A 3-year-old girl has been a fussy eater since being weaned, particularly when fruit is part of her diet. She would get cranky, sweat, and display dizziness, and lethargy, after eat- ing a meal with fruit. Her mother noticed this correlation, and as long as fruit was withdrawn from her diet the child did not display such symptoms. The problems the girl exhibits when eating fruit is most likely due to which one of the following?
(A) Decreased levels of fructose in the blood
(B) Elevated levels of glyceraldehyde in liver
cells
(C) High levels of sucrose in the stool
(D) Elevated levels of fructose-1-phosphate in
liver cells
(E) Decreased levels of fructose in the urine

A mutation in aldolase B is the cause of the patient's HFI. Sucrose wouldn't rise in the feces because sucrase would still cleave it. Since fructose would not be digested normally, its levels in the blood and urine would rise. Since fructose 1-phosphate wouldn't be broken down by aldolase B, its concentration would rise and glyceraldehyde wouldn't be formed.

When fructose-1-phosphate builds up in people with low levels of aldolase B activity, the glycolytic and gluconeogenic pathways are subsequently inhibited, which results in hypoglycemia.

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