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1型戈谢病。一名12岁女孩反复感染疟疾掩盖了其罕见遗传性脂质代谢紊乱的诊断。

Type 1 Gaucher's Disease. A Rare Genetic Lipid Metabolic Disorder Whose Diagnosis Was Concealed by Recurrent Malaria Infections in a 12-Year-Old Girl.

作者信息

Mitala Yekosani, Birungi Abraham, Mushabe Branchard, Manzi John, Ssenkumba Brian, Atwine Raymond, Ankunda Siyadora

机构信息

Department of Pathology, Mbarara University of Science and Technology, Mbarara City, Uganda.

Department of Pediatrics, Kabale University, Kabale, Uganda.

出版信息

J Blood Med. 2024 Jan 20;15:1-7. doi: 10.2147/JBM.S444296. eCollection 2024.

Abstract

INTRODUCTION

Gaucher disease is a rare autosomal recessive lysosomal storage disease with unknown prevalence in Africa and no record of the disease exists in Uganda.

CASE PRESENTATION

We report a case of a 12-year-old female, the last born of 6 from a family with no known familial disease who presented with non-neuronopathic Gaucher disease and superimposed malaria. The disease was initially misdiagnosed as hyperreactive malarial splenomegaly but was subsequently confirmed by examination of the bone marrow smear and core. The disease was managed supportively and splenectomy was done due to worsening hematological parameters. She currently takes morphine for bone pains in addition to physiotherapy.

CONCLUSION

Always HMS is a common complication in malaria endemic areas, other causes of hepatosplenomegaly need to be excluded before the diagnosis is made. Diagnosis and treatment of patients with rare conditions like GD is still a challenge in developing countries. Although splenectomy is indicated in GD, it should only be done when it is absolutely necessary.

摘要

引言

戈谢病是一种罕见的常染色体隐性溶酶体贮积病,在非洲患病率未知,乌干达也没有该疾病的记录。

病例报告

我们报告一例12岁女性病例,她是一个无已知家族疾病家庭中6个孩子里最小的一个,患有非神经病变型戈谢病并合并疟疾。该疾病最初被误诊为高反应性疟疾脾肿大,但随后通过骨髓涂片和活检得以确诊。对该疾病进行了支持性治疗,由于血液学参数恶化进行了脾切除术。她目前除了接受物理治疗外,还服用吗啡来缓解骨痛。

结论

在疟疾流行地区,高反应性疟疾脾肿大总是一种常见并发症,在做出诊断前需要排除肝脾肿大的其他原因。在发展中国家,诊断和治疗像戈谢病这样的罕见病患者仍然是一项挑战。虽然脾切除术适用于戈谢病,但只有在绝对必要时才应进行。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fec8/10807272/0552922191f9/JBM-15-1-g0001.jpg

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