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Pompe Disease

Differential Diagnosis

Historically, Pompe disease has sometimes been misdiagnosed as limb girdle muscular dystrophy, Duchenne muscular dystrophy, or polymyositis. [1, 2] Depending on the individual's presenting symptoms and age of onset, there may be several other possible causes to evaluate during the diagnostic query. The table below summarizes the more common differential diagnoses as well as the shared manifestations that may be suggestive of that particular disease. [3, 4, 5, 6]

Please click here to view definitions of differential diagnoses terms.

Differential Diagnoses for Infantile-Onset
Differential Diagnoses for Infantile-Onset Shared Signs & Symptoms
Acute Werdnig-Hoffman disease
(Spinal muscular atrophy I)
Hypotonia, progressive proximal muscle weakness, absent reflexes
Danon disease Hypertrophic cardiomyopathy, skeletal muscle myopathy, vacuolar storage of glycogen
Endocardial fibroelastosis Breathlessness, feeding difficulties, cardiomegaly, heart failure
Glycogen storage diseases III, VI Hypotonia, cardiomegaly, muscle weakness, elevated creatine kinase (CK)
Idiopathic hypertrophic cardiomyopathy Biventricular hypertrophy
Liver failure Elevated aspartate aminotransferase (AST), hepatomegaly
Mitochondrial disorders Hepatomegaly, elevated creatine kinase (CK), cardiomyopathy, myopathy
Myocarditis Inflammation of the myocardium contributing to cardiac enlargement

Differential Diagnoses for Late-Onset
Differential Diagnoses for Late-Onset Shared Signs & Symptoms
Duchenne muscular dystrophy (DMD) Progressive proximal muscle weakness, respiratory impairment, difficulty walking
Glycogen storage diseases III, VI Hypotonia, hepatomegaly, muscle weakness, elevated creatine kinase (CK)
Glycogen storage disease V Elevated creatine kinase (CK), muscle cramps during exercise
Liver failure Elevated aspartate aminotransferase (AST), hepatomegaly
Limb girdle muscular dystrophy (LGMD) Progressive muscle weakness in the pelvis, legs, or shoulders
Polymyositis Unexplained muscle weakness
Rigid spine syndrome Spinal rigidity, lower back pain
Rheumatoid arthritis Pain upon exertion
Scapuloperoneal syndromes Progressive muscle weakness behind the knees and around the shoulder blades
Sleep apnea Morning headaches, frequent nocturnal awakenings, daytime fatigue and drowsiness

References

1. King, Frank J. Acid Maltase Deficiency Myopathy. eMedicine Specialties. Available at: http://www.emedicine.com/pmr/topic2.htm . Accessed November 7, 2002.

2. Anderson, Wayne E. Glycogen Storage Disease Type II. eMedicine Specialties. Available at: http://www.emedicine.com/med/topic908.htm . Accessed November 7, 2002.

3. Personal communication with Dr. Priya Kishnani, Department of Pediatrics, Duke University Medical Center, Durham, North Carolina.

4. Hirschhorn, Rochelle and Arnold J. J. Reuser. Glycogen Storage Disease Type II: Acid-Alpha Glucosidase (Acid Maltase) Deficiency. In: Wonsiewicz M, Noujaim S, Boyle P, eds. The Metabolic and Molecular Bases of Inherited Disease. 8th Edition. New York: McGraw-Hill; 2001; 3389-3420.

5. King, Frank J. Acid Maltase Deficiency Myopathy. eMedicine Specialties. Available at: http://www.emedicine.com/pmr/topic2.htm . Accessed November 7, 2002.

6. Ibrahim, Jennifer. Glycogen Storage Disease Type II. eMedicine Specialties. Available at: http://www.emedicine.com/ped/topic1866.htm Accessed November 7, 2002.

 
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Lysosomal Storage Disorders
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MPS I Disease
Pompe Disease