Gaucher's disease - a review of the most important information about the disease in Paediatrics
DOI:
https://doi.org/10.12775/QS.2025.43.61358Keywords
Gaucher disease, GBA1, Gaucher cells, ERT, SRTAbstract
Gaucher disease is an autosomal recessive spirochete disease caused by a deficiency of the enzyme glucocerebrosidase. A mutation in the GBA1 gene induces the accumulation of abnormal products in macrophages resulting in the transformation into Gaucher cells in many organs. There are three main types of the disease, 1 being the most common type (non-neuropathic). The 2nd and 3rd types of the disease are neuropathic types and these occur mainly in childhood. Among paediatric patients, Gaucher's disease manifests mainly with enlargement of the liver, spleen, thrombocytopenia, anaemia, but skeletal, ocular and central nervous system symptoms may be present. Diagnosis based on enzymatic and genetic tests - analysis of the GBA1 gene mutation - is essential to prolong patients' lives, improve their quality of life and select an appropriate form of treatment. Currently, care for patients with this disease is based on ERT (enzyme replacement therapy), SRT (substrate replacement therapy). The disease is characterised by rather non-specific symptoms and course, and can be interpreted by physicians as a haematological-proliferative disease due to frequent changes in the structure of the liver, spleen and changes in blood morphological parameters. Increased awareness among doctors of the symptoms of this disease would allow earlier detection and implementation of treatment. This paper presents the current diagnostic and therapeutic methods and the characteristic symptoms any paediatrician may encounter. The challenges of diagnosing this disease are also highlighted.
References
1. Ginzburg L., Kacher Y., Futerman A.H. The pathogenesis of glycosphingolipid storage disorders. Semin. Cell Dev. Biol. 2004;15:417–431. doi: 10.1016/j.semcdb.2004.03.003.
2. Devine EA, Smith M, Arredondo-Vega FX, Shafit-Zagardo B, Desnick RJ. Regional assignment of the structural gene for human acid betaglucosidase to q42 leads to qter on chromosome 1. Cytogenet Cell Genet. 1982;33(4):340–4.
3. Louwerse, M., Bila, K. O., van der Lienden, M. J., de Beaufort, A. J. M., Boot, R. G., Artola, M., ... & Aerts, J. M. (2025). Cultured Macrophage Models for the Investigation of Lysosomal Glucocerebrosidase and Gaucher Disease. International Journal of Molecular Sciences, 26(6), 2726.
4. WANG, Chung-Hsing, et al. GBA1 as a risk gene for osteoporosis in the specific populations and its role in the development of Gaucher disease. Orphanet Journal of Rare Diseases, 2024, 19.1: 144.
5. Subspecialty Group of Endocrinologic, Hereditary and Metabolic Diseases, the Society of Pediatrics, Chinese Medical Association; Subspecialty Group of Hematology, the Society of Pediatrics, Chinese Medical Association; Society of Medical Genetics, Chinese Medical Association; China Alliance for Rare Diseases. Expert consensus on diagnosis and treatment of pediatric Gaucher disease (2021). Zhonghua Er Ke Za Zhi. (2021) 12:1025–31. doi: 10.3760/cma.j.cn112140-20210611- 00494
6. STONE, William L.; BASIT, Hajira; MASTER, Samip R. Gaucher disease. 2017.
7. LIU, Qi, et al. The molecular mechanism of Gaucher disease caused by compound heterozygous mutations in GBA1 gene. Frontiers in Pediatrics, 2023, 11: 1092645.
8. Silva Garcia, R.; de Frutos, L.L.; Arreguin, E.A.; Gonzalez, C.C.; Ortiz, J.E.G.; Ornelas, S.F.; Castellano, P.G.; Favela, F.B. Gaucher Disease: Identification and Novel Variants in Mexican and Spanish Patients. Arch. Med. Res. 2021, 52, 731–737.
9. Stirnemann J., Vigan M., Hamroun D., Heraoui D., Rossi-Semerano L., Berger M.G., Rose C., Camou F., de Roux-Serratrice C., Grosbois B., et al. The French Gaucher’s disease registry: Clinical characteristics, complications and treatment of 562 patients. Orphanet J. Rare Dis. 2012;7:77.
10. ALAEI, Mohammadreza, et al. Are there neurological symptoms in type 1 of gaucher disease?. Iranian journal of child neurology, 2018, 12.2: 99.
11. AIN, Noor Ul, et al. Eliglustat substrate reduction therapy in children with Gaucher disease type 1. Frontiers in Pediatrics, 2025, 13: 1543136.
12. ZHU, Jianfang, et al. Case report: Multidisciplinary collaboration in diagnosis and treatment of child gaucher disease. Frontiers in pediatrics, 2023, 11: 1057574.
13. MARCUCCI, Gemma; BRANDI, Maria Luisa. The Diagnosis and Therapy of Osteoporosis in Gaucher Disease. Calcified Tissue International, 2025, 116.1: 1-11.
14. BULUT, Fatma Derya, et al. Four Gaucher disease type II patients with three novel mutations: a single centre experience from Turkey. Metabolic Brain Disease, 2018, 33: 1223-1227.
15. DI COSTANZO, Margherita, et al. Pediatric Gaucher Disease Type 3 Presenting with Oculomotor Apraxia: A Case Report. Children, 2024, 11.8: 960.
