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Fructose Intolerance

OMIM ID:

autosomal recessive

Fructose Intolerance

Alternate Names

fructosemia
aldolase deficiency
hereditary fructose intolerance

Defective Genes

ALDOB

Clinical Characteristics

Ocular Features

Dense cataracts have been reported in the first decade of life in several patients.

Systemic Features

Abdominal pain, vomiting and hypoglycemia usually appears in infancy upon the introduction of fructose or sucrose to the diet.  Some infants have a more severe reaction to such sugars with lethargy, seizures and coma.  Older children and adults develop a protective aversion to fruits and sweets.  Chronic ingestion leads to liver cirrhosis, renal tubule damage, growth retardation, and even malnutrition.  Adults may also have hypoglycemia and metabolic acidosis when challenged with sucrose and fructose.

Genetics

Inheritance

This is an autosomal recessive disorder resulting from mutations in the ALDOB gene (9q31.1).  However, several heterozygous patients with symptoms have been reported and such individuals may be predisposed to hyperuricemia.  Multiple mutations have been identified in the ALDOB gene.

Pedigree

Autosomal recessive

In order for autosomal recessive disorders to be expressed, offspring generally must inherit two mutations, one from each carrier parent.  Carriers with only one mutation, such as the parents, do not have clinical disease.  Note that carrier parents can expect that 1 in 4 children (25%) will inherit both mutations and have the disorder, 2 in 4 children (50%) will be carriers like their parents, while 1 in 4 children (25%) inherit neither mutation.

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Sample pedigree of autosomal recessive inheritance

In order for autosomal recessive disorders to be expressed, offspring generally must inherit two mutations, one from each carrier parent. Carriers with only one mutation, such as the parents, do not have clinical disease. Note that carrier parents can expect that 1 in 4 children (25%) will inherit both mutations and have the disorder, 2 in 4 children (50%) will be carriers like their parents, while 1 in 4 children (25%) inherit neither mutation.

Treatment & Management

Treatment with a fructose restricted diet is highly effective but must be strictly enforced to allow normal growth.

Publications

Displaying 1 - 3 of 3

Fructose intolerance associated with congenital cataract: Report of a case

PubMedID: 5719655

Hereditary fructose intolerance.

PubMedID: 9610797

Two cases of hereditary fructose intolerance

PubMedID: 23105397