COMPASSIONATE ALLOWANCE INFORMATION

GAUCHER DISEASE (GD) - Type 2

DESCRIPTION

Gaucher disease (GD) is an inherited metabolic disorder in which harmful quantities of a fatty substance called glucocerebroside accumulate in the spleen, liver, lungs, bone marrow, and sometimes in the brain. In GD Type 2, liver and spleen enlargement are apparent by 3 months of age. Children have extensive and progressive brain damage and usually die by 2 years of age. All GD individuals exhibit a deficiency of an enzyme called glucocerebrosidase that is involved in the breakdown and recycling of glucocerebroside. The buildup of this fatty material within cells prevents the cells and organs from functioning properly. GD is one of several lipid storage diseases.

ALTERNATE NAMES

Gaucher disease-Type 2; GD2; Gaucher disease, infantile cerebral; Gaucher disease, acute neuronopathic type; Gaucher's disease type 2; Gaucher's disease type 2; Gaucher syndrome type 2

DIAGNOSTIC TESTING AND CODING

The diagnosis of GD relies on demonstration of deficient glucosylceramidase enzyme activity in peripheral blood leukocytes or other nucleated cells. Identification of two disease-causing alleles in GBA, the only gene known to be associated with GD, provides additional confirmation of the diagnosis but not in lieu of biochemical testing. Molecular genetic testing using sequence analysis identifies mutations in the majority of affected individuals.

TREATMENT

There is no effective treatment for the severe brain damage that may occur in children with GD Type 2.

PROGRESSION

The prognosis for children with GD Type 2 with onset before age two years is limited psychomotor development and a rapidly progressive course with death by age two to four years.

SUGGESTED PROGRAMMATIC ASSESSMENT*

Suggested MER for Evaluation: Enzyme assay level of glucosylceramidase (glucocerebrosidase) activity of less than 15%, physical findings of hepatosplenomegaly, and evidence of progressive neurodevelopmental delay.

Suggested Listings for Evaluation:

DETERMINATION

LISTING

REMARKS

Meets Listing

110.08B

Catastrophic congenital abnormalities or disease.

Medical Equals

* Adjudicators may, at their discretion, use the Medical Evidence of Record or Listings suggested to evaluate the claim. However, the decision to allow or deny the claim rests with the adjudicator.

Last Updated: 9/10/08

Office of Disability Programs