Hereditary fructose intolerance Health Article

Definition

Hereditary fructose intolerance is a disorder in which a person lacks the protein needed to break down fructose. Fructose is a fruit sugar that naturally occurs in the body. Man-made fructose is used as a sweetener in many foods, including baby food and drinks.

Alternative Names

Fructosemia; Fructose intolerance; Fructose aldolase B-deficiency; Fructose 1, 6 bisphosphate aldolase deficiency

Causes, incidence, and risk factors

This condition occurs when the body is missing an enzyme called aldolase B. This substance is needed to break down fructose.

If a person without this substance eats fructose and sucrose (cane or beet sugar, table sugar), complicated chemical changes occur in the body. The body cannot change its energy storage material, glycogen, into glucose. As a result, the blood sugar falls and dangerous substances build up in the liver.

Hereditary fructose intolerance is inherited, which means it is passed down through families. If both parents carry an abnormal gene, each of their children has a 25% chance of being affected. The condition may be as common as 1 in 20,000 people in some European countries.

Symptoms

Symptoms can be seen after a baby starts eating food or formula.

The early symptoms of fructose intolerance are similar to those of galactosemia. Later symptoms relate more to liver disease.

Symptoms may include:

• Convulsions
• Excessive sleepiness
• Irritability
• Jaundice
• Poor feeding as a baby
• Problems after eating fruits and fructose/sucrose-containing foods
• Vomiting

Signs and tests

Physical examination may show:

• Enlarged liver and spleen (hepatosplenomegaly)
• Yellow skin or eyes

Tests that confirm the diagnosis include:

• Blood clotting tests
• Blood sugar test
• Enzyme studies
• Genetic testing
• Kidney function tests
• Liver function tests
• Liver biopsy
• Uric acid blood test
• Urinalysis

Blood sugar will be low, especially after receiving fructose or sucrose. Uric acid levels will be high.

Treatment

Removing fructose and sucrose from the diet is an effective treatment for most patients. Complications are treated. For example, some patients can take medication to lower the level of uric acid in their blood and decrease their risk for gout.