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by Neff DM

Lysosomal Storage Disease

(Glycoprotein Storage Diseases; Mucopolysaccharidoses; MPS)

Definition

Lysosomal storage disease is a group of disorders that affect specific enzymes. These enzymes normally break down items for reuse in the cells. If the enzymes are missing or don't work properly the items can build up and become toxic. This occurs in an area of the cell called lysosomes. The build up eventually leads to damage of cells and organs in the body.
There are over 40 different types of lysosomal diseases. The diseases are characterized by the specific enzymes involved:
  • Fabry Morquio’s disease—affects the kidney, heart, and skin
  • Gaucher disease —affects the spleen and bones, and causes anemia
  • Hurler’s syndrome—affects the spleen, liver, joints, and eyes; causes intellectual disability and deafness
  • Maroteaux-Larny disease—affects the skin, bones, liver, and spleen
  • Niemann-Pick disease —affects the spleen, liver, and lungs
  • Pompe disease—affects the liver, heart, and muscle tissue
  • Tay-Sachs disease —affects the brain

Causes

Lysosomal storage disease is caused by a genetic problem. The genes that plan the production of the enzymes is faulty. Both parents must pass the gene on to the child in order for the disease to develop.
Genetic Material
Chromosome DNA
Copyright © Nucleus Medical Media, Inc.

Risk Factors

Lysosomal storage disease is more common in families with Ashkenazi Jewish, Finnish, or Dutch heritage. A family history increases the chance of the disease as well.

Symptoms

Symptoms can be severe and appear shortly after birth or mild and detected later in life. Symptoms will depend on the specific type of disease. Some common symptoms include:
  • Recurrent infections or hernias
  • Developmental delays
  • Problems with hearing or sight
  • Problems including pain with bones
  • Problems with heart
These symptoms may be caused by other conditions. If your child has any of these symptoms, talk to the doctor right away.

Diagnosis

The doctor will ask about your child's symptoms and medical history. A physical exam will be done. Skin and blood testing may be done to look for the specific enzyme that is causing the problem.
Other tests may include:
Prenatal testing and newborn screening may help with early detection.

Treatment

Treatment is focused on managing the symptoms caused by the missing enzymes. Specific treatment depends on the enzyme defect that your child has but options may include:
  • Dialysis —to remove substances from the blood
  • Physical therapy
  • Surgery
  • Medication
Other treatments may include:
  • Substrate synthesis inhibition therapy (SSI)—Medication that decreases the item that build up in the cells due to missing enzymes.
  • Enzyme replacement therapy (ERT)—Working enzymes are delivered through an IV to do the job of the defective enzymes.
  • Stem cell transplant— Stem cells are transplanted through IV to encourage the body to make the missing enzyme.

Prevention

There are no current guidelines to prevent these disorders.

RESOURCES

Lysosomal Disease Network
http://www.lysosomaldiseasenetwork.org
National MPS Society
http://www.mpssociety.org

CANADIAN RESOURCES

Canadian Society for Mucopolysaccharide & Related Diseases
http://www.mpssociety.ca
Health Canada
http://www.hc-sc.gc.ca

References

Lysosomal Storage Disease. American Society of Gene and Cell Therapy website. Available at: http://www.asgct.org/general-public/educational-resources/gene-therapy-and-cell-therapy-for-diseases/lysosomal-storage-diseases. Accessed August 15, 2014.
Lysosomal storage diseases. Children's Hospitals amd Clinics of Minnesota website. Available at: http://www.childrensmn.org/web/services/189101.asp. Accessed August 15, 2014.
Lipid storage disease fact sheet. National Institute of Neurological Disorders an Stroke website. Available at: http://www.ninds.nih.gov/disorders/lipid%5Fstorage%5Fdiseases/detail%5Flipid%5Fstorage%5Fdiseases.htm. Updated April 16, 2014. Accessed August 15, 2014.
Lysosomal storage disorders. National Organization of Rare Disorders website. Available at: https://www.rarediseases.org/rare-disease-information/rare-diseases/byID/1132/viewFullReport. Updated March 14, 2008. Accessed August 15, 2014.
Marsden D, Levy H. Newborn screening of lysosomal storage disorders. Clin Chem. 2010;56(7):1079.
Wynn RF, Wraith JE, Mercer J, et al. Improved metabolic correction in patients with lysosomal storage disease treated with hematopoietic stem cell transplant compared with enzyme replacement therapy. J Pediatr. 2009;154(4):609.

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