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gamma-Glutamyltransferase deficiency

MedGen UID:
82813
Concept ID:
C0268524
Disease or Syndrome
Synonyms: Gamma-glutamyl transpeptidase deficiency; Gamma-glutamyltranspeptidase deficiency; GGT deficiency; GGT1 deficiency; Glutathioninuria; Glutathionuria; GTG deficiency
SNOMED CT: Gamma-glutamyl transpeptidase deficiency (78586005); Gamma-glutamyl transferase deficiency (78586005); Glutathionuria (78586005)
Modes of inheritance:
Autosomal recessive inheritance
MedGen UID:
141025
Concept ID:
C0441748
Intellectual Product
Source: Orphanet
A mode of inheritance that is observed for traits related to a gene encoded on one of the autosomes (i.e., the human chromosomes 1-22) in which a trait manifests in individuals with two pathogenic alleles, either homozygotes (two copies of the same mutant allele) or compound heterozygotes (whereby each copy of a gene has a distinct mutant allele).
 
Gene (location): GGT1 (22q11.23)
 
Monarch Initiative: MONDO:0009285
OMIM®: 231950
Orphanet: ORPHA33573

Definition

A disorder that is characterized by increased glutathione concentration in the plasma and urine. [from ORDO]

Clinical features

From HPO
Urinary incontinence
MedGen UID:
22579
Concept ID:
C0042024
Finding
Loss of the ability to control the urinary bladder leading to involuntary urination.
Glutathione high in urine
MedGen UID:
1830244
Concept ID:
C5779509
Finding
Level of glutathione in the urine above the upper limit of normal.
Constipation
MedGen UID:
1101
Concept ID:
C0009806
Sign or Symptom
Infrequent or difficult evacuation of feces.
Tremor
MedGen UID:
21635
Concept ID:
C0040822
Sign or Symptom
An unintentional, oscillating to-and-fro muscle movement about a joint axis.
Hyperreflexia
MedGen UID:
57738
Concept ID:
C0151889
Finding
Hyperreflexia is the presence of hyperactive stretch reflexes of the muscles.
Corpus callosum, agenesis of
MedGen UID:
104498
Concept ID:
C0175754
Congenital Abnormality
The corpus callosum is the largest fiber tract in the central nervous system and the major interhemispheric fiber bundle in the brain. Formation of the corpus callosum begins as early as 6 weeks' gestation, with the first fibers crossing the midline at 11 to 12 weeks' gestation, and completion of the basic shape by age 18 to 20 weeks (Schell-Apacik et al., 2008). Agenesis of the corpus callosum (ACC) is one of the most frequent malformations in brain with a reported incidence ranging between 0.5 and 70 in 10,000 births. ACC is a clinically and genetically heterogeneous condition, which can be observed either as an isolated condition or as a manifestation in the context of a congenital syndrome (see MOLECULAR GENETICS and Dobyns, 1996). Also see mirror movements-1 and/or agenesis of the corpus callosum (MRMV1; 157600). Schell-Apacik et al. (2008) noted that there is confusion in the literature regarding radiologic terminology concerning partial absence of the corpus callosum, where various designations have been used, including hypogenesis, hypoplasia, partial agenesis, or dysgenesis.
Action tremor
MedGen UID:
65875
Concept ID:
C0234376
Sign or Symptom
A tremor present when the limbs are active, either when outstretched in a certain position or throughout a voluntary movement.
Dysdiadochokinesis
MedGen UID:
115975
Concept ID:
C0234979
Sign or Symptom
A type of ataxia characterized by the impairment of the ability to perform rapidly alternating movements, such as pronating and supinating his or her hand on the dorsum of the other hand as rapidly as possible.
Gray matter heterotopia
MedGen UID:
452349
Concept ID:
C0266491
Finding
Heterotopia or neuronal heterotopia are macroscopic clusters of misplaced neurons (gray matter), most often situated along the ventricular walls or within the subcortical white matter.
Global developmental delay
MedGen UID:
107838
Concept ID:
C0557874
Finding
A delay in the achievement of motor or mental milestones in the domains of development of a child, including motor skills, speech and language, cognitive skills, and social and emotional skills. This term should only be used to describe children younger than five years of age.
Intellectual disability
MedGen UID:
811461
Concept ID:
C3714756
Mental or Behavioral Dysfunction
Intellectual disability, previously referred to as mental retardation, is characterized by subnormal intellectual functioning that occurs during the developmental period. It is defined by an IQ score below 70.
Asthma
MedGen UID:
2109
Concept ID:
C0004096
Disease or Syndrome
Asthma is characterized by increased responsiveness of the tracheobronchial tree to multiple stimuli, leading to narrowing of the air passages with resultant dyspnea, cough, and wheezing.
Eczematoid dermatitis
MedGen UID:
3968
Concept ID:
C0013595
Disease or Syndrome
Eczema is a form of dermatitis that is characterized by scaly, pruritic, erythematous lesions located on flexural surfaces.
Reduced gamma-glutamyltransferase level
MedGen UID:
1842159
Concept ID:
C5826398
Finding
Decreased level of the enzyme gamma-glutamyltransferase (GGT). GGT is mainly present in kidney, liver, and pancreatic cells, but small amounts are present in other tissues.
Reduced tissue gamma-glutamyltransferase activity
MedGen UID:
1053651
Concept ID:
CN377410
Finding
Activity of gamma-glutamyltransferase in the tissues below the lower limit of normal. The activity can be measured in multiple tissues including leukocytes and cultured fibroblasts.
Strabismus
MedGen UID:
21337
Concept ID:
C0038379
Disease or Syndrome
A misalignment of the eyes so that the visual axes deviate from bifoveal fixation. The classification of strabismus may be based on a number of features including the relative position of the eyes, whether the deviation is latent or manifest, intermittent or constant, concomitant or otherwise and according to the age of onset and the relevance of any associated refractive error.
Hypotelorism
MedGen UID:
96107
Concept ID:
C0424711
Finding
Interpupillary distance less than 2 SD below the mean (alternatively, the appearance of an decreased interpupillary distance or closely spaced eyes).

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVgamma-Glutamyltransferase deficiency

Recent clinical studies

Etiology

Siebold L, Dick AA, Thompson R, Maggiore G, Jacquemin E, Jaffe R, Strautnieks S, Grammatikopoulos T, Horslen S, Whitington PF, Shneider BL
Liver Transpl 2010 Jul;16(7):856-63. doi: 10.1002/lt.22074. PMID: 20583290
Liu LY, Wang ZL, Wang XH, Zhu QR, Wang JS
Liver Int 2010 Jul;30(6):809-15. Epub 2009 Oct 21 doi: 10.1111/j.1478-3231.2009.02112.x. PMID: 19845854
Whitfield JB
Crit Rev Clin Lab Sci 2001 Aug;38(4):263-355. doi: 10.1080/20014091084227. PMID: 11563810
Mayatepek E, Zelezny R, Lehmann WD, Hammond JW, Hoffmann GF
J Inherit Metab Dis 2000 Jun;23(4):404-8. doi: 10.1023/a:1005664204956. PMID: 10896305

Diagnosis

Liu LY, Wang ZL, Wang XH, Zhu QR, Wang JS
Liver Int 2010 Jul;30(6):809-15. Epub 2009 Oct 21 doi: 10.1111/j.1478-3231.2009.02112.x. PMID: 19845854
Ristoff E, Larsson A
Orphanet J Rare Dis 2007 Mar 30;2:16. doi: 10.1186/1750-1172-2-16. PMID: 17397529Free PMC Article
Iida M, Yasuhara T, Mochizuki H, Takakura H, Yanagisawa T, Kubo H
J Inherit Metab Dis 2005;28(1):49-55. doi: 10.1007/s10545-005-4417-8. PMID: 15702405
Ristoff E, Larsson A
Chem Biol Interact 1998 Apr 24;111-112:113-21. doi: 10.1016/s0009-2797(97)00155-5. PMID: 9679548
Russo SA, Harris MB, Greengard O
Am J Hematol 1987 Sep;26(1):67-75. doi: 10.1002/ajh.2830260108. PMID: 2888307

Therapy

Rojas E, Shi ZZ, Valverde M, Paules RS, Habib GM, Lieberman MW
Biofactors 2003;17(1-4):13-9. doi: 10.1002/biof.5520170102. PMID: 12897424
Hanigan MH, Gallagher BC, Townsend DM, Gabarra V
Carcinogenesis 1999 Apr;20(4):553-9. doi: 10.1093/carcin/20.4.553. PMID: 10223181Free PMC Article
Iyngkaran N, Yadav M, Boey CG
Acta Paediatr Scand 1991 May;80(5):549-50. doi: 10.1111/j.1651-2227.1991.tb11902.x. PMID: 1678569

Prognosis

Siebold L, Dick AA, Thompson R, Maggiore G, Jacquemin E, Jaffe R, Strautnieks S, Grammatikopoulos T, Horslen S, Whitington PF, Shneider BL
Liver Transpl 2010 Jul;16(7):856-63. doi: 10.1002/lt.22074. PMID: 20583290
Ristoff E, Larsson A
Orphanet J Rare Dis 2007 Mar 30;2:16. doi: 10.1186/1750-1172-2-16. PMID: 17397529Free PMC Article
Whitfield JB
Crit Rev Clin Lab Sci 2001 Aug;38(4):263-355. doi: 10.1080/20014091084227. PMID: 11563810
Russo SA, Harris MB, Greengard O
Am J Hematol 1987 Sep;26(1):67-75. doi: 10.1002/ajh.2830260108. PMID: 2888307
Griffith OW, Meister A
Proc Natl Acad Sci U S A 1980 Jun;77(6):3384-7. doi: 10.1073/pnas.77.6.3384. PMID: 6106190Free PMC Article

Clinical prediction guides

Siebold L, Dick AA, Thompson R, Maggiore G, Jacquemin E, Jaffe R, Strautnieks S, Grammatikopoulos T, Horslen S, Whitington PF, Shneider BL
Liver Transpl 2010 Jul;16(7):856-63. doi: 10.1002/lt.22074. PMID: 20583290
Ristoff E, Larsson A
Orphanet J Rare Dis 2007 Mar 30;2:16. doi: 10.1186/1750-1172-2-16. PMID: 17397529Free PMC Article
Whitfield JB
Crit Rev Clin Lab Sci 2001 Aug;38(4):263-355. doi: 10.1080/20014091084227. PMID: 11563810
Ben-Yoseph Y, Rembelski P, Nadler HL
Pediatr Res 1984 Dec;18(12):1340-3. doi: 10.1203/00006450-198412000-00025. PMID: 6151640

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