Pitfalls in the diagnosis of Gaucher disease in Iraq: A diagnostic experience from a developing country

Rabab Farhan Thejeal; Saja Baheer Abdulwahhab; Nebal Waill Saadi

doi:10.12669/pjms.37.3.2930

Rabab Farhan Thejeal Assistant professor, college of Medicine-Baghdad University/pediatric department. Pediatric Gastroenterology -Children Welfare Teaching Hospital/Baghdad
Saja Baheer Abdulwahhab Pediatrician-C.A.B.P., metabolic clinic/ Children Welfare Teaching Hospital/Baghdad,
Nebal Waill Saadi College of Medicine- Baghdad University

DOI: https://doi.org/10.12669/pjms.37.3.2930

Keywords: Gaucher disease, Diagnostic errors, Developing country

Abstract

Background and Objectives: Gaucher disease (GD) is a rare hereditary disorder caused by deficiency of the lysosomal enzyme β-glucocerebrosidase. An early and definitive diagnosis minimizes the sequelae of misdiagnoses, and unnecessary and invasive diagnostic procedures.

Methods: A cross-sectional descriptive study was conducted in the period from June to August, 2018, to analysing data of thirteen patients, retrospectively. They presented to the gastrointestinal and metabolic clinics in Children Welfare Teaching Hospital in Iraq, and had wrong and delayed diagnosis of GD.

Results: Two groups of patients were identified, based on diagnosis by enzymatic assay (considering the test positive when the enzyme level is below the normal value); those who had false positive (low level of the enzyme) result and received enzyme replacement therapy for long time, and those who had false negative (normal level of the enzyme) results which caused delay in their diagnosis and treatment. Two main factors that misled the diagnosis were identified.

Conclusion: Each patient with Gaucher disease need to be approached by taking a thorough history, a proper clinical examination, and then by being investigated, accordingly. Biomarkers and molecular genetic studies are more accurate and solid additional tools, to the enzymatic assays on dried blood sample (DBS).

doi: https://doi.org/10.12669/pjms.37.3.2930

How to cite this:
Thejeal RF, Abdul-Wahhab SB, Saadi NW. Pitfalls in the diagnosis of Gaucher disease in Iraq: A diagnostic experience from a developing country. Pak J Med Sci. 2021;37(3):782-787. doi: https://doi.org/10.12669/pjms.37.3.2930

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.