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戈谢病 1 型和 3 型相关多发性神经病:描述性病例系列研究。

Polyneuropathy in Gaucher disease type 1 and 3 - a descriptive case series.

机构信息

Department of Neurology, Karolinska University Hospital, Stockholm, Sweden.

Center for Neurology, Academic Specialist Center, Stockholm, Sweden.

出版信息

Sci Rep. 2019 Oct 25;9(1):15358. doi: 10.1038/s41598-019-51976-2.

Abstract

Polyneuropathy (PNP) has been reported to be a possible phenotypic feature in Gaucher disease type 1 (GD1), while less is known about PNP in type 3 (GD3). We performed a cross-sectional study, exploring PNP in a Swedish GD cohort. Clinical assessment and blood biochemistry were carried out in 8 patients with GD1 and 11 patients with GD3. In patients with symptoms or clinical findings indicative of PNP, nerve conduction studies and quantitative sensory testing were performed. Assessments were compared to historic controls. A subclinical small fiber neuropathy (SFN) was demonstrated in 2 of 8 patients in the significantly (p = 0,021) older GD1 cohort. A large fiber PNP was evident in an additional 3 GD1 patients but could not be ascribed as disease manifestation. No GD3 patients exhibited neurophysiological evidence of small or large fiber PNP attributed to GD3. Compared to historic controls, no significant group differences were evident with regard to neuropathy rating scores. In summary, our study does not support large fiber PNP as a prevalent manifestation of GD. SFN is a possible feature in GD1, although small sample size limits definite conclusions. Our study provides novel data, arguing against clinically significant small or large fiber PNP in GD3.

摘要

周围神经病(PNP)已被报道为 1 型戈谢病(GD1)的一种可能的表型特征,而关于 3 型 GD(GD3)的 PNP 则知之甚少。我们进行了一项横断面研究,探索了瑞典 GD 队列中的 PNP。对 8 名 GD1 患者和 11 名 GD3 患者进行了临床评估和血液生化检查。对于有 PNP 症状或临床发现的患者,进行了神经传导研究和定量感觉测试。将评估结果与历史对照进行了比较。在明显(p=0.021)年龄较大的 GD1 队列中,有 2 名患者存在亚临床小纤维神经病(SFN)。另外 3 名 GD1 患者出现了大纤维 PNP,但不能归因于疾病表现。没有 GD3 患者表现出与 GD3 相关的小纤维或大纤维 PNP 的神经生理学证据。与历史对照相比,神经病变评分无显著组间差异。总之,我们的研究不支持大纤维 PNP 是 GD 的常见表现。尽管样本量小限制了明确的结论,但 SFN 可能是 GD1 的一个特征。我们的研究提供了新的数据,表明 GD3 中不存在有临床意义的小纤维或大纤维 PNP。

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