Issue Date:
Share this article
Anyone you share the following link with will be able to read this content:
Sorry, a shareable link is not currently available for this article.
Provided by the Springer Nature SharedIt content-sharing initiative