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GALACTOSEMIA AND
    LACTOSE
 INTELORANCE!!!
GALACTOSEMIA


• Galactosemia is a rare genetic metabolic genetic
  disorder that affects an individual's ability to metabolize
  the sugar galactose properly.

• Galactosemia means "galactose in the blood ".

• Galactose is a type of food sugar found mainly in dairy
  products, and is produced within the body as well.
lactose           glucose       galactose




• Lactose in food (such as dairy products) is broken down
  by the enzyme lactase into glucose and galactose.



• Glucose can be used as a source of energy by the body,
  but galactose needs to be further broken down by a
  specific chemical (enzyme) before it can be utilized.
• An autosomal recessive mode of inheritance that
  confers a deficiency in an enzyme responsible for
  galactose degradation.

• Meaning a child must inherit one defective gene from
  each parent to show the disease.
CAUSES OF GALACTOSEMIA!!!!

• Individuals with this disease the enzyme for the
  metabolism of galactose is diminished or missing entirely
• This leads to toxic level of galactose-1-phosphate in
  various tissue resulting in hematomegaly (an enlarged
  liver), chirrosis, renal failure, cataracts, brain damage
  and ovarian failure (female only).
Types of galactosemia!!!

• Galactose is converted into glucose into 3 types of
  enzyme.
• Known as the Leloir pathway.
TYPE       GENE      LOCUS    ENZYME                 NAME



  1       GALT        9p13      galactose-1-        classic
                              phosphate uridyl   galactosemia
                                transferase

  2       GALK1      17q24     galactokinase     galactokinase
                                                   deficiency

  3       GALE      1p35-36   UDP galactose       galactose
                               epimerase          epimerase
                                                  deficiency
• Classic galactosemia, also known as type I, is the most
  common and most severe form of the condition.

• If infants with classic galactosemia are not treated
  promptly with a low-galactose diet, life-threatening
  complications appear within a few days after birth.

• Typically develop feeding difficulties, a lack of energy
  (lethargy), a failure to gain weight and grow as
  expected (failure to thrive), yellowing of the skin and
  whites of the eyes (jaundice), liver damage, and
  bleeding.
• Galactosemia type II (galactokinase deficiency) causes
  fewer medical problems than the classic type.

• Marked by an accumulation
  of galactose and galactitol secondary to the decreased
  conversion of galactose to galactose-1-
  phosphate by galactokinase.

• Affected infants develop cataracts, but otherwise
  experience few long-term complications.
• The signs and symptoms of galactosemia type III vary
  from mild to severe and can include cataracts, delayed
  growth and development, intellectual disability, liver
  disease, and kidney problems.

• There are 2 forms of epimerase deficiency: benign
  RBC deficiency and Severe liver deficiency.

• Severe form is similar to galactosemia.
Treatment for galactosemia!!!!


• It is stated that the only treatment for galactosemia is by
  eliminating lactose and galactose from diet……
LACTOSE INTOLERANCE
• Is also called lactose deficiency or hypoclastia.

• Inability of a person to digest lactose in the diet.

• Not a disorder but a genetically determined
  characteristic.

• It is inherited in the pattern of autosomal recessive
  diseases
• Lactose intolerant individuals have insufficient levels
  of lactase, an enzyme that catalyzes hydrolysis of
  lactose into glucose and galactose, in their digestive
  system.

• When lactose moves through the large
  intestine (colon) without being properly digested, it can
  cause uncomfortable symptoms such as gas, belly
  pain, and bloating.
• Almost all Asians and Native Americans are lactose
  intolerant, and up to 80% of African Americans and
  Hispanic Americans also have symptoms of lactose
  intolerance.
• Their ancestors did not eat dairy foods, so their bodies
  were not prepared to digest dairy, and they passed
  these genes on from generation to generation.
Symptoms of lactose intolerance!!!!

• abdominal
• bloating
• cramps
• flatulence
• diarrhea
• nausea
• borborygmi(rumbling stomach)
•  vomiting
-after consuming significant amounts of lactose
Types of lactose intolerance!!!

