Gaucher Disease

Pronounced: go-shay disease

Definition

Gaucher disease is a rare disease. It causes the abnormal storage of fatty substances. They build up in the bones, liver, lungs, spleen and sometimes the brain. There are three types of this disease. Each type affects the brain differently:

  • Type 1—most common, but does not change the brain
  • Type 2—rare, quickly progressive form that causes severe damage to the brain
  • Type 3—rare; affects the brain, but damage can vary

Spleen

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Causes    TOP

Gaucher disease is caused by a faulty gene. The gene limits the amount of a certain enzyme. The enzyme normally breaks down a fat called glucocerebroside. The faulty gene lowers this enzyme and some of this fat is not broken down the right way. As a result, the fat builds up.

Risk Factors    TOP

Your risk may be higher if you are of Ashkenazi Jewish background. Your risk may also be raised if you have people in your family with this disease.

Symptoms    TOP

Symptoms differ from person to person and across the three types of the disease. Here are some common ones:

  • Swollen belly
  • Easy bruising
  • Lack of energy
  • Bone pain
  • Slow growth
  • Delayed puberty
  • Breathing problems

In general, the later the age at the start of symptoms, the less likely that they will be severe. People with type 1 may have mild health problems that are treatable. This type does not change the growth of the brain.

Type 2 appears within the first few months of life. Symptoms are mostly neurological, such as severe brain damage, seizures, and jerky muscle movements. Children with this type usually do not live past two years of age.

Type 3 tends to appear later in childhood. There are neurological symptoms but they are often not as severe as type 2. Symptoms also happen slowly over time. Children with type 3 can survive to become adults.

Diagnosis    TOP

You will be asked about your child's symptoms and health history. A physical exam will be done. Blood tests will be done.

Treatment    TOP

There is no cure. Type 1 can be managed by replacing the missing enzyme. This doesn’t affect the neurological symptoms found with type 2 and type 3. Supportive care is often the only option for these symptoms.

Here are some options:

Medications

Enzyme replacement therapy can bring enzymes up to normal levels to prevent fat build up. It is most useful for people with type 1. It may also help people with type 3 control non-neurological symptoms. This medicine can’t pass into the brain, so it is not useful for build up in the brain.

Substrate reduction therapy is a medicine that lowers the amount of glucocerebroside the body makes. This therapy may not be helpful for everyone.

Medicine for supportive care may be pain medicine or medicine to help maintain bones.

Surgery

An enlarged spleen can lead to other health problems. It may need to be removed with asplenectomy.

Prevention    TOP

Gaucher disease can’t be prevented. If you have Gaucher disease or have a family history of it, you can talk to a genetic counselor. They can help you find out the risk of Gaucher disease in your offspring.

RESOURCES:

Gauchers Association
http://www.gaucher.org.uk
National Gaucher Foundation
http://www.gaucherdisease.org

CANADIAN RESOURCES:

The National Gaucher Foundation of Canada
http://www.gauchercanada.ca

References:

About Gaucher. Gauchers Association website. Available at:
...(Click grey area to select URL)
Accessed July 3, 2018.
Gaucher disease. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114844/Gaucher-disease. Updated November 30, 2017. Accessed July 3, 2018.
Gaucher disease. National Gaucher Foundation website. Available at: https://www.gaucherdisease.org/about-gaucher-disease/what-is/. Accessed July 3 ,2018.
Gaucher disease. National Institute of Neurological Disorders and Stroke website. Available at: https://www.ninds.nih.gov/Disorders/All-Disorders/Gaucher-Disease-Information-Page. Accessed July 3, 2018.
Martins AM, Valadares ER, Porta G, et al. Recommendations on the diagnosis, treatment, and monitoring of Gaucher disease. J Pediatrics. 2009;155(4 Suppl):S10-S18.
3/5/2010 DynaMed Plus Systematic Literature Surveillance http://www.dynamed...: FDA approves therapy to treat Gaucher disease. US Food and Drug Administration website. Available at:
...(Click grey area to select URL)
Accessed June 6, 2016.
Last reviewed June 2018 by Kari Kassir, MD
Last Updated: 7/3/2018

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