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Glycine encephalopathy 2(GCE2)

MedGen UID:
1841195
Concept ID:
C5830559
Disease or Syndrome
Synonym: GCE2
 
Gene (location): AMT (3p21.31)
 
Monarch Initiative: MONDO:0958192
OMIM®: 620398

Definition

Glycine encephalopathy (GCE), also called nonketotic hyperglycinemia (NKH), is an inborn error of metabolism characterized by accumulation of a large amount of glycine in body fluids. Typical cases have severe neurologic features, including seizures, lethargy, and muscular hypotonia soon after birth, and most die with the neonatal period; atypical cases have later onset and less severe psychomotor development (summary by Nanao et al., 1994). For a general description and a discussion of genetic heterogeneity of glycine encephalopathy, see GCE1 (605899). [from OMIM]

Clinical features

From HPO
Seizure
MedGen UID:
20693
Concept ID:
C0036572
Sign or Symptom
A seizure is an intermittent abnormality of nervous system physiology characterized by a transient occurrence of signs and/or symptoms due to abnormal excessive or synchronous neuronal activity in the brain.
Intellectual disability, severe
MedGen UID:
48638
Concept ID:
C0036857
Mental or Behavioral Dysfunction
Severe mental retardation is defined as an intelligence quotient (IQ) in the range of 20-34.
EEG with burst suppression
MedGen UID:
369943
Concept ID:
C1969156
Finding
The burst suppression pattern in electroencephalography refers to a characteristic periodic pattern of low voltage (<10 microvolts) suppressed background and a relatively shorter pattern of higher amplitude slow, sharp, and spiking complexes.
Mild global developmental delay
MedGen UID:
861405
Concept ID:
C4012968
Finding
A mild delay in the achievement of motor or mental milestones in the domains of development of a child.
Increased CSF glycine concentration
MedGen UID:
1691638
Concept ID:
C5139615
Finding
Abnormally increased levels of glycine in cerebrospinal fluid.
Respiratory failure
MedGen UID:
257837
Concept ID:
C1145670
Disease or Syndrome
A severe form of respiratory insufficiency characterized by inadequate gas exchange such that the levels of oxygen or carbon dioxide cannot be maintained within normal limits.
Glycine encephalopathy
MedGen UID:
155625
Concept ID:
C0751748
Disease or Syndrome
Nonketotic hyperglycinemia (NKH) is the inborn error of glycine metabolism defined by deficient activity of the glycine cleavage enzyme system (GCS), which results in accumulation of large quantities of glycine in all body tissues including the brain. Based on ultimate outcome NKH is categorized into severe NKH (no developmental progress and intractable epilepsy) and attenuated NKH (variable developmental progress and treatable or no epilepsy). The majority of children with NKH have onset in the neonatal period manifest as progressive lethargy evolving into profound coma and marked hypotonia; 85% have severe NKH and 15% attenuated NKH. Those with onset between two weeks and three months typically present with hypotonia; 50% have severe NKH and 50% attenuated NKH. Those with onset after age three months have attenuated NKH. Severe versus attenuated NKH is consistent within families, but the degree of developmental progress in those with attenuated NKH can vary.

Professional guidelines

PubMed

Zou W, Li M, Wang X, Lu H, Hao Y, Chen D, Zhu S, Ji D, Zhang Z, Zhou P, Cao Y
J Assist Reprod Genet 2024 May;41(5):1245-1259. Epub 2024 Mar 12 doi: 10.1007/s10815-024-03057-1. PMID: 38470552Free PMC Article
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Recent clinical studies

Etiology

Leyne E, Anselem O, Jordan P, Vivanti AJ, Benachi A, Salomon L, Jacquier M, Jouannic JM, Dhombres F, Cambier T, Rosenblatt J, Pannier E, Goffinet F, Tsatsaris V, Athiel Y
Acta Obstet Gynecol Scand 2024 Jan;103(1):51-58. Epub 2023 Nov 9 doi: 10.1111/aogs.14716. PMID: 37942915Free PMC Article
Kuseyri Hübschmann O, Juliá-Palacios NA, Olivella M, Guder P, Zafeiriou DI, Horvath G, Kulhánek J, Pearson TS, Kuster A, Cortès-Saladelafont E, Ibáñez S, García-Jiménez MC, Honzík T, Santer R, Jeltsch K, Garbade SF, Hoffmann GF, Opladen T, García-Cazorla Á
Ann Neurol 2022 Aug;92(2):292-303. Epub 2022 Jun 16 doi: 10.1002/ana.26423. PMID: 35616651
Vatanavicharn N, Ratanarak P, Liammongkolkul S, Sathienkijkanchai A, Wasant P
Clin Chim Acta 2012 Jul 11;413(13-14):1141-4. Epub 2012 Mar 23 doi: 10.1016/j.cca.2012.03.014. PMID: 22465081
Schiffmann R, Kaye EM, Willis JK 3rd, Africk D, Ampola M
Ann Neurol 1989 Feb;25(2):201-3. doi: 10.1002/ana.410250218. PMID: 2919871
Geison RL, Rowley BO, Gerritsen T
Clin Chim Acta 1975 Apr 16;60(2):137-42. doi: 10.1016/0009-8981(75)90118-7. PMID: 1126035

