Therefore, if the sulfatase enzymes for Sanfilippo syndrome type A (heparan-N-sulfatase) or type D (N-acetylglucosamine 6-sulfatase) are deficient, then at least one other sulfatase should be assayed to rule out multiple sulfatase deficiency [31]. This evidence concerns the gene GNS and hyperinsulinemic hypoglycemia, familial, 4.