NGLY1 and hyperinsulinemic hypoglycemia, familial, 4: Chang et al. later identified elevations in plasma methionine, plasma S-adenosylmethionine (SAM), and plasma S-adenosylhomocysteine (SAH) in a 5-year-old female with NGLY1 deficiency, which remained elevated for at least one year following the initial assessment [29].