Lysosomal storage diseases - key points
In this diseases the problem has to do with sphingolipids. They are made up of: sphingosine and
fatty acid forming something callled ceramide. Each sphingolipid is different from one another bc a
modification of the head group on ceramides.
In general all lysosomal disease are automosal recessive, except from: fabry´s disease and hunter´s
syndrome. Also in general none lysosomal disease have a treatment except from: fabry´s disease
and gaucher´s disease.
FABRY´S DISEASE
Deficiency of alfa galactosidase A
Accumulation of ceramide trihexodise
Classic case child with pain in hands/feet (neuropathy)
lack of sweat
skin findings (angiokearatomas)
Other symptoms are:
— Angiokeratomas: red spots
— Renal disease: proteinuria, renal failure
— Cardiac disease: left ventricular hypertrophy, heart failure
— CNS problems: TIA/stroke at early age
GAUCHER´S DISEASE (most common lysosomal storage disease)
Deficiency of glucocerebrosidase
Accumulation of glucocerebroside
Classic case child of ashkenasi jewish descent
splenomegaly
anemia
brusing
joint pain/ fractures
Other symptoms: (lpids acummulate in spleen, liver and bones)
— Hepatosplenomegaly: most commn initial sign
— Bones: marrow (anemia and thrombocytopenia, easy brusing) and avascular necrosis on
joints
— Bone crisis: severe pain due to infarction, with fever.
— CNS: rare! dementia, ataxia.
# Macrophage (liver, spleen) filled with lipid: crinkled paper
There are 3 types: the most common one is type I (it has minimal CNS dysfrunction, and has
everything else). Type II and III are rare and has neurological deficit.
In this diseases the problem has to do with sphingolipids. They are made up of: sphingosine and
fatty acid forming something callled ceramide. Each sphingolipid is different from one another bc a
modification of the head group on ceramides.
In general all lysosomal disease are automosal recessive, except from: fabry´s disease and hunter´s
syndrome. Also in general none lysosomal disease have a treatment except from: fabry´s disease
and gaucher´s disease.
FABRY´S DISEASE
Deficiency of alfa galactosidase A
Accumulation of ceramide trihexodise
Classic case child with pain in hands/feet (neuropathy)
lack of sweat
skin findings (angiokearatomas)
Other symptoms are:
— Angiokeratomas: red spots
— Renal disease: proteinuria, renal failure
— Cardiac disease: left ventricular hypertrophy, heart failure
— CNS problems: TIA/stroke at early age
GAUCHER´S DISEASE (most common lysosomal storage disease)
Deficiency of glucocerebrosidase
Accumulation of glucocerebroside
Classic case child of ashkenasi jewish descent
splenomegaly
anemia
brusing
joint pain/ fractures
Other symptoms: (lpids acummulate in spleen, liver and bones)
— Hepatosplenomegaly: most commn initial sign
— Bones: marrow (anemia and thrombocytopenia, easy brusing) and avascular necrosis on
joints
— Bone crisis: severe pain due to infarction, with fever.
— CNS: rare! dementia, ataxia.
# Macrophage (liver, spleen) filled with lipid: crinkled paper
There are 3 types: the most common one is type I (it has minimal CNS dysfrunction, and has
everything else). Type II and III are rare and has neurological deficit.
