caa a22 4500 467932425 CHVBK 20180406152947.0 cr unu---uuuuu 170328e20060201xx s 000 0 eng 10.1007/s10545-006-0121-6 doi (NATIONALLICENCE)springer-10.1007/s10545-006-0121-6 Enzyme replacement therapy and bony changes in Egyptian paediatric Gaucher disease patients [Elektronische Daten] [A. El-Beshlawy, L. Ragab, I. Youssry, K. Yakout, H. El-Kiki, K. Eid, I. Mansour, S. El-Hamid, M. Yang, P. Mistry] Summary: Background. In Gaucher disease, the infiltration of the bone marrow by glucocerebroside-laden macrophages (Gaucher cells) triggers a diverse pattern of skeletal disease that results in crippling complications. Reliable ascertainment of the severity and pattern of skeletal disease is essential to determine disease status and the response to enzyme replacement therapy (ERT). Although there is ample documentation of reversal of haematological and visceral disease by ERT, there is a paucity of data on skeletal response to ERT in children. Aim. To delineate the pattern of bone disease in children with Gaucher disease in Egypt and to evaluate its response to ERT. Method. Twenty-two children with Gaucher disease were treated with ERT. Phenotyping by clinical, laboratory and radiological criteria was performed at baseline and following 11.2 ± 4 months of ERT. Genotyping for glucocerebrosidase (GBA) mutations was performed by gene sequencing, and genotype-phenotype correlations were performed. Results. Two-thirds of the patients were from consanguineous pedigrees and 14/22 patients were homozygous or compound heterozygous for L444P and D409H mutations. Bone involvement was detected by plain radiology in 11 children (50%) and in 16 (73%) by magnetic resonance imaging (MRI). There was no correlation of severity of bone involvement and GBA genotype. ERT ameliorated bone disease: 10 of the 11 children with abnormal radiographic findings at baseline showed improvement in skeletal lesions; while 9/16 showed improvement of marrow disease by MRI. Radiographic sensitivity and specificity were 62% and 82% compared to MRI for detection of bone involvement in this patient population. At baseline, bone pain was present in 5 patients and ERT resulted in complete symptomatic remission in all of them. ERT was associated with significant improvement in growth parameters and amelioration of haematological and visceral involvement. Conclusion. Symptomatic and radiological skeletal disease is common in children with Gaucher disease in Egypt. MRI is the most accurate technique for detecting early skeletal involvement. There was no correlation between severity of skeletal involvement and GBA genotype. ERT was effective in ameliorating radiological manifestations of skeletal disease and achieving complete remission of bone pain. SSIEM and Springer, 2006 El-Beshlawy A. Department of Pediatrics, Cairo University School of Medicine, 1 Ben Kutiba Street, Section seven, 11487, Nasr city, Cairo, Egypt aut Ragab L. Department of Pediatrics, Cairo University School of Medicine, 1 Ben Kutiba Street, Section seven, 11487, Nasr city, Cairo, Egypt aut Youssry I. Department of Pediatrics, Cairo University School of Medicine, 1 Ben Kutiba Street, Section seven, 11487, Nasr city, Cairo, Egypt aut Yakout K. Department of Radiology, Cairo University School of Medicine, Cairo, Egypt aut El-Kiki H. Department of Radiology, Cairo University School of Medicine, Cairo, Egypt aut Eid K. Department of Pediatrics, Cairo University School of Medicine, 1 Ben Kutiba Street, Section seven, 11487, Nasr city, Cairo, Egypt aut Mansour I. Department Clinical Pathology, Cairo University School of Medicine, Cairo, Egypt aut El-Hamid S. Department of Pediatrics, Cairo University School of Medicine, 1 Ben Kutiba Street, Section seven, 11487, Nasr city, Cairo, Egypt aut Yang M. Department of Pediatrics and Medicine, Yale University School of Medicine, New Haven, Connecticut, USA aut Mistry P. Department of Pediatrics and Medicine, Yale University School of Medicine, New Haven, Connecticut, USA aut Journal of Inherited Metabolic Disease Kluwer Academic Publishers 29/1(2006-02-01), 92-98 0141-8955 29:1<92 2006 29 10545 https://doi.org/10.1007/s10545-006-0121-6 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10545-006-0121-6 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- El-Beshlawy A. Department of Pediatrics, Cairo University School of Medicine, 1 Ben Kutiba Street, Section seven, 11487, Nasr city, Cairo, Egypt aut NATIONALLICENCE 700 1- Ragab L. Department of Pediatrics, Cairo University School of Medicine, 1 Ben Kutiba Street, Section seven, 11487, Nasr city, Cairo, Egypt aut NATIONALLICENCE 700 1- Youssry I. Department of Pediatrics, Cairo University School of Medicine, 1 Ben Kutiba Street, Section seven, 11487, Nasr city, Cairo, Egypt aut NATIONALLICENCE 700 1- Yakout K. Department of Radiology, Cairo University School of Medicine, Cairo, Egypt aut NATIONALLICENCE 700 1- El-Kiki H. Department of Radiology, Cairo University School of Medicine, Cairo, Egypt aut NATIONALLICENCE 700 1- Eid K. Department of Pediatrics, Cairo University School of Medicine, 1 Ben Kutiba Street, Section seven, 11487, Nasr city, Cairo, Egypt aut NATIONALLICENCE 700 1- Mansour I. Department Clinical Pathology, Cairo University School of Medicine, Cairo, Egypt aut NATIONALLICENCE 700 1- El-Hamid S. Department of Pediatrics, Cairo University School of Medicine, 1 Ben Kutiba Street, Section seven, 11487, Nasr city, Cairo, Egypt aut NATIONALLICENCE 700 1- Yang M. Department of Pediatrics and Medicine, Yale University School of Medicine, New Haven, Connecticut, USA aut NATIONALLICENCE 700 1- Mistry P. Department of Pediatrics and Medicine, Yale University School of Medicine, New Haven, Connecticut, USA aut NATIONALLICENCE 773 0- Journal of Inherited Metabolic Disease Kluwer Academic Publishers 29/1(2006-02-01), 92-98 0141-8955 29:1<92 2006 29 10545 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer