About Glycogen Storage Disease Type II
Glycogen Storage Disease Type II results from mutations in the GAA gene encoding acid alpha-glucosidase, the sole enzyme responsible for degrading glycogen within lysosomes. GAA deficiency leads to massive glycogen accumulation, particularly in cardiac myocytes, skeletal muscle fibers, and anterior horn cells. The pathophysiology involves lysosomal dysfunction, autophagic impairment, cellular stress, and ultimately muscle fiber death. The infantile form, with complete or near-complete GAA deficiency, manifests with rapid glycogen accumulation primarily in cardiac tissue, leading to severe cardiomyopathy.
Infantile-onset GSD II presents before age 1 year with hypotonia, poor feeding, failure to thrive, and cardiomegaly. Cardiac dysfunction is life-limiting, with most untreated patients dying from cardiac failure by age 2 years. Respiratory muscles are progressively affected. Late-onset GSD II begins in childhood with progressive proximal muscle weakness, preserving cardiac function initially. Adult-onset form is even more indolent, with slow progressive myopathy predominantly affecting lower extremities and trunk, presenting years or decades after birth. Respiratory insufficiency develops insidiously, often becoming apparent initially during sleep. CK levels are markedly elevated. Muscle biopsy shows characteristic glycogen-filled vacuoles. Enzyme replacement therapy with alglucosidase alfa has dramatically improved outcomes, particularly in infantile-onset disease, converting what was a uniformly fatal condition to a manageable chronic disease.
Common Symptoms of Glycogen Storage Disease Type II
Recognizing the signs of Glycogen Storage Disease Type II early can lead to faster diagnosis and better outcomes. Symptoms may vary in severity from person to person. If you or a loved one are experiencing any of the following, consider speaking with a specialist.
- Infantile form: hypotonia, failure to thrive, and profound muscle weakness
- Cardiomyopathy with heart enlargement and failure
- Progressive respiratory muscle weakness requiring ventilation
- Late-onset: progressive proximal muscle weakness starting in childhood
- Adult-onset: slow progressive myopathy primarily affecting legs and trunk
- Respiratory insufficiency particularly during sleep
Who Glycogen Storage Disease Type II Affects
Infantile-onset (classic) form presents before age 1 year with severe symptoms. Late-onset form presents in early childhood to adolescence. Adult-onset form presents in adulthood with slower progression. Affects males and females equally. Autosomal recessive inheritance. Occurs in all populations with variable prevalence.
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Help Paying for Glycogen Storage Disease Type II Treatment
Charity funds and drugmaker programs for Glycogen Storage Disease Type II, checked at the source. Pick your insurance to see what fits.
- From a charity · TotalAssist (formerly PAN Foundation)Pompe Disease fundOpen
Pays for: Out-of-pocket costs for approved medications, up to $9,500 per year. Requires health insurance (any kind).
- From a charity · The Assistance FundPompe Disease fundWaitlist
Pays for: Copays, coinsurance, deductibles and other health-related expenses.
The foundation says: “WAITLIST — Accepting Waitlist Patients. TAF is currently accepting requests to join the enrollment waitlist for this program. Waitlists a…”
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Genetic Testing
Genetic testing can confirm a diagnosis, guide treatment decisions, and identify family members who may be at risk.
The GAA gene page lists every condition Orphanet links to the gene and the open trials that name it.
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Trusted Glycogen Storage Disease Type II Resources
Reputable organizations and medical references for learning more about Glycogen Storage Disease Type II, including disease registries, foundation resources, and clinical guidelines.