Second-tier test when newborn screening results with reduced beta-glucosidase (GBA) activity are identified
Diagnosis and monitoring of patients with Gaucher disease using whole blood specimens
Supporting the biochemical diagnosis of Gaucher disease
Monitoring a patient's response to treatment
This test is not useful for identifying carriers of GBA variants.
Gaucher disease is an autosomal recessive lysosomal storage disorder caused by deficient beta-glucosidase activity.
There are 3 described types of Gaucher disease with varying clinical presentations generally distinguished based on whether there is central nervous system involvement.
Glucopsychosine (glucosylsphingosine: lyso-GL1) is elevated in symptomatic patients and supports a diagnosis of Gaucher disease.
For more information see Newborn Screen Follow-up for Gaucher Disease
If the patient has abnormal newborn screening results for Gaucher disease, refer to the appropriate American College of Medical Genetics and Genomics Newborn Screening ACT Sheet.(1)
Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)
Gaucher disease
Glucopsychosine
Glucosylsphingosine
Lyso-GL1
For more information see Newborn Screen Follow-up for Gaucher Disease
If the patient has abnormal newborn screening results for Gaucher disease, refer to the appropriate American College of Medical Genetics and Genomics Newborn Screening ACT Sheet.(1)
Whole blood
This test is also available as a part of panel; see HSMWB / Hepatosplenomegaly Panel, Blood. If this test (GPSYW) is ordered with either CTXWB / Cerebrotendinous Xanthomatosis, Blood or OXYWB / Oxysterols, Blood, the individual tests will be canceled and HSMWB ordered.
Container/Tube:
Preferred: Lavender top (EDTA)
Acceptable: Green top (sodium heparin, lithium heparin) or yellow top (ACD B)
Specimen Volume: 1 mL
Collection Instructions: Send whole blood in original vial. Do not aliquot.
1. Biochemical Genetics Patient Information (T602)
2. If not ordering electronically, complete, print, and send a Biochemical Genetics Test Request (T798) with the specimen.
0.25 mL
Gross hemolysis | OK |
Gross lipemia | OK |
Gross icterus | OK |
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Whole blood | Refrigerated (preferred) | 72 hours | |
Ambient | 48 hours |
Second-tier test when newborn screening results with reduced beta-glucosidase (GBA) activity are identified
Diagnosis and monitoring of patients with Gaucher disease using whole blood specimens
Supporting the biochemical diagnosis of Gaucher disease
Monitoring a patient's response to treatment
This test is not useful for identifying carriers of GBA variants.
Gaucher disease is an autosomal recessive lysosomal storage disorder caused by deficient beta-glucosidase activity.
There are 3 described types of Gaucher disease with varying clinical presentations generally distinguished based on whether there is central nervous system involvement.
Glucopsychosine (glucosylsphingosine: lyso-GL1) is elevated in symptomatic patients and supports a diagnosis of Gaucher disease.
For more information see Newborn Screen Follow-up for Gaucher Disease
If the patient has abnormal newborn screening results for Gaucher disease, refer to the appropriate American College of Medical Genetics and Genomics Newborn Screening ACT Sheet.(1)
Gaucher disease (GD) is an autosomal recessive lysosomal storage disorder caused by a deficiency of the enzyme, beta-glucosidase, which facilitates the lysosomal degradation of glucosylceramide (glucocerebroside) and