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Title:Delayed diagnosis of mild GLUT1 deficiency syndrome caused by an apparently De Novo SLC2A1 p.(Phe445del) variant in a child with a history of severe neonatal hyperkalemia
Authors:ID Ivančan, Simona (Author)
ID Debeljak, Maruša (Author)
ID Loboda, Tanja (Author)
ID Grosek, Štefan (Author)
Files:.pdf PDF - Presentation file, download (182,24 KB)
MD5: A07F91778D8E8C668131B4134BDBB736
 
URL URL - Source URL, visit https://www.mdpi.com/2227-9067/13/7/883
 
Language:English
Typology:1.03 - Other scientific articles
Organization:Logo UKC LJ - Ljubljana University Medical Centre
Abstract:Background/Objectives: Glucose transporter type 1 deficiency syndrome (GLUT1DS) is a rare neurometabolic disorder with an expanding clinical spectrum, including mild and non-classical presentations. We report a boy with severe transient neonatal hyperkalemia, bilateral congenital cataracts, and later subtle neurological and neurocognitive symptoms, in whom genomic testing supported the diagnosis of mild GLUT1DS. Methods: This single-patient case report describes clinical follow-up from birth to nine years of age, including neurological, metabolic, neuropsychological, imaging, and genetic investigations. Whole-exome sequencing using next-generation sequencing technology was performed. Results: The patient required intensive care immediately after birth because of severe transient hyperkalemia of unclear etiology. Bilateral congenital cataracts were surgically corrected during infancy. Later, he developed two brief seizure episodes, reduced exercise tolerance, episodic fatigue, attentional difficulties, motor restlessness, and mild graphomotor impairment. Neuropsychological assessment showed overall average intellectual functioning, below-average verbal abilities, low-average non-verbal abilities, and attention-deficit/hyperactivity disorder. Repeated metabolic investigations, electroencephalography, and brain magnetic resonance imaging were unrevealing. Whole-exome sequencing identified an apparently de novo heterozygous SLC2A1 variant, NM_006516.4.1333_1335del, p.(Phe445del), supporting the diagnosis of mild GLUT1DS. Because of the mild phenotype and preserved everyday functioning, ketogenic diet therapy was not initiated. Conclusions: This case highlights the diagnostic challenges of mild GLUT1DS and the value of genomic testing in children with unexplained neurological or neurocognitive symptoms despite normal routine investigations. Although neonatal hyperkalemia and GLUT1DS coexisted in this patient, current evidence is insufficient to establish a causal relationship.
Keywords:GLUT1 deficiency syndrome, SLC2A1, whole-exome sequencing, apparently de novo variant, neurocognitive phenotype, ADHD, hyperkalemia
Publication status:Published
Publication version:Version of Record
Year of publishing:2026
Number of pages:str. 1-7
Numbering:Vol. 13, iss. 7, [article no.] 883
PID:20.500.12556/DiRROS-31301 New window
UDC:616-053.2
ISSN on article:2227-9067
DOI:10.3390/children13070883 New window
COBISS.SI-ID:283169795 New window
Note:Nasl. z nasl. zaslona; Opis vira z dne 1.. 7. 2026;
Publication date in DiRROS:27.07.2026
Views:50
Downloads:38
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Record is a part of a journal

Title:Children
Shortened title:Children
Publisher:MDPI AG
ISSN:2227-9067
COBISS.SI-ID:523029017 New window

Document is financed by a project

Funder:ARIS - Slovenian Research and Innovation Agency
Project number:P3-0458-2025
Name:Prirojene in pridobljene okvare imunosti

Licences

License:CC BY 4.0, Creative Commons Attribution 4.0 International
Link:http://creativecommons.org/licenses/by/4.0/
Description:This is the standard Creative Commons license that gives others maximum freedom to do what they want with the work as long as they credit the author.

Secondary language

Language:Slovenian
Keywords:sindrom pomanjkanja GLUT1, sekvenciranje celotnega eksoma, očitno na novo nastala različica, nevrokognitivni fenotip, motnja pozornosti s hiperaktivnostjo, hiperkalemija


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