Lysosomal Storage Disorders Flashcards

1
Q

Gaucher Type I

A
  • Least severe
  • hepatosplenomegaly (HSM)
  • enlarged liver and spleen leads to anemia and thrombocytopenia
  • Bone disease
  • Pulmonary tension
  • Little to no neurological symptoms, may have Parkinsonian features
  • Normal lifespan
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2
Q

Gaucher Type II

A
  • Most severe
  • HSM
  • enlarged liver and spleen leads to anemia and thrombocytopenia
  • NO bone disease
  • Severe neurological symptoms
  • seizures, opsithotonic posturing
  • Typical lifespan is no longer than 2 years
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3
Q

Gaucher Type III

A
  • Moderate severity
  • HSM
  • enlarged liver and spleen leads to anemia and thrombocytopeia
  • Bone disease
  • Moderate neurological symptoms
  • oculomotor apraxia (jarring eye movement, difficulty with peripheral vision), seizures
  • Somewhat limited lifespan, can be extended with treatment
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4
Q

Gaucher Inheritance/Gene info

A
  • Gene: GBA
  • Chromosome 1
  • Autosomal recessive inheritance
  • Malfunctioning enzyme is glucocerebrosidase
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5
Q

Gaucher Screening and Treatment

A
  • Enzyme and molecular testing
  • Bone marrow biopsy will show enlarged “Gaucher cells”
  • Treatment with enzyme replacement therapy: Cerezyme
  • New small molecular inhibitor Cerdelga is sometimes used for treatment instead of ERT
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6
Q

Fabry Symptoms

A
  • GI Distress-Corneal whorl (does not affect vision)
  • Left ventricular hypertrophy
  • Proteinurea
  • Hypohydrosis
  • lack of sweat
  • can lead to easy overheating
  • Acroparathesias:severe pain in hands and feet
  • Gradual hearing loss
  • Depression/Anxiety
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7
Q

Fabry Inheritance/Gene info

A
  • Gene: GLA
  • X Chromosome
  • Can affect females due to skewed X-inactivation
  • X-linked inheritance with affected females (pseudo-dominant)
  • Malfunctioning enzyme is alpha galactosidase
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8
Q

Fabry testing and treatment

A
  • Enzyme testing can be useful on males
  • Enzyme testing is not helpful for females because the enzyme deficiency may be limited, or may not be detected in the blood
  • Molecular testing
  • Symptomatic treatment of pain, cardiac issues, and GI distress with appropriate medication
  • Enzyme replacement therapy with Fabrazyme, Replegal
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9
Q

Pompe Disease Symptoms - Infantile Onset

A
  • Cardiomegaly
  • Cardiorespiratory failure
  • Difficulty breathing
  • Muscle weakness (floppy baby)
  • Head lag, delayed motor skills
  • Difficulty feeding, enlarged tongue, hepatomegaly (enlarged liver)
  • Glycogen storage disease
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10
Q

Pompe Disease Symptoms - Late Onset

A
  • Respiratory difficulty
  • Diaphragmatic weakness
  • Muscle weakness, difficulty walking (these symtpoms can appear to be a type of muscular dystrophy)
  • Difficulty maintaining weight
  • Difficulty swallowing
  • Acid maltase difficiency
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11
Q

Pompe Inheritance/Gene info

A
  • Gene: GAA
  • Chromosome 17
  • Autosomal recessive inheritance
  • Enzyme deficiency is acid alpha glucosidase
  • Glycogen buildup
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12
Q

Pompe testing and treatment

A
  • Enzyme testing
  • Western blot to test for presence of protein-Molecular testing
  • Enzyme replacement therapy with myozyme for infants, lumizyme for adults
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13
Q

Mucopolysaccharidoses (MPS)

A
  • Types I-VII with subtypes
  • Leads to improper breakdown of GAGs (glycosaminoglycans), which affect to connective tissue development
  • Can be detected through MPS urine screen, enzyme testing, and molecular testing-Regression is a key symptom in most MPS types
  • Skin pebbling occurs due to substrate buildup
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14
Q

MPS Type I

A
  • Hurler Syndrome
  • Autosomal Recessive Inheritance
  • Coarse facial features
  • Hepatosplenomegaly
  • Cardiac problems
  • Hydrocephalus
  • Developmental delay
  • Corneal clouding (DOES affect eyesight)
  • Recurrent ENT problems
  • Hearing loss
  • Regression
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15
Q

MPS Type II

A

-Hunter Syndrome
- X-linked Inheritance
-Coarse facial features
-Hepatosplenomegaly
-Hydrocephalus
-CLEAR CORNEAS
–Regression
-Developmental delays
-Hearing loss
-Recurrent ENT problems
-Cardiac problems
SAME AS TYPE I BESIDES BEING X-LINKED AND CLEAR CORNEAS

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16
Q

MPS Type III

A
  • Autosomal recessive inheritance
  • Milder skeletal phenotypes
  • Still coarse facial features
  • No associated cardiac problems
  • Progressive sleep and behavioral difficulties
17
Q

MPS Type IV

A
  • Autosomal recessive inheritance
  • Severe skeletal phenotypes
  • Chest deformities
  • Heart problems
  • Short stature
  • Malformed bones
  • Macrocephaly
  • Normal cognitive function
18
Q

MPS Type VI

A
  • Autosomal recessive inheritance
  • Coarse facial features
  • Short stature
  • Corneal clouding
  • Cardiac problems
  • Normal cognitive function
19
Q

MPS Type VII

A
  • Autosomal recessive inheritance
  • Developmental delay
  • Regression
  • Course facial features
  • Hepatosplenomegaly
  • Recurrent ENT problems
  • Cardiac problems
20
Q

MPS Type I and Type II treatments

A
  • Enzyme replacement therapy (does not cross blood/brain barrier)
  • Bone marrow or stem cell transplant before onset of cognitive delay (less efficient in Type II than in Type I)
  • Intrathecal ERT is in trial (enzyme given through the spinal column to access the blood/brain barrier)
21
Q

MPS Type III-VII treatments

A

-Enzyme replacement therapy