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Distinct Clinical and Genetic Findings in Iranian Patients With Glycogen Storage Disease Type 3

Nazari, Ferdos, MD*; Sinaei, Farnaz, MD*; Nilipour, Yalda, MD; Petit, François, PharmD, PhD; Oveisgharan, Shahram, MD*; Nassiri-Toosi, Mohsen, MD§; Razzaghy-Azar, Maryam, MD; Mahmoudi, Mahdi, PhD; Nafissi, Shahriar, MD*

Journal of Clinical Neuromuscular Disease: June 2018 - Volume 19 - Issue 4 - p 203–210
doi: 10.1097/CND.0000000000000212
Original Article

Objectives: Glycogen storage disease type 3 (GSD-III) is a rare inherited metabolic disorder caused by glycogen debranching enzyme deficiency. Various pathogenic mutations of the AGL gene lead to abnormal accumulation of glycogen in liver, skeletal, and cardiac muscles. Here, we report distinct clinical and genetic data of Iranian patients with GSD-III.

Methods: Clinical and laboratory data of 5 patients with GSD-III were recorded. Genetic investigation was performed to identify the causative mutations.

Results: Three patients had typical liver involvement in childhood and one was diagnosed 2 years after liver transplantation for cirrhosis of unknown etiology. Four patients had vacuolar myopathy with glycogen excess in muscle biopsy. All patients had novel homozygous mutations of the AGL gene namely c.378T>A, c.3295T>C, c.3777G>A, c.2002-2A>G, and c.1183C>T.

Conclusions: This is the first comprehensive report of patients with GSD-III in Iran with 2 uncommon clinical presentations and 5 novel mutations in the AGL gene.

*Iranian Center of Neurological Research, Neuroscience Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran;

Department of Pathology, Pediatric Pathology Research Center, Mofid Children Hospital, Shahid Beheshti Medical University, Tehran, Iran;

Laboratoire de génétique moléculaire, Service d'histologie-embryologie-cytogénétique, Hôpital Antoine Béclère, GH Paris-Sud, AP-HP, Paris, France;

§Digestive Disease Research Center, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran;

Metabolic Disorders Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran; and

Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Reprints: Shahriar Nafissi, MD, Department of Neurology, Shariati Hospital, North Karegar St, Tehran 14114, Iran (e-mail:

The authors report no financial/conflicts of interest.

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