Evidence map›Paper›PMID 40866742›Full record

ReviewHormones (Athens, Greece)2025

Glucose dynamics in glycogen storage disease type IXa with novel PHKA2 variants: insights from our experience and a comprehensive review of the disease spectrum.

Federico Baronio, Giacomo Biasucci, Egidio Candela, Maria Giulia Regazzi, Valeria Di Natale, Rita Ortolano, Marcello Lanari

Abstract readReviewCase Reports
In one paragraph

Review in Hormones (Athens, Greece), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Federico BaronioPediatric Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, via Massarenti 9, Bologna, Italy.
Giacomo BiasucciPediatrics and Neonatology Unit, Guglielmo da Saliceto Hospital, Piacenza, 29121, Italy.
Egidio CandelaPediatric Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, via Massarenti 9, Bologna, Italy. egidio.candela2@unibo.it.ORCID http://orcid.org/0000-0002-4573-9314
Maria Giulia RegazziClinical Nutrition and Metabolism Unit- IRCCS Azienda Ospedaliero- Universitaria di Bologna, via Massarenti 9, Bologna, Italy.
Valeria Di NatalePediatric Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, via Massarenti 9, Bologna, Italy.
Rita OrtolanoPediatric Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, via Massarenti 9, Bologna, Italy.
Marcello LanariPediatric Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, via Massarenti 9, Bologna, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundGlycogen storage disease type IXa (GSD IXa), caused by phosphorylase kinase mutations, primarily PHKA2, presents variably from mild hepatomegaly to severe liver dysfunction or isolated ketotic hypoglycemia. Its phenotypic overlap with other metabolic disorders complicates diagnosis, requiring genetic confirmation.

methodsWe retrospectively analyzed clinical, biochemical, genetic, and radiological data from patients affected by GSD IXa diagnosed at our regional metabolic disease center in Bologna (Emilia-Romagna, Italy) over recent decades and we reviewed the relevant scientific literature on the pathology.

resultsWe report three patients with recurrent symptomatic ketotic hypoglycemia affected by PHKA2 variants of uncertain significance (VUS) and review the literature concerning GSD IXa.

conclusionGSD IXa should be considered in the differential diagnosis even when persistent ketotic hypoglycemia is the sole presenting feature, underscoring the critical importance of clinical suspicion in such cases. Improved genetic testing has refined diagnosis, even in milder cases without hepatomegaly, while dietary management with uncooked cornstarch (CS) and extended-release cornstarch (ER-CS) effectively prevents complications and maintains good glycemic control.

Indexed as

Blood GlucoseGlycogen Storage DiseasePhosphorylase KinaseHumansHypoglycemiaMutationRetrospective StudiesBlood GlucosePHKA2 protein, humanPhosphorylase KinaseExtended-release cornstarchGlycogen storage disease IXGlycosadeGSD IXKetotic hypoglycemiaPediatric endocrinologyPediatric metabolic diseasePHKA2Uncooked cornstarch

Identifiers

PMID40866742
PMCPMC12678572

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.