Fructosemia- hereditary
Overview
Hereditary fructose intolerance (HFI) or fructose poisoning is a hereditary condition caused by a deficiency of liver enzymes that metabolise fructose. It is also known as hereditary fructosemia, or fructose in the blood (-emia means in the blood)
Symptoms
Some of the symptoms of Fructosemia, hereditary incude: Vomiting Failure to thrive Jaundice Enlarged liver Asymptomatic if no fructose containing food ingested
Causes
The deficient enzyme is aldolase-B, which converts fructose-1-phosphate to DHAP and glyceraldehyde. This means that the fructose cannot be further metabolised beyond fructose-1-phosphate. This traps phosphates; which are needed to phosphorylate glycogen phosphorylase which carries on to release units of glucose-1-phosphate from glycogen. (Glucose-1-phosphate gets converted to glucose-6-phosphate and then dephosphorylated to form glucose). In addition, Aldolase A plays an important role in gluconeogenesis, producing fructose-1,6-bisphosphate from glyceraldehyde-3-phosphate and DHAP. But, glucose may still be released through the breakdown of glycogen. Although, it cannot be synthesized from gluconeogenesis, resulting in severe hypoglycaemia.
Treatment
Treatment is with a fructose free diet, which if adhered to, is concordant with a good prognosis. [1] Fructose and sucrose eliminated from die