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IEMbase 0483: FBP1-related fructose-1,6-bisphosphatase deficiency

Scope

Field Value
IEMbase ID 483
Nosology 3.2.02.01
Gene FBP1
External IDs OMIM:229700; ORPHA:348
Generated mapping UNMAPPED; best candidate Hereditary_Fructose_Intolerance.yaml
Candidate DisMech targets No exact local target; rejected candidate Hereditary_Fructose_Intolerance.yaml
Review date 2026-07-07

IEMbase phenotype signal

IEMbase represents autosomal recessive FBP1-related fructose-1,6-bisphosphatase deficiency. Treatments are dietary fructose/sucrose avoidance and uncooked cornstarch. Biochemical rows include increased plasma alanine, decreased hepatic fructose-1,6-bisphosphatase activity, increased plasma and urine ketones, decreased plasma glucose, increased plasma lactate, low-to-normal phosphate, normal-to-increased triglycerides and uric acid, and normal-to-increased urinary glycerol. The only clinical row in this record is tachypnea.

DisMech phenotype coverage

No exact DisMech disease file was found for FBP1 fructose-1,6-bisphosphatase deficiency. Hereditary_Fructose_Intolerance.yaml models ALDOB-related aldolase B deficiency with fructose-1-phosphate accumulation after fructose exposure, not FBP1 loss of hepatic gluconeogenesis. Type_2_Diabetes_Mellitus.yaml mentions FBP1 only as a metformin target in hepatic gluconeogenesis, and Glycogen_Storage_Disease_Type_VII.yaml references the adjacent glycolytic fructose-6-phosphate to fructose-1,6-bisphosphate step, not FBP1 deficiency.

Concordance and completeness

Judgement: true local gap; reject hereditary fructose intolerance as an exact mapping.

FBP1 deficiency and ALDOB/HFI share fructose-related vocabulary and hypoglycemia, but the causal lesions are different. FBP1 deficiency blocks a gluconeogenic step and presents with fasting/illness-related hypoglycemia, lactic acidosis, ketosis, and alanine elevation; HFI is an ALDOB fructose catabolism defect with fructose-1-phosphate accumulation and toxicity after fructose/sucrose/sorbitol exposure. The overlap is useful context, not coverage.

Curation actions

  • Create a future DisMech entry for FBP1-related fructose-1,6-bisphosphatase deficiency / ORPHA:348 if this disorder is prioritized.
  • Do not map this row to Hereditary_Fructose_Intolerance.yaml.
  • Evidence review should focus on FBP1 loss, impaired gluconeogenesis, fasting hypoglycemia, lactic acidosis, ketosis, alanine elevation, cornstarch, and fructose/sucrose restriction.