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戈谢病的流行病学与自然史:文献综述

Gaucher disease epidemiology and natural history: a comprehensive review of the literature.

作者信息

Nalysnyk Luba, Rotella Philip, Simeone Jason C, Hamed Alaa, Weinreb Neal

机构信息

a Sanofi Genzyme , Cambridge , MA , USA.

b Evidera , Waltham , MA , USA.

出版信息

Hematology. 2017 Mar;22(2):65-73. doi: 10.1080/10245332.2016.1240391. Epub 2016 Oct 20.

DOI:10.1080/10245332.2016.1240391
PMID:27762169
Abstract

OBJECTIVES

The objectives of this research were: (1) to heighten awareness of Gaucher disease (GD), a rare lysosomal storage disorder with highly heterogeneous patterns of organ involvement and disease severity, to clinicians most likely to encounter these patients, and; (2) to summarize the published evidence on GD epidemiology which is essential to accurately depict the total societal burden of this rare worldwide disorder.

METHODS

A comprehensive literature review was undertaken to summarize the published evidence on the epidemiology of GD. MEDLINE, EMBASE, CENTRAL, and 'grey' literature sources published in English between January 1990 and March 2015 were searched to identify relevant publications.

RESULTS

In total, 188 full-text articles were reviewed and findings from 49 studies are summarized herein. The standardized birth incidence of GD in the general population varied from 0.39 to 5.80 per 100 000, and prevalence ranged from 0.70 to 1.75 per 100 000, respectively. Time from onset of GD symptoms to clinical diagnosis was highly variable, with median delays of up to 7 years reported.

DISCUSSION

The incidence and prevalence of GD is substantially higher among the Ashkenazi Jewish population than the general population. Limited epidemiologic information was available from Latin America, Africa, Asia, and developed nations such as the United States, Germany, and the United Kingdom.

CONCLUSIONS

Signs and symptoms of GD frequently mimic more common hematologic conditions resulting in missed or delayed diagnosis. Early diagnosis and prompt initiation of treatment when indicated is crucial to prevent or minimize life-altering or life-threatening liver and skeletal complications.

摘要

目的

本研究的目的是:(1)提高临床医生对戈谢病(GD)的认识,这是一种罕见的溶酶体贮积症,器官受累模式和疾病严重程度高度异质,这些临床医生最有可能接触到此类患者;(2)总结已发表的关于GD流行病学的证据,这对于准确描述这种全球罕见疾病的总体社会负担至关重要。

方法

进行了全面的文献综述,以总结已发表的关于GD流行病学的证据。检索了1990年1月至2015年3月期间以英文发表的MEDLINE、EMBASE、CENTRAL和“灰色”文献来源,以识别相关出版物。

结果

总共审查了188篇全文文章,本文总结了49项研究的结果。普通人群中GD的标准化出生发病率为每10万人0.39至5.80例,患病率分别为每10万人0.70至1.75例。从GD症状出现到临床诊断的时间差异很大,报告的中位延迟长达7年。

讨论

GD在阿什肯纳兹犹太人群中的发病率和患病率明显高于普通人群。来自拉丁美洲、非洲、亚洲以及美国、德国和英国等发达国家的流行病学信息有限。

结论

GD的体征和症状常常类似于更常见的血液系统疾病,导致诊断遗漏或延迟。早期诊断并在有指征时及时开始治疗对于预防或尽量减少改变生活或危及生命的肝脏和骨骼并发症至关重要。

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