39. Gaucher’s Disease
Definition
Gaucher’s disease is an autosomal recessive inherited disorder resulting from deficiency of acid beta-glucosidase. It is characterized by thrombocytopenia, anemia, hepatosplenomegaly, and bone pain.
Incidence
The incidence of Gaucher’s disease in non-Jewish populations is 1:40,000. For the Ashkenazi Jewish population, the carrier rate is 1:15, whereas the disease rate is 1:855. In those of Norrbottnian Swedish descent, the incidence of Type III Gaucher’s disease is 1:50,000.
Etiology
All three types of Gaucher’s disease are caused by deficiency of the acid β-glucoside as the result of a mutation in the structural gene providing the enzyme encoding.
Subtypes of Gaucher’s Disease
• Type I: Adult/non-neuronopathic form
• Type II: Infantile/acute neuronopathic form
• Type III: Juvenile/Norrbottnian form
Signs and Symptoms
• Ataxia
• Dementia
• Fatigue
• Generalized weakness
• Hepatosplenomegaly
• Pathologic fractures
• Psychomotor retardation
• Seizures
• Severe bone and joint pain