• three types:
 1.Primary lactase deficiency is genetic, only affects
  adults and is caused by the absence of a lactase
  persistence allele. It is the most common cause of
  lactose intolerance as a majority of the world's
  population lacks these alleles.
2.Secondary, acquired, or transient lactase
 deficiency is caused by an injury to the small intestine, 
 usually during infancy, from 
 acute gastroenteritis, diarrhea,chemotherapy,intestinal 
 parasites or other environmental causes.
3.Congenital lactase deficiency is a very 
   rare, autosomal recessive genetic disorder that prevents 
   lactase expression from birth.
   It is particularly common in Finland.
   People with congenital lactase deficiency are unable to 
   digest lactose from birth, and they are unable to digest 
   breast milk.
What causes lactose intolerance ?

• Is due to the mutation in LCT genes. 
• Mutation in both the LCT genes will result in this 
  diseases as it is autosomal recessive.
• Certain mutation in the LCT gene allow lactase continue 
  to be expressed after stopping breast feeding.
• The LCT gene which encodes the lactase protein is 
  located on the long arm (q) of chromosome 2 in region 
  21. (2q21)
Treatment of lactose intolerance!!!

• avoidance of dietary lactose

• substitution to maintain nutrient intake

•  regulation of calcium intake

•  use of enzyme substitute also known as enzyme 
  replacement theraphy in which mostly intravenous 
  injection containing the enzyme is given to the patients
POINT TO REMEMBER

• Lactose intolerance is the inability or insufficient ability to digest 
  lactose, a sugar found in milk and milk products.

• Lactose intolerance is caused by a deficiency of the enzyme lactase, 
  which is produced by the cells lining the small intestine.

• Not all people with lactase deficiency have digestive symptoms, but 
  those who do may have lactose intolerance.

• Most people with lactose intolerance can tolerate some amount of 
  lactose in their diet.

• People with lactose intolerance may feel uncomfortable after 
  consuming milk and milk products. Symptoms can include abdominal 
  pain, abdominal bloating, gas, diarrhea, and nausea.
• The symptoms of lactose intolerance can be managed with dietary 
  changes.

• Getting enough calcium and vitamin D is a concern for people with 
  lactose intolerance when the intake of milk and milk products is 
  limited. Many foods can provide the calcium and other nutrients the 
  body needs.

• Talking with a doctor or registered dietitian may be helpful in 
  planning a balanced diet that provides an adequate amount of 
  nutrients—including calcium and vitamin D—and minimizes 
  discomfort. A health professional can determine whether calcium and 
  other dietary supplements are needed.

• Milk and milk products are often added to processed foods. 
  Checking the ingredients on food labels is helpful in finding possible 
  sources of lactose in food products.

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Galactosemia and lactose intelorance!!!

