Liver and intrahepatic bile ducts - nontumor
Metabolic diseases
Gaucher disease

Author: Komal Arora, M.D. (see Authors page)

Revised: 26 October 2017, last major update April 2012

Copyright: (c) 2002-2017, PathologyOutlines.com, Inc.

PubMed Search: Liver[MH] Gaucher disease[TI]

Cite this page: Arora, K. Gaucher disease. PathologyOutlines.com website. http://pathologyoutlines.com/topic/livergauchers.html. Accessed November 17th, 2017.
Definition / general
  • Preferable to "Gaucher's disease"
Epidemiology
  • Highest risk in Ashkenazi Jews; 1 in 15 are carriers
Etiology
  • Lysosomal storage disease caused by an autosomal recessive mutation in the β glucocerebrosidase gene (also called glucosylceramidase and β glucosidase)
  • Defective enzyme leads to accumulation of glucocerebroside substrate in cells of the mononuclear phagocyte system, including histiocytes in the spleen, lymph nodes, bone marrow, GI and GU tracts; Kupffer cells in liver; osteoclasts in bone; microglia in CNS; and alveolar macrophages in lungs (Arch Pathol Lab Med 2008;132:851)
Clinical features
  • Three subtypes; all may have hepatosplenomegaly, hypersplenism, osteoporosis, yellow brown skin, anemia (GeneReviews: Gaucher Disease [Accessed 26 October 2017])
    • Type I: nonneuropathic, may be mild
    • Type II (acute infantile neuropathic Gaucher disease): affects infants within a few months of birth, usually fatal within 2 years; may have seizures and dementia
    • Type III: chronic neurological variant, with onset anytime between birth and adulthood, presents with slowly progressing neurological decline; may have seizures and dementia
Diagnosis
  • < 15% of mean normal glucocerebrosidase activity in peripheral blood leukocytes is diagnostic
  • Note: enzyme activity in carriers (heterozygotes) is generally half normal but may overlap with healthy controls
  • Molecular analysis, particular in Ashkenazi patients, may also be helpful
Case reports
Treatment
  • Enzyme replacement therapy with imiglucerase (Cerezyme), a recombinant version of β glucocerebrosidase, for patients with types I or III (Curr Opin Pediatr 2007;19:628)
Microscopic (histologic) description
  • Enlarged Kupffer cells and portal macrophages with "crinkled paper" cytoplasm
Microscopic (histologic) images

Images hosted on PathOut server:

Various images

PAS

Iron

Thick section



Images hosted on other servers:

Various images

Electron microscopy description
  • Intralysosomal tubular inclusions
  • Angulated lysosomes
Electron microscopy images

Images hosted on PathOut server:

Electron microscopy

Differential diagnosis