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Perinatal-lethal Gaucher disease.

C Mignot1, A Gelot, B Bessières

  • 1Neurologie Pédiatrique, Hôpital Armand Trousseau, Paris, France.

American Journal of Medical Genetics. Part A
|July 3, 2003
PubMed
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Perinatal-lethal Gaucher disease presents unique fetal symptoms like hydrops fetalis and hepatosplenomegaly. This specific phenotype, distinct from classical Gaucher disease, aids in diagnosing this underrecognized condition.

Area of Science:

  • Genetics
  • Biochemistry
  • Pediatrics

Background:

  • Gaucher disease is a lysosomal storage disorder due to glucocerebrosidase deficiency.
  • While often visceral, some Gaucher disease patients exhibit neurological signs.
  • Fetal onset Gaucher disease is rare, with limited case descriptions.

Purpose of the Study:

  • To delineate the specific phenotype of perinatal-lethal Gaucher disease.
  • To highlight diagnostic clues for this likely underdiagnosed condition.
  • To differentiate it from classical type 2 Gaucher disease.

Main Methods:

  • Retrospective study of eight original cases with proven Gaucher disease and fetal onset.
  • Analysis of clinical features including hydrops fetalis, hepatosplenomegaly, ichthyosis, arthrogryposis, and facial dysmorphy.

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  • Comparison with 33 previously reported cases.
  • Main Results:

    • Non-immune hydrops fetalis was observed in all but one case.
    • Hepatosplenomegaly, ichthyosis, arthrogryposis, and facial dysmorphy were associated findings.
    • When hydrops was absent, neurological involvement led to death within three months.

    Conclusions:

    • Perinatal-lethal Gaucher disease is a distinct entity with specific clinical signs.
    • Hydrops fetalis, in utero fetal death, and neonatal distress are prominent features.
    • Biochemical confirmation is crucial for diagnosis and genetic counseling.