title: Gaucher disease in a family from Maranhão.
abstract: BACKGROUND
  Gaucher disease is an inborn, autosomal recessive error of the metabolism which belongs to the group of lysosomal storage disorders.
  
  
  OBJECTIVE
  This work reports on the treatment of Gaucher disease in several members of the same family from the countryside of Maranhão.
  
  
  METHODS
  This was an observational, retrospective and prospective, descriptive case study about the efficacy of enzyme replacement therapy.
  
  
  RESULTS
  The results showed that women were more affected (80% of patients) by the disease, age at diagnosis ranged from 24 to 33 years, the predominant ethnicity was mulatto (80%) and all cases were classified as type 1. The diagnosis of these patients was performed by measuring the levels of glucocerebrosidase and chitotriosidase enzymes and confirmed by genotyping. All patients suffering from Gaucher disease had low glucocerebrosidase levels. Before replacement therapy, hepatosplenomegaly was the most common clinical manifestation (100%) and osteopenia was seen in 80% of the cases. Regarding hematological manifestations, anemia and leukopenia were found in 40% of patients at diagnosis; however the hemoglobin and leukocyte levels were normalized after four years of therapy. Thrombocytopenia, observed in 20% of cases, was normalized after the second year of treatment.
  
  
  CONCLUSIONS
  In these cases, despite gaps in the treatment as the family resides in the rural region of the state, the patients with Gaucher disease showed satisfactory therapeutic response over time.
authors.affiliation: Universidade Estadual do Maranhão (UEMA), Caxias, MA, Brazil.
authors.forename: Samira Shizuko Parreão
authors.initials: SS
authors.lastname: Oi
authors.affiliation: Universidade Federal do Maranhão (UFMA), São Luis, MA, Brazil.
authors.forename: Dario Itapary
authors.initials: DI
authors.lastname: Nicolau
authors.affiliation: Universidade Estadual do Maranhão (UEMA), Caxias, MA, Brazil.
authors.forename: Sebastião Kelson Alves
authors.initials: SK
authors.lastname: Dos Santos
authors.affiliation: Universidade Federal do Maranhão (UFMA), São Luis, MA, Brazil.
authors.forename: Marcos Antonio Custódio Neto
authors.initials: MA
authors.lastname: da Silva
authors.affiliation: Universidade Federal do Maranhão (UFMA), São Luis, MA, Brazil.
authors.forename: Graça Maria
authors.initials: GM
authors.lastname: de Castro Viana
authors.affiliation: Universidade Federal do Maranhão (UFMA), São Luis, MA, Brazil. Electronic address: cnsd.ma@gmail.com.
authors.forename: Maria
authors.initials: M
authors.lastname: do Desterro Soares Brandão Nascimento
keywords: Enzyme replacement therapy; Family; Gaucher disease