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颌骨受累在戈谢氏病中的表现:一种罕见疾病的并非少见的特征。

Jaw involvement in Gaucher disease: a not-so-uncommon feature of a rare disease.

机构信息

Lysosomal Storage Disorders Unit, Royal Free London NHS Foundation Trust, London, UK.

Special Care Dentistry, University College London Hospitals NHS Foundation Trust, London, UK.

出版信息

BMJ Case Rep. 2021 Nov 16;14(11):e244298. doi: 10.1136/bcr-2021-244298.

Abstract

Gaucher disease is an inborn error of metabolism resulting from the deficiency of the enzyme glucocerebrosidase and consequent accumulation of glucocerebroside within the lysosomes of macrophages. The clinical presentation is very diverse, depending on the age of onset and the severity of the disease, and results from the progressive infiltration of lipid-laden cells in various organs. Common manifestations of Gaucher disease include enlarged liver and/or spleen (hepatosplenomegaly), bone marrow disease (pancytopenia) and bone abnormalities, which are extremely variable and can affect multiple skeletal sites. While bone involvement of long bones and vertebrae is a well-recognised feature of Gaucher disease, jawbone involvement is less commonly noted. Here, we describe a case of a 63-year-old patient with type 1 Gaucher disease with a history of long-term use of bisphosphonates and who had presented with dental pain, with subsequent investigations confirming the radiological features of jaw involvement in Gaucher disease, including periodontal disease.

摘要

戈谢病是一种由于葡萄糖脑苷脂酶缺乏导致的先天性代谢错误,从而使葡萄糖脑苷脂在巨噬细胞溶酶体中蓄积。临床表现非常多样化,取决于发病年龄和疾病严重程度,是由于富含脂质的细胞在各种器官中逐渐浸润所致。戈谢病的常见表现包括肝脾肿大(肝脾肿大)、骨髓疾病(全血细胞减少症)和骨骼异常,这些异常变化极其多样,可影响多个骨骼部位。虽然长骨和脊椎的骨骼受累是戈谢病的一个公认特征,但颌骨受累则较少见。在这里,我们描述了一例 63 岁的 1 型戈谢病患者,该患者长期使用双膦酸盐,并有牙痛病史,随后的检查证实了戈谢病颌骨受累的放射学特征,包括牙周病。

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