Gaucher disease typically affects the body in many ways as a result of Gaucher cells accumulating in various organs, especially the liver, spleen, and the bone marrow. The disease’s bone-related symptoms can be particularly painful and debilitating, impairing a patient’s mobility.
Teenagers with Gaucher disease frequently experience a delay in the onset of puberty. By their late teens, however, most children with Gaucher disease catch up with the rest of the population. They generally obtain their genetically programmed height and experience normal sexual development.
Adolescence is a time when self-image and acceptance by peers are very important to a healthy mental attitude. Counseling may be appropriate for teenagers suffering from low self-esteem.
An enlarged liver and/or spleen, suseptibility to bone fractures, and other potential symptoms may make children with Gaucher disease less agile, or prevent them from engaging in contact sports. These children may discover more appropriate activities such as swimming, bicycle riding, or dancing.
The diagram below illustrates how Gaucher disease affects various parts of a teenager’s body. Please click on a number to view the various signs and symptoms of Gaucher disease in teenagers.
Click to view
1. Enlarged liver and/or spleen
Gaucher patients may have protruding abdomens, caused by the liver and/or spleen swelling to unusual sizes because of accumulated Gaucher cells. The spleen can swell to greater than 15 times its normal size, while the liver can swell to 2.5 times its normal size.
An enlarged liver and/or spleen can have many other effects on teenagers, including appetite suppression, blood-related problems, and low self-esteem related to appearance. Appetite suppression is caused by the enlarged organs pressing on the stomach and creating the sensation of feeling full.
2. Low blood platelet count
Platelets are the blood cells responsible for blood clotting; they are formed in bone marrow and then released into the blood. A build-up of Gaucher cells in bone marrow may cause fewer blood platelets to be produced. In addition, an enlarged, overactive spleen may break down blood cells faster than they are produced, thus also contributing to an overall lower platelet count. As a result, Gaucher patients’ blood may not clot well, and they may experience excessive bruising and bleeding, such as frequent nosebleeds, bleeding gums, and longer, heavier menstrual periods.
3. Low red blood cell count (anemia)
Red blood cells are responsible for carrying oxygen to all cells in the body. The spleen is responsible for breaking down these cells, but when it is enlarged, it may become overactive and break down blood cells faster than they are produced. The resulting red blood cell deficiency is called anemia, and it causes people to feel fatigued because the body is not getting enough oxygen. While anemia is often responsible for fatigue and low stamina in Gaucher patients, these symptoms may also result from a higher-than-normal metabolism found in many teenagers suffering from Gaucher disease.
Some teenagers may lack the energy and stamina to participate in activites with their peers. They may have difficulty staying alert in the classroom, or concentrating on their homework. Ordinary activities may require more effort for a teenager with Gaucher disease. However, most teenagers find that they can engage in their normal activities if they are careful to pace themselves and if they plan accordingly with family, friends, teachers, and others involved in their care.
4. Low white blood cell count
White blood cells are responsible for helping fight infection, such as when bacteria or viruses enter the body. The spleen is responsible for filtering these cells, but when it is enlarged as a result of accumulated Gaucher cells, it may become overactive and filter white blood cells faster than usual. The resulting white blood cell deficiency makes it harder for the body to fend off infection, so Gaucher patients may get sick more frequently than their peers.
5. Bone crisis
Gaucher patients may experience severe bone pain, called “bone crisis,” caused by insufficient blood circulation to the bone due to interference from Gaucher cells and by the local release of chemical factors. The pain is intense, often accompanied by fever, and can last from a few hours to a few days or even weeks, usually rendering patients bedridden during this time. Hospitalization may also be necessary.
6. Bone tissue death
As Gaucher cells accumulate in bone marrow, they can restrict normal blood flow - sometimes to the point that bone tissue dies. This bone destruction causes severe pain and can lead to fractures and joint collapse.
7. Bone thinning
Gaucher disease causes reduced mass and density of bone tissue, causing it to thin and weaken and thus be more susceptible to fractures.
8. Pathological fracture
Pathological fractures are broken bones caused by disease rather than by trauma (such as impact from a fall or accident). The accumulation of Gaucher cells in bone marrow can weaken bones in various ways, making them susceptible to such fractures resulting simply from normal activity.
9. Erlenmeyer flask deformity
Gaucher disease includes abnormalities in the way bones develop, or remodel, resulting in irregular shapes. The most common among Gaucher patients is the Erlenmeyer flask deformity, named after the type of laboratory flask whose shape it resembles. The ends of the bone, most commonly the femur and tibia develop a flared, flattened shape rather than the normal rounded form.