Levrat V, Forest I, Fouilhoux A, Guffon N
Centre de référence des Maladies Héréditaires du Métabolisme, Hôpital Edouard Herriot, 5, place d'Arsonval, 69437 Lyon 03, France.
Rev Med Interne. 2007 Oct;28 Suppl 2:S183-6. doi: 10.1016/s0248-8663(07)78879-3.
Gaucher disease is well-known in adult patients and must be regarded as a pediatric disease, two thirds of the patients manifesting before the age of 20. Three clinical forms have been defined based on the presence of neurological involvement. Gaucher disease type 1, without neurological signs, generally begins before the five years age with splenomegaly as the main symptom. The bone crises are more frequent than in adulthood. Gaucher disease type 2 or acute neuronopathic form begins between three and six months and do not have any treatment. Type 3 or chronic neuronopathic form appears like a type 1 with progressive horizontal saccade-initiation failure and developmental delay. Onset in childhood is predictive of a severe and progressive phenotype. The presence of neurological symptoms induces important consequences for treatment, prognosis and genetic counselling.
戈谢病在成年患者中广为人知,但必须被视为一种儿科疾病,三分之二的患者在20岁之前出现症状。根据是否存在神经系统受累情况,已定义了三种临床类型。1型戈谢病无神经系统体征,通常在5岁前发病,主要症状为脾肿大。与成人期相比,骨危象更为常见。2型戈谢病或急性神经病变型在3至6个月时发病,且无任何治疗方法。3型戈谢病或慢性神经病变型表现类似1型,但伴有进行性水平扫视启动障碍和发育迟缓。儿童期发病预示着严重且进行性的表型。神经系统症状的出现对治疗、预后和遗传咨询具有重要影响。