16. Stirnemann J, Belmatoug N, Camou F, Serratrice C, Froissart R, Caillaud C, Levade T, Astudillo L, Serratrice J, Brassier A, Rose C, Billette de Villemeur T, Berger MG. A Review of Gaucher Disease Pathophysiology, Clinical Presentation and Treatments. Int J Mol Sci. 2017 Feb 17;18(2):441. doi: 10.3390/ijms18020441. PMID: 28218669; PMCID: PMC5343975.
17. Hughes DA, Pastores GM. Choroba Gauchera. 2000 Jul 27 [Zaktualizowano 2023 Dec 7]. W: Adam MP, Feldman J, Mirzaa GM, et al., redaktorzy. GeneReviews® [Internet]. Seattle (WA): University of Washington, Seattle; 1993-2025.
18. Hruska K.S., LaMarca M.E., Scott C.R., Sidransky E. Gaucher disease: Mutation and polymorphism spectrum in the glucocerebrosidase gene (GBA) Hum. Mutat. 2008;29:567–583. doi: 10.1002/humu.20676.
19. Rosenbaum H. Hemorrhagic aspects of Gaucher disease. Rambam Maimonides Med. J. 2014;5:e0039. doi: 10.5041/RMMJ.10173.
20. Pession, A., Di Rocco, M., Venturelli, F., Tappino, B., Morello, W., Santoro, N., ... & Pediatric Gaucher Study Group Mura Rosamaria 19 Russo Bambina 20 Tornesello Assunta 21 Menna Giuseppe 22 Russo Delia 23 Caniglia Maurizio 24 Schettini Sergio 25 Onofrillo Daniela 26 Ladogana Saverio 27 Civino Adele 28. (2023). GAU-PED study for early diagnosis of Gaucher disease in children with splenomegaly and cytopenia. Orphanet Journal of Rare Diseases, 18(1), 151.
21. Hollak C.E., Belmatoug N., Cole J.A., Vom Dahl S., Deegan P.B., Goldblatt J., Rosenbloom B., van Dussen L., Tylki-Szymanska A., Weinreb N.J., et al. Characteristics of type I Gaucher disease associated with persistent thrombocytopenia after treatment with imiglucerase for 4–5 years. Br. J. Haematol. 2012;158:528–538. doi: 10.1111/j.1365-2141.2012.09175.x.
22. Pastores G.M., Wallenstein S., Desnick R.J., Luckey M.M. Bone density in Type 1 Gaucher disease. J. Bone Miner. Res. Off. J. Am. Soc. Bone Miner. Res. 1996;11:1801–1807. doi: 10.1002/jbmr.5650111125.
23. Elstein D., Tiomkin M., Hadas-Halpern I., Zimran A. Organ volume by computed tomography correlates with longitudinal axis on ultrasound in patients with Gaucher disease. Ultrasound Q. 2011;27:225–228. doi: 10.1097/RUQ.0b013e318239c5eb.
24. Hollak C.E., van Weely S., van Oers M.H., Aerts J.M. Marked elevation of plasma chitotriosidase activity. A novel hallmark of Gaucher disease. J. Clin. Investig. 1994;93:1288–1292. doi: 10.1172/JCI117084.
25. Andrade-Campos, M., Alfonso, P., Irun, P., Armstrong, J., Calvo, C., Dalmau, J., ... & Giraldo, P. (2017). Diagnosis features of pediatric Gaucher disease patients in the era of enzymatic therapy, a national-base study from the Spanish Registry of Gaucher Disease. Orphanet journal of rare diseases, 12, 1-9.
26. EL-BESHLAWY, Amal, et al. Diagnosis and management of patients with Gaucher disease: an Egyptian expert opinion. Egyptian Journal of Medical Human Genetics, 2024, 25.1: 88.
27. ALHEJAZI, Ayman, et al. Management Algorithms for Gaucher Disease Type 1 in Saudi Arabia: A Consensus Result from a National Meeting. Blood, 2019, 134: 4864.
28. GLEASON, Adenrele M., et al. The D409H variant in GBA1: Challenges in predicting the Gaucher phenotype in the newborn screening era. American Journal of Medical Genetics Part A, 2023, 191.7: 1783-1791.
29. Mistry, P.K.; Lopez, G.; Schiffmann, R.; Barton, N.W.; Weinreb, N.J.; Sidransky, E. Gaucher disease: Progress and ongoing challenges. Mol. Genet. Metab. 2017, 120, 8–21.
30. Vigan M., Stirnemann J., Caillaud C., Froissart R., Boutten A., Fantin B., Belmatoug N., Mentre F. Modeling changes in biomarkers in Gaucher disease patients receiving enzyme replacement therapy using a pathophysiological model. Orphanet J. Rare Dis. 2014;9:95. doi: 10.1186/1750-1172-9-95.
31. Gordon S. Alternative activation of macrophages. Nat. Rev. Immunol. 2003;3:23–35. doi: 10.1038/nri978.
32. Murugesan V., Chuang W.L., Liu J., Lischuk A., Kacena K., Lin H., Pastores G.M., Yang R., Keutzer J., Zhang K., et al. Glucosylsphingosine is a key biomarker of Gaucher disease. Am. J. Hematol. 2016;91:1082–1089. doi: 10.1002/ajh.24491.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Jakub Jarmołowicz, Paulina Krzeszowska, Aleksandra Kujawa, Karolina Krochmal, Adrianna Samoraj, Jakub Zajączkowski, Karolina Marrodán-Wojtczak, Jan Wilk, Kacper Stępniak, Radosław Kuźma

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Stats
Number of views and downloads: 239
Number of citations: 0