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The diagnosis and management of Gaucher disease in pediatric patients: Where do we go from here?
Journal article   Open access   Peer reviewed

The diagnosis and management of Gaucher disease in pediatric patients: Where do we go from here?

Neal J. Weinreb, Ozlem Goker-Alpan, Priya S. Kishnani, Nicola Longo, T. Andrew Burrow, John A. Bernat, Punita Gupta, Nadene Henderson, Helio Pedro, Carlos E. Prada, …
Molecular genetics and metabolism, Vol.136(1), pp.4-21
05/01/2022
DOI: 10.1016/j.ymgme.2022.03.001
PMID: 35367141
url
https://doi.org/10.1016/j.ymgme.2022.03.001View
Published (Version of record) Open Access

Abstract

Gaucher disease (GD) is an autosomal recessive inherited lysosomal storage disease that often presents in early childhood and is associated with damage to multiple organ systems. Many challenges associated with GD diagnosis and management arise from the considerable heterogeneity of disease presentations and natural history. Phenotypic classification has traditionally been based on the absence (in type 1 GD) or presence (in types 2 and 3 GD) of neurological involvement of varying severity. However, patient management and prediction of prognosis may be best served by a dynamic, evolving definition of individual phenotype rather than by a rigid system of classification. Patients may experience considerable delays in diagnosis, which can potentially be reduced by effective screening programs; however, program implementation can involve ethical and practical challenges. Variation in the clinical course of GD and an uncertain prognosis also complicate decisions concerning treatment initiation, with differing stakeholder perspectives around efficacy and acceptable cost/benefit ratio. We review the challenges faced by physicians in the diagnosis and management of GD in pediatric patients. We also consider future directions and goals, including acceleration of accurate diagnosis, improvements in the understanding of disease heterogeneity (natural history, response to treatment, and prognosis), the need for new treatments to address unmet needs for all forms of GD, and refinement of the tools for monitoring disease progression and treatment efficacy, such as specific biomarkers. (c) 2022 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY license (http:// creativecommons.org/licenses/by/4.0/).
Endocrinology & Metabolism Genetics & Heredity Life Sciences & Biomedicine Medicine, Research & Experimental Research & Experimental Medicine Science & Technology

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