Potential efficacy of enzyme replacement and substrate reduction therapy in three siblings with Gaucher disease type III

  • J. Cox-Brinkman
  • M. J. van Breemen
  • B. T. van Maldegem
  • L. Bour
  • W. E. Donker
  • C. E. M. Hollak
  • F. A. Wijburg
  • J. M. F. G. Aerts
Original Article

Summary

We report three siblings with Gaucher disease type III, born between 1992 and 2004. During this period, new developments resulted in different potential therapies, changing clinical practice. The two eldest siblings received enzyme replacement therapy (ERT) from the age of 24 and 5 months respectively, later followed by an increase in dosage. ERT was combined with substrate reduction therapy (SRT) from the ages of 12 and 8 years, respectively. In the youngest sibling the combination of high-dose ERT and SRT was given from the age of 5 months. The two eldest siblings showed significant neurological impairment from the age of 1.5 years, starting with a convergent strabismus and partial oculomotor apraxia, followed by cognitive decline and an abnormal EEG and BAER. In contrast, the neurological development in the youngest sibling is almost completely normal. At the age of 3 years, cognitive development, EEG and BAER are all normal. Disturbed saccadic eye movements, which were already present at the start of therapy, remained stable. In addition to the clinical efficacy, we report on the biochemical response to therapy. Based on our results, the combination of high-dose ERT and SRT should be considered as a possible therapeutic approach for GD III, especially if started at a young age. Further follow-up studies are necessary to explore the long-term therapeutic effects.

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Copyright information

© Springer Science+Business Media B.V. 2008

Authors and Affiliations

  • J. Cox-Brinkman
    • 1
  • M. J. van Breemen
    • 2
  • B. T. van Maldegem
    • 1
  • L. Bour
    • 3
  • W. E. Donker
    • 2
  • C. E. M. Hollak
    • 4
  • F. A. Wijburg
    • 1
  • J. M. F. G. Aerts
    • 2
  1. 1.Department of Pediatrics, G8–205Academic Medical CenterAmsterdamThe Netherlands
  2. 2.Department of Medical BiochemistryAcademic Medical CenterAmsterdamThe Netherlands
  3. 3.Department of Clinical NeurophysiologyAcademic Medical CenterAmsterdamThe Netherlands
  4. 4.Department of Internal MedicineAcademic Medical CenterAmsterdamThe Netherlands

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