“…Three are associated with a decreased free Sia production: GNE myopathy (GNE mutations, Online Mendelian Inheritance in Man (OMIM) 605820), manifesting with the distal muscle weakness leading patients to a wheelchair-bound state (5); spondyloepimetaphyseal dysplasia, Genevieve type (NANS mutations, OMIM 610442), causing severe neurodevelopmental delay and skeletal dysplasia (6); and congenital disorder of glycosylation, type IIf (OMIM 603585), caused by cytidine monophosphate (CMP)-Sia transporter deficiency (SLC35A1 mutations) and presenting with proteinuria, macro-thrombocytopenia, and neurological disease (7)(8)(9). The remaining three, associated with increased levels of free Sia, are French-type sialuria (OMIM 269921, GNE mutations), leading to developmental delays (10), and infantile sialic storage/Salla disease (OMIM 269920/604369, SLC17A5 mutations), causing progressive neurologic deterioration and resulting in psychomotor delay, spasticity, athetosis, and epileptic seizures (11). No specific therapies for any of these diseases have been approved yet, highlighting the need of further research in this area (12).…”