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Extensive cardiovascular involvement in a young boy with Gaucher's disease: a case report
Mohammadreza Naderian1, Hamid Khederlou1, Ali Hosseinsabet1
1Tehran Heart Center, Tehran University of Medical Sciences, North Kargar Street, Tehran, Iran.
Insights
Gaucher's disease, a lysosomal storage disorder, can cause severe heart valve issues. This case highlights successful surgical intervention for complex valvular heart disease in a Gaucher patient.
Area of Science:
- Cardiology
- Genetics
- Rare Diseases
Background:
- Lysosomal storage diseases (LSDs) are rare genetic disorders.
- Gaucher's disease (GD) is the most common LSD, characterized by enzyme deficiencies.
- Cardiovascular manifestations, particularly in GD Type III, include valvular calcification and aortic involvement.
Background:
Lysosomal storage diseases (LSDs) are rare, progressive, multi-organ disorders caused by inherited enzyme deficiencies. Gaucher's disease (GD) is the most prevalent form of LSDs.
Case Summary:
A 19-year-old Caucasian male presented with exertional dyspnoea. Physical examination revealed a Grade III/VI systolic diamond murmur at the heart base and a Grade IV/VI systolic murmur at the apex. Electrocardiogram showed signs of left ventricular hypertrophy (LVH). Trans-thoracic echocardiography (TTE) and trans-oesophageal echocardiography (TEE) demonstrated moderate LVH, severe aortic valve stenosis, severe supra-valvular aortic stenosis, and moderate mitral stenosis with severe degenerative mitral valve regurgitation. Bone marrow biopsy and aspiration confirmed the presence of characteristic Gaucher's cells. The patient underwent the Bentall procedure and mitral valve replacement and was discharged in good condition.
Discussion:
Gaucher's disease exhibits three clinical phenotypes, and cardiovascular involvement is commonly seen in GD Type III. Valvular calcification and ascending aorta involvement are frequent cardiovascular manifestations. Although severe valvular heart involvement is rare in GD, cardiac valve surgery has shown favourable outcomes in previous studies and our case.
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