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Gaucher's disease type 3

Authoring team

Gaucher's disease type 3 is an autosomal recessive disorder characterized by reduced glucocerebrosidase activity.

Clinically it is intermediate between types 1 and 2, where splenomegaly and bone involvement are the dominant clinical features, and type 2 Gaucher disease, where central nervous system dysfunction, convulsions, and progressive mental deterioration dominate.

Other organs such as the liver, spleen and lymph nodes may be involved.

Type 3

Phenotype

Accounts for 4% of GD cases.

Typically infantile-childhood onset; sub-acute and slowly progressive may result in death during the second decade although some have survived to their 4th decade

Visceral symptoms

Hepatomegaly, splenomegaly and interstitial lung disease

Hematopoietic symptoms

Anaemia and thrombocytopenia

Orthopaedic symptoms

Bony pain crisis, osteopenia, aseptic necrosis of femoral head, bony lytic lesions, bony infarctions and pathological fractures

Neurologic symptoms

Oculomotor apraxia, myoclonic epilepsy, generalized tonic-clonic seizures, and cognitive impairment

The development of enzyme replacement therapy (ERT) and substrate reduction therapy (SRT) have made GD treatable with the exception of the neurological deterioration associated with types 2 and 3

  • ERT aims to replace the defective or missing enzyme with a functional protein that is infused into the bloodstream and taken up into cellular lysosomes
  • ERT targets the underlying metabolic deficit rather than providing symptomatic management
  • SRT targets the failure of the lysosomal metabolic pathway by inhibiting the production of glucosylceramide and thereby reducing its accumulation in the lysosomes and the likelihood of subsequent multi organ dysfunction

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The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

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