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The Clinical Characteristics and Gene Analysis of Korean Gaucher Disease with Central Nervous System Involvement

Journal of the Korean Pediatric Society 2000;43(5):611-618.
Published online May 15, 2000.
The Clinical Characteristics and Gene Analysis of Korean Gaucher Disease with Central Nervous System Involvement
Hoi Seok Choi1, Sung Hwan Kim1, Hiroyuki Ida2, Hyun Ju Kim3
1Department of Pediatrics, School of Medicine, Ajou University, Suwon Korea.
2Department of Pediatrics, Jikei University School of Medicine
3Department of Genetics, School of Medicine, Ajou University, Suwon Korea.
중추신경계를 침범한 한국인 고셔병 환자의 임상적 특성과 유전자 분석
최희석1, 김성환1, Hiroyuki Ida2, 김현주3
1아주대학교 의과대학 소아과학교실
2Department of Pediatrics, Jikei University School of Medicine
3아주대학교 의과대학 유전의학 클리닉
Abstract
Purpose
: We performed the study to determine the clinical characteristics and natural history of Gaucher disease with CNS involvement in Korea as well as to determine whether gene analysis would be helpful in the identification of neuronopathic Gaucher disease.
Methods
: We described the initial symptom, clinical manifestations, age of onset, clinical neurophysiologic findings and brain MRI findings from the medical records of 13 patients with neuronopathic Gaucher disease identifed from the Korean Gaucher Disease Patient Registry. Mutation analysis was performed in 7 cases of neurono pathic Gaucher disease patients by PCR or PCR-single strand conformation polymorphism(SSCP).
Results
: Among 46 cases of Korean Gaucher disease, type Ⅱ was found in 6 cases(13%) and type Ⅲ was found in 7 cases(15%). Type II Gaucher disease showed typical clinical features, and those patients expired in less than 2 years of age. All the type IIIa patients presented epileptic seizure as an initial symptom and most of the patients survived. All the type IIIa patients revealed epileptiform activity and photoparoxysmal response. Mutation analysis in neuronopathic Gaucher disease patients revealed L444P/L444P(2 cases), F213I/F213I(1 case), F213I/?(1 case) and N188S/?(1 case). However, mutation analysis in type I Gaucher disease revealed L444P/?(4 cases), F213I/?(2 cases) and L444P/F213I(1 case).
Conclusion
: The clinical characteristics and natural history of Korean Gaucher disease is similar to those of Jewish Gaucher disease. Brain MRI, clinical neurophysiologic study and gene analysis are not helpful in the identification of neuronopathic Gaucher disease. Regular neurologic examinations are the only method to determine CNS involvement in Gaucher disease.
Key Words: Gaucher disease, CNS involvement, Gene analysis


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