Eduard Veseliny, Peter Jarčuška, Jana Šaligová
Gaucher disease (GD), the most common lysosomal storage disorder, is an autosomal recessive metabolic disease which if undiagnosed or diagnosed late results in devastating complications. GD is caused by the defective activity of the lysosomal enzyme, acid-β-glucosidase (glucocerebrosidase) leading to accumulation of glucosylceramide and other glycolipids within the lysosomes of macrophages. Clinicians should be aware of this rare but potentially treatable disease in patients who present with unexplained organomegaly (usually massive splenomegaly, hepatomegaly), thrombocytopenia, anaemia, and some skeletal complications. Because of the variability in the manifestations, severity, and progression of GD, management and treatment must be individualized. Each patient should undergo a comprehensive initial assessment of all potentially affected organ systems. Treatment is then individualized to achieve specific therapeutic goals. The treatment options for adult type GD include enzyme replacement therapy (ERT) and substrate reduction therapy (SRT). Future treatment options are gene therapy and enzyme enhancement therapy by chemical chaperones. In this review, we present the key issues about GD and new developments that clinicians should be aware of.