Diagnosis

Swanson MA, Coughlin CR Jr, Scharer GH, Szerlong HJ, Bjoraker KJ, Spector EB, Creadon-Swindell G, Mahieu V, Matthijs G, Hennermann JB, Applegarth DA, Toone JR, Tong S, Williams K, Van Hove JL
Ann Neurol 2015 Oct;78(4):606-18. Epub 2015 Aug 10 doi: 10.1002/ana.24485. PMID: 26179960Free PMC Article
Mitchell JP, Yancy A, Saint Louis L, Rosberger DF
J Natl Med Assoc 2009 Apr;101(4):373-6. doi: 10.1016/s0027-9684(15)30888-9. PMID: 19397231
Applegarth DA, Toone JR
Am J Med Genet A 2006 Jan 15;140(2):186-8. doi: 10.1002/ajmg.a.31030. PMID: 16353254
Schiffmann R, Kaye EM, Willis JK 3rd, Africk D, Ampola M
Ann Neurol 1989 Feb;25(2):201-3. doi: 10.1002/ana.410250218. PMID: 2919871
Biasioli S, D'Andrea G, Feriani M, Chiaramonte S, Fabris A, Ronco C, La Greca G
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Therapy

Jiang T, Dong Y, Zhu W, Wu T, Chen L, Cao Y, Yu X, Peng Y, Wang L, Xiao Y, Zhong T
Crit Rev Food Sci Nutr 2024 Nov;64(31):11543-11555. Epub 2023 Jul 27 doi: 10.1080/10408398.2023.2240886. PMID: 37497995
Shelkowitz E, Saneto RP, Al-Hertani W, Lubout CMA, Stence NV, Brown MS, Long P, Walleigh D, Nelson JA, Perez FE, Shaw DWW, Michl EJ, Van Hove JLK
Orphanet J Rare Dis 2022 Dec 5;17(1):423. doi: 10.1186/s13023-022-02581-6. PMID: 36471344Free PMC Article
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Neurol India 2022 Jan-Feb;70(1):312-314. doi: 10.4103/0028-3886.338670. PMID: 35263902
Kennedy KN, Wang YD
Am J Med 2019 May;132(5):585-587. Epub 2019 Jan 9 doi: 10.1016/j.amjmed.2018.12.024. PMID: 30639550
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Prognosis

Kuseyri Hübschmann O, Juliá-Palacios NA, Olivella M, Guder P, Zafeiriou DI, Horvath G, Kulhánek J, Pearson TS, Kuster A, Cortès-Saladelafont E, Ibáñez S, García-Jiménez MC, Honzík T, Santer R, Jeltsch K, Garbade SF, Hoffmann GF, Opladen T, García-Cazorla Á
Ann Neurol 2022 Aug;92(2):292-303. Epub 2022 Jun 16 doi: 10.1002/ana.26423. PMID: 35616651
Swanson MA, Coughlin CR Jr, Scharer GH, Szerlong HJ, Bjoraker KJ, Spector EB, Creadon-Swindell G, Mahieu V, Matthijs G, Hennermann JB, Applegarth DA, Toone JR, Tong S, Williams K, Van Hove JL
Ann Neurol 2015 Oct;78(4):606-18. Epub 2015 Aug 10 doi: 10.1002/ana.24485. PMID: 26179960Free PMC Article
Aliefendioğlu D, Tana Aslan Ay, Coşkun T, Dursun A, Cakmak FN, Kesimer M
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Applegarth DA, Toone JR, Rolland MO, Black SH, Yim DK, Bemis G
Prenat Diagn 2000 May;20(5):367-70. doi: 10.1002/(sici)1097-0223(200005)20:5<367::aid-pd814>3.0.co;2-e. PMID: 10820402
Schiffmann R, Kaye EM, Willis JK 3rd, Africk D, Ampola M
Ann Neurol 1989 Feb;25(2):201-3. doi: 10.1002/ana.410250218. PMID: 2919871

Clinical prediction guides

Shelkowitz E, Saneto RP, Al-Hertani W, Lubout CMA, Stence NV, Brown MS, Long P, Walleigh D, Nelson JA, Perez FE, Shaw DWW, Michl EJ, Van Hove JLK
Orphanet J Rare Dis 2022 Dec 5;17(1):423. doi: 10.1186/s13023-022-02581-6. PMID: 36471344Free PMC Article
Kuseyri Hübschmann O, Juliá-Palacios NA, Olivella M, Guder P, Zafeiriou DI, Horvath G, Kulhánek J, Pearson TS, Kuster A, Cortès-Saladelafont E, Ibáñez S, García-Jiménez MC, Honzík T, Santer R, Jeltsch K, Garbade SF, Hoffmann GF, Opladen T, García-Cazorla Á
Ann Neurol 2022 Aug;92(2):292-303. Epub 2022 Jun 16 doi: 10.1002/ana.26423. PMID: 35616651
Swanson MA, Coughlin CR Jr, Scharer GH, Szerlong HJ, Bjoraker KJ, Spector EB, Creadon-Swindell G, Mahieu V, Matthijs G, Hennermann JB, Applegarth DA, Toone JR, Tong S, Williams K, Van Hove JL
Ann Neurol 2015 Oct;78(4):606-18. Epub 2015 Aug 10 doi: 10.1002/ana.24485. PMID: 26179960Free PMC Article
Hennermann JB, Berger JM, Grieben U, Scharer G, Van Hove JL
J Inherit Metab Dis 2012 Mar;35(2):253-61. Epub 2011 Oct 15 doi: 10.1007/s10545-011-9398-1. PMID: 22002442
Geison RL, Rowley BO, Gerritsen T
Clin Chim Acta 1975 Apr 16;60(2):137-42. doi: 10.1016/0009-8981(75)90118-7. PMID: 1126035

Recent systematic reviews

Lora-Tamayo J, Palom X, Sarrá J, Gasch O, Isern V, Fernández de Sevilla A, Pujol R
Clin Lymphoma Myeloma 2008 Dec;8(6):363-9. doi: 10.3816/CLM.2008.n.054. PMID: 19064403

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