• About PGC
• Donations
• Get Involved
• Register

Classic Galactosemia is a rare genetic metabolic disorder. The child with classic galactosemia inherits a gene for galactosemia from both parents, who are carriers. Patients who inherit the classic galactosemia gene from each parent are sometimes described as having the genetic makeup "G/G". Normally when a person consumes a product that contains lactose (e.g., dairy products such as milk, cheese, butter), the body breaks the lactose down into galactose and glucose. Glucose is the sugar used by the body for energy. Galactosemia means too much galactose in the blood caused by the individual "missing" the enzyme (known as GALT) to convert galactose into glucose. This accumulation of galactose is a poison to the body and can cause serious complications such as the following and if untreated, as high as 75% of infants will die:

Diagnosis is made usually within the first week of life by blood test from a heel prick as part of a standard newborn screening. Treatment requires the strict exclusion of lactose/galactose from the diet. Although galactosemic children are started on diet restriction at birth, there continues to be a high incidence of long-term complications involving speech and language, fine and gross motor skill delays and specific learning disabilities. Ovarian failure may occur in girls. Prenatal diagnosis by amniocentresis is also available.

Duarte Galactosemia is a variant of classic galactosemia. Fortunately, the complications associated with classic galactosemia have not been associated with Duarte galactosemia. The child with Duarte galactosemia inherits a gene for classic galactosemia (G) from one parent, and a Duarte variant gene (D) from the other parent. Patients with this genetic make-up are frequently referred to as D/G galactosemics.

Diagnosis of Duarte galactosemia is made usually within the first weeks of life by the same blood test used to diagnose classic galactosemia. Galactose-1-phosphate uridyltransferase (GALT) enzyme activity in D/G patients is approximately 25%-50% of that found in children born with no galactosemia gene.

There is some disagreement over the need for dietary restriction in the treatment of children with Duarte galactosemia. Consult your medical advisors (preferrably a pediatric metabolic geneticist) for their advice on this topic. Dietary Options include :

There is no research that conclusively reveals medical or other developmental complications attributable to Duarte galactosemia in D/G patients.

A person unaffected by galactosemia (neither carrier nor galactosemic) inherits two ‘normal' genes for the production of the GALT enzyme (the enzyme needed to convert galactose into a form useable by the body) . This person's genotype would be N/N and their enzyme activity would be normal.

A person who is a carrier of classic galactosemia inherits one normal gene from one parent and one gene containing the error that leads to classic galactosemia from the other parent. This person's genotype would be G/N and their enzyme activity would be less than normal, but not so much so as to cause medical complications or require dietary management.

A person who is classic galactosemic inherits two genes with the error, one from each of his/her parents. This person's genotype would be G/G and their enzyme activity would be essentially zero.

Genotypes involving the Duarte variant gene include:

D/N = carrier of Duarte galactosemia (about 75% enzyme activity)
D/D = homozygous carrier of Duarte galactosemia (about 50% enzyme activity)
D/G = Duarte galactosemia (about 25 - 50% enzyme activity ??)

Galactosemia was first "discovered" in 1908. Von Ruess, in a 1908 publication entitled, "Sugar Excretion in Infancy," reported on a breast-fed infant with failure to thrive, enlargement of the liver and spleen, and "galactosuria". This infant ceased to excrete galactose through the urine when milk products were removed from the diet. The infant, however, later died because of other complications (the baby had been given tea laced with cognac as treatment as well). An autopsy revealed cirrhosis of the liver, which they thought was due to the infant's alcohol ingestion. Though confirmation of the diagnosis was not possible at that time, it has been generally accepted that Von Ruess was the first to report on a patient with galactosemia.

By 1917, "galactosuria" was a broadly recognized inherited disorder and was treated by removal of milk products from the diet.

The disease was first recognized and described in detail (ie published work) in 1935 by Mason and Turner. Leloir worked out the metabolic pathway and the process of sugar-nucleotides and won the Nobel prize in Chemistry in 1970 for his work. He and coworkers elucidated the pathway for converting galactose to glucose in the early 50's.

Although, the clinicians recognized galactosemia very early in the century, the defective gene that caused it wasn't found until 1956. Another major break-through was when it was first found to be detectable through a newborn screening method in 1963. This method was developed by Guthrie and Paigen. Galactosemia was the second disorder found to be detectable through newborn screening methods by Robert Guthrie.

PGC is happy to provide assistance to students writing research papers, essays, etc. about galactosemia. The following information was prepared by Barb Bense, (the mother of a galactosemic child), Paul Taylor (ptaylortse@aol.com the father of a galactosemic child), and Paul Atkinson (also the father of a galactosemic child) to provide additional information to students who are researching galactosemia. Thank you Barb, Paul, and Paul !!