What happens in this disease?
A change in the MAN2B1 gene disrupts the enzyme alpha-mannosidase. This enzyme breaks down sugar chains attached to proteins. The chains that are not broken down build up in the cells and damage them. There are different forms, from mild to severe.
Which symptoms can occur?
Symptoms vary greatly from person to person. Mild forms progress slowly.
- Delayed mental development, difficulty with speech
- Hearing loss
- Frequent infections
- Distinctive facial features and skeletal changes
- Unsteady movements and muscle weakness
- Delay in sitting and walking
- Cataract in the eye, meaning clouding of the lens
- In some people, mental health symptoms such as anxiety or depression
How is it diagnosed?
The enzyme alpha-mannosidase is measured in white blood cells. Some sugar chains may be found to be high in the urine. The diagnosis is confirmed with a genetic test for the MAN2B1 gene.
Treatment and care
There is an approved enzyme replacement therapy for symptoms outside the nervous system. Infections are treated early. Hearing aids and ear tubes help hearing. Physiotherapy, speech therapy and special education are important. A bone marrow transplant is an option being researched. The doctor who follows the disease decides which treatment is suitable.
For the family: inheritance and genetic counselling
The disease is passed on through recessive inheritance. The mother and father are usually healthy carriers. For a couple who are both carriers, the chance of having an affected child is 1 in 4 in each pregnancy. Diseases of this kind may be more common in marriages between relatives. Genetic counselling guides the family.