  • 1. GALACTOSEMIA AND LACTOSE INTELORANCE!!!
  • 2. GALACTOSEMIA • Galactosemia is a rare genetic metabolic genetic disorder that affects an individual's ability to metabolize the sugar galactose properly. • Galactosemia means "galactose in the blood ". • Galactose is a type of food sugar found mainly in dairy products, and is produced within the body as well.
  • 3. lactose glucose galactose • Lactose in food (such as dairy products) is broken down by the enzyme lactase into glucose and galactose. • Glucose can be used as a source of energy by the body, but galactose needs to be further broken down by a specific chemical (enzyme) before it can be utilized.
  • 4. • An autosomal recessive mode of inheritance that confers a deficiency in an enzyme responsible for galactose degradation. • Meaning a child must inherit one defective gene from each parent to show the disease.
  • 5. CAUSES OF GALACTOSEMIA!!!! • Individuals with this disease the enzyme for the metabolism of galactose is diminished or missing entirely
  • 6. • This leads to toxic level of galactose-1-phosphate in various tissue resulting in hematomegaly (an enlarged liver), chirrosis, renal failure, cataracts, brain damage and ovarian failure (female only).
  • 7. Types of galactosemia!!! • Galactose is converted into glucose into 3 types of enzyme. • Known as the Leloir pathway. TYPE GENE LOCUS ENZYME NAME 1 GALT 9p13 galactose-1- classic phosphate uridyl galactosemia transferase 2 GALK1 17q24 galactokinase galactokinase deficiency 3 GALE 1p35-36 UDP galactose galactose epimerase epimerase deficiency
  • 8.
  • 9. • Classic galactosemia, also known as type I, is the most common and most severe form of the condition. • If infants with classic galactosemia are not treated promptly with a low-galactose diet, life-threatening complications appear within a few days after birth. • Typically develop feeding difficulties, a lack of energy (lethargy), a failure to gain weight and grow as expected (failure to thrive), yellowing of the skin and whites of the eyes (jaundice), liver damage, and bleeding.
  • 10. • Galactosemia type II (galactokinase deficiency) causes fewer medical problems than the classic type. • Marked by an accumulation of galactose and galactitol secondary to the decreased conversion of galactose to galactose-1- phosphate by galactokinase. • Affected infants develop cataracts, but otherwise experience few long-term complications.
  • 11. • The signs and symptoms of galactosemia type III vary from mild to severe and can include cataracts, delayed growth and development, intellectual disability, liver disease, and kidney problems. • There are 2 forms of epimerase deficiency: benign RBC deficiency and Severe liver deficiency. • Severe form is similar to galactosemia.
  • 12. Treatment for galactosemia!!!! • It is stated that the only treatment for galactosemia is by eliminating lactose and galactose from diet……
  • 14. • Is also called lactose deficiency or hypoclastia. • Inability of a person to digest lactose in the diet. • Not a disorder but a genetically determined characteristic. • It is inherited in the pattern of autosomal recessive diseases
  • 15. • Lactose intolerant individuals have insufficient levels of lactase, an enzyme that catalyzes hydrolysis of lactose into glucose and galactose, in their digestive system. • When lactose moves through the large intestine (colon) without being properly digested, it can cause uncomfortable symptoms such as gas, belly pain, and bloating.
  • 16. • Almost all Asians and Native Americans are lactose intolerant, and up to 80% of African Americans and Hispanic Americans also have symptoms of lactose intolerance. • Their ancestors did not eat dairy foods, so their bodies were not prepared to digest dairy, and they passed these genes on from generation to generation.
  • 17. Symptoms of lactose intolerance!!!! • abdominal • bloating • cramps • flatulence • diarrhea • nausea • borborygmi(rumbling stomach) • vomiting -after consuming significant amounts of lactose
  • 18. Types of lactose intolerance!!! • three types: 1.Primary lactase deficiency is genetic, only affects adults and is caused by the absence of a lactase persistence allele. It is the most common cause of lactose intolerance as a majority of the world's population lacks these alleles.
  • 19. 2.Secondary, acquired, or transient lactase deficiency is caused by an injury to the small intestine,  usually during infancy, from  acute gastroenteritis, diarrhea,chemotherapy,intestinal  parasites or other environmental causes.
  • 20. 3.Congenital lactase deficiency is a very  rare, autosomal recessive genetic disorder that prevents  lactase expression from birth.    It is particularly common in Finland.    People with congenital lactase deficiency are unable to  digest lactose from birth, and they are unable to digest  breast milk.
  • 21. What causes lactose intolerance ? • Is due to the mutation in LCT genes.  • Mutation in both the LCT genes will result in this  diseases as it is autosomal recessive. • Certain mutation in the LCT gene allow lactase continue  to be expressed after stopping breast feeding. • The LCT gene which encodes the lactase protein is  located on the long arm (q) of chromosome 2 in region  21. (2q21)
  • 22. Treatment of lactose intolerance!!! • avoidance of dietary lactose • substitution to maintain nutrient intake •  regulation of calcium intake •  use of enzyme substitute also known as enzyme  replacement theraphy in which mostly intravenous  injection containing the enzyme is given to the patients
  • 23. POINT TO REMEMBER • Lactose intolerance is the inability or insufficient ability to digest  lactose, a sugar found in milk and milk products. • Lactose intolerance is caused by a deficiency of the enzyme lactase,  which is produced by the cells lining the small intestine. • Not all people with lactase deficiency have digestive symptoms, but  those who do may have lactose intolerance. • Most people with lactose intolerance can tolerate some amount of  lactose in their diet. • People with lactose intolerance may feel uncomfortable after  consuming milk and milk products. Symptoms can include abdominal  pain, abdominal bloating, gas, diarrhea, and nausea.
  • 24. • The symptoms of lactose intolerance can be managed with dietary  changes. • Getting enough calcium and vitamin D is a concern for people with  lactose intolerance when the intake of milk and milk products is  limited. Many foods can provide the calcium and other nutrients the  body needs. • Talking with a doctor or registered dietitian may be helpful in  planning a balanced diet that provides an adequate amount of  nutrients—including calcium and vitamin D—and minimizes  discomfort. A health professional can determine whether calcium and  other dietary supplements are needed. • Milk and milk products are often added to processed foods.  Checking the ingredients on food labels is helpful in finding possible  sources of lactose in food products.