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Uşurelu N, Blăniţă D, Boiciuc C, Hlistun V, Egorov V, Popovici E, Gnatcova E, Stamati A, Oglindă A, Revenco N, Gladun S, Ţurea V. Gaucher disease type 1: the first experience of enzyme replacement therapy in pediatric practice in Moldova - case report. Med Pharm Rep 2021; 94:S57-S60. [PMID: 34527913 DOI: 10.15386/mpr-2232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
We report on a case of a little girl patient diagnosed with Gaucher disease (GD) type 1 in her early childhood and our first experience with enzyme replacement therapy (ERT). She was first diagnosed accidentally with enlarged spleen during a pediatric examination when she was three years old, but the family ignored investigations; she was hospitalized for diagnosis at six years old. The GD was confirmed based on: clinical manifestations of left abdominal flank pain, multiple bruising, general weakness, bone pain, low appetite, failure to thrive <5th percentile, minor hepato- and severe splenomegaly, enlarged submaxillary lymph nodes, associated by anemia with normal platelets; low activity of beta-Glucosidase, two found mutations in GBA gene, Gaucher cells in bone marrow. The ERT was initiated with Imiglucerase (54 UI/kg/2 wks) two years later after diagnosis, avoiding the splenectomy. Subsequently, the platelets showed the first a promising result, gradually increasing their number every 2 weeks and maintaining it in good parameters till the reported moment (2.5 yrs from the start). The hemoglobin level was appreciated within normal ranges 3 months after ERT start and stabilized completely after 6 months. On the other hand, the red blood count normalized within 20 months of applied therapy. The Lyso-GL-1 decreased by 30% after three months of therapy, no antibodies to Imiglucerase were found. The initial spleen volume (1178.19 cm3) decreased by almost 60% in 6 months of ERT, reaching absolutely normal dimensions after 9 months. The ERT with Imiglucerase was tolerated very well by the patient, showing a clear improvement of clinical symptoms after 4-6 months of therapy, hematological picture and splenomegaly solving. Even if the little patient had to come every 2 weeks for infusion, her quality of life improved a lot, being a totally happy child, going to school and having friends. The ERT should be initiated immediately after diagnosis to prevent the multisystem complications.
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Affiliation(s)
- Natalia Uşurelu
- Institute of Mother and Child, Chişinău, Republic of Moldova
| | - Daniela Blăniţă
- Institute of Mother and Child, Chişinău, Republic of Moldova
| | - Chiril Boiciuc
- Institute of Mother and Child, Chişinău, Republic of Moldova
| | | | - Vladimir Egorov
- Institute of Mother and Child, Chişinău, Republic of Moldova
| | - Eugen Popovici
- Institute of Mother and Child, Chişinău, Republic of Moldova
| | - Elena Gnatcova
- Institute of Mother and Child, Chişinău, Republic of Moldova
| | - Adela Stamati
- "Nicolae Testemiţanu" State University of Medicine and Pharmacy, Chişinău, Republic of Moldova
| | - Ana Oglindă
- "Nicolae Testemiţanu" State University of Medicine and Pharmacy, Chişinău, Republic of Moldova
| | - Ninel Revenco
- Institute of Mother and Child, Chişinău, Republic of Moldova.,"Nicolae Testemiţanu" State University of Medicine and Pharmacy, Chişinău, Republic of Moldova
| | - Sergiu Gladun
- Institute of Mother and Child, Chişinău, Republic of Moldova
| | - Valentin Ţurea
- Institute of Mother and Child, Chişinău, Republic of Moldova.,"Nicolae Testemiţanu" State University of Medicine and Pharmacy, Chişinău, Republic of Moldova
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Herráez-Albendea MM, Fernández-Cofrades EG, Jarilla-Fernández MC, Jiménez-Burgos F. A case report of Gaucher disease. REUMATOLOGIA CLINICA 2017; 13:242-243. [PMID: 27825580 DOI: 10.1016/j.reuma.2016.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 07/06/2016] [Accepted: 09/02/2016] [Indexed: 06/06/2023]
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