Grabowski Gregory A
The Children's Hospital Research Foundation, Cincinnati Children's Hospital Medical Center, and the Department of Pediatrics of the University of Cincinnati, Cincinnati, Ohio 45229-3039, USA.
Curr Opin Pediatr. 2005 Aug;17(4):519-24. doi: 10.1097/01.mop.0000172702.33128.19.
Major clinical advances in Gaucher disease focus on detection, prediction and treatment of variant phenotypes.
The advent of efficacious enzyme therapy has emphasized the importance of early diagnosis and intervention to prevent the morbid manifestations of the disease including organomegaly, growth and pubertal retardation, and osteopenia/osteoporosis. Genotype/phenotype correlations provide some guidance for prognosis by categorical distinctions of nonneuronopathic (type 1) and neuronopathic (types 2 and 3) variants. Early detection of children genetically predisposed to severe disease are a management challenge for the pediatrician and metabolic physician. The development of specific therapeutic goals provides a framework for assessments of visceral therapeutic and palliative responses in children with type 1, and types 2 and 3, respectively.
The pediatrician plays a major role in these clinical and genetically based decisions.
戈谢病的主要临床进展集中在变异型表型的检测、预测和治疗方面。
有效酶替代疗法的出现凸显了早期诊断和干预对于预防该病病态表现(包括器官肿大、生长和青春期发育迟缓以及骨质减少/骨质疏松)的重要性。基因型/表型相关性通过对非神经病变型(1型)和神经病变型(2型和3型)变异进行分类区分,为预后提供了一些指导。对于儿科医生和代谢科医生而言,早期发现具有严重疾病遗传易感性的儿童是一项管理挑战。制定特定的治疗目标分别为评估1型、2型和3型儿童的内脏治疗和姑息治疗反应提供了一个框架。
儿科医生在这些基于临床和遗传学的决策中发挥着主要作用。