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Adult type I Gaucher disease with splenectomy caused by a compound heterozygous GBA1 mutation in a Chinese patient: a case report.

作者信息

Zhang Jian-Hui, Chen Hui, Ruan Dan-Dan, Chen Ying, Zhang Li, Gao Mei-Zhu, Chen Qian, Yu Hong-Ping, Wu Jia-Yi, Lin Xin-Fu, Fang Zhu-Ting, Zheng Xiao-Ling, Luo Jie-Wei, Liao Li-Sheng, Li Hong

机构信息

Department of Traditional Chinese Medicine, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou, China.

Department of Traditional Chinese Medicine, Fujian Provincial Hospital, Fuzhou, China.

出版信息

Ann Hematol. 2024 May;103(5):1765-1774. doi: 10.1007/s00277-024-05710-2. Epub 2024 Mar 20.


DOI:10.1007/s00277-024-05710-2
PMID:38509388
Abstract

Gaucher disease (GD) is an autosomal recessive ailment resulting from glucocerebrosidase deficiency caused by a mutation in the GBA1 gene, leading to multi-organ problems in the liver, spleen, and bone marrow. In China, GD is extremely uncommon and has a lower incidence rate than worldwide. In this study, we report the case of an adult male with an enlarged spleen for 13 years who presented with abdominal distension, severe loss of appetite and weight, reduction of the three-line due to hypersplenism, frequent nosebleeds, and bloody stools. Regrettably, the unexpected discovery of splenic pathology suggestive of splenic Gaucher disease was only made after a splenectomy due to a lack of knowledge about rare disorders. Our patient's delayed diagnosis may have been due to the department where he was originally treated, but it highlights the need for multidisciplinary consultation in splenomegaly of unknown etiology. We then investigated the patient's clinical phenotypes and gene mutation features using genetically phenotypical analysis. The analysis of the GBA1 gene sequence indicated that the patient carried a compound heterozygous mutation consisting of two potentially disease-causing mutations: c.907C > A (p. Leu303Ile) and c.1448 T > C (p. Leu483Pro). While previous research has linked the p. Leu483Pro mutation site to neurologic GD phenotypes (GD2 and GD3), the patients in this investigation were identified as having non-neuronopathic GD1. The other mutation, p. Leu303Ile, is a new GD-related mutation not indexed in PubMed that enriches the GBA1 gene mutation spectrum. Biosignature analysis has shown that both mutations alter the protein's three-dimensional structure, which may be a pathogenic mechanism for GD1 in this patient.

摘要

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[3]
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[4]
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[5]
The diagnosis and management of Gaucher disease in pediatric patients: Where do we go from here?

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[6]
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[7]
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[8]
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Clin Chem Lab Med. 2020-6-25

[9]
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[10]
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