1. New Variant Mutation of Glucosylceramidase Beta (GBA) and Early Enzyme Replacement Therapy for Neuronopathic Gaucher Disease: A Case Report and Literature Review
- Author
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Daiji Takajo, Takahiro Noguchi, Naoto Nishimura, Hiroshi Matsumoto, and Shigeaki Nonoyama
- Subjects
0301 basic medicine ,Pediatrics ,medicine.medical_specialty ,business.industry ,Glucosylceramidase beta ,Enzyme replacement therapy ,Degeneration (medical) ,Disease ,Compound heterozygosity ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,Pediatrics, Perinatology and Child Health ,Mutation (genetic algorithm) ,Failure to thrive ,Medicine ,Missense mutation ,medicine.symptom ,business ,030217 neurology & neurosurgery - Abstract
Introduction: Types 2 and 3 Gaucher disease (GD) are neuronopathic forms that are mainly distinguished by the rate of neurological degeneration. All symptomatic children with type 1 or 3 GD should receive enzyme replacement therapy (ERT), whereas the treatment of children with type 2 GD is usually supportive. Case Presentation: We present the case of a 3-month-old Japanese girl diagnosed with neuronopathic GD. She initially presented with failure to thrive and inspiratory stridor. Treatment using ERT was initiated at 5 months of age. Genetic analysis of glucosylceramidase beta (GBA) revealed a compound heterozygous mutation including RecNciI and the novel missense mutation c.1052G > T (p.W351L). Although several clinical improvements were observed, she showed rapid neurological deterioration at 8 months of age. Conclusions: The patient with the compound heterozygous mutation including RecNciI and c.1052G > T (p.W351L) in GBA presented with clinical symptoms consistent with those of type 2 GD. ERT was initiated at 5 months of age; however, it failed to prevent refractory seizures and neurological deterioration.
- Published
- 2020
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