Liver involvement in patients with Gaucher disease types I and III

Rodrigo Tzovenos Starosta, Filippo Pinto e. Vairo, Alícia Dorneles Dornelles, Suélen Porto Basgalupp, Marina Siebert, Maria Lúcia Alves Pedroso, Carlos Thadeu Schmidt Cerski, Mário Reis Álvares-da-Silva, Ida Vanessa Doederlein Schwartz

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Abstract

Background & aims: Gaucher disease (GD) is a multisystemic disease. Liver involvement in GD is not well characterised and ranges from hepatomegaly to cirrhosis and hepatocellular carcinoma. We aim to describe, and assess the effect of treatment, on the hepatic phenotype of a cohort of patients with GD types I and II. Methods: Retrospective study based on the review of the medical files of the Gaucher Reference Centre of the Hospital de Clínicas de Porto Alegre, Brazil. Data from all GD types I and III patients seen at the centre since 2003 were analysed. Variables were compared as pre- (“baseline”) and post-treatment (“follow-up”). Results: Forty-two patients (types I: 39, III: 3; female: 22; median age: 35 y; enzyme replacement therapy: 37; substrate reduction therapy: 2; non-treated: 3; median time on treatment-MTT: 124 months) were included. Liver enzyme abnormalities, hepatomegaly, and steatosis at baseline were seen in 19/28 (68%), 28/42 (67%), and 3/38 patients (8%), respectively; at follow-up, 21/38 (55%), 15/38 (39%) and 15/38 (39%). MRI iron quantification showed overload in 7/8 patients (treated: 7; MTT: 55 months), being severe in 2/7 (treated: 2/2; MTT: 44.5 months). Eight patients had liver biopsy (treated: 6; MTT: 58 months), with fibrosis in 3 (treated: 1; time on treatment: 108 months) and steatohepatitis in 2 (treated: 2; time on treatment: 69 and 185 months). One patient developed hepatocellular carcinoma. Conclusions: GD is a heterogeneous disease that causes different patterns of liver damage even during treatment. Although treatment improves the hepatocellular damage, it is associated with an increased rate of steatosis. This study highlights the importance of a follow-up of liver integrity in these patients.

Original languageEnglish (US)
Article number100564
JournalMolecular Genetics and Metabolism Reports
Volume22
DOIs
StatePublished - Mar 2020

Keywords

  • Biopsy, large-core needle
  • Cholelithiasis
  • Enzyme replacement therapy
  • Gaucher disease
  • Hemosiderosis
  • Liver steatosis

ASJC Scopus subject areas

  • Molecular Biology
  • Genetics
  • Endocrinology

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  • Cite this

    Starosta, R. T., Vairo, F. P. E., Dornelles, A. D., Basgalupp, S. P., Siebert, M., Pedroso, M. L. A., Cerski, C. T. S., Álvares-da-Silva, M. R., & Schwartz, I. V. D. (2020). Liver involvement in patients with Gaucher disease types I and III. Molecular Genetics and Metabolism Reports, 22, [100564]. https://doi.org/10.1016/j.ymgmr.2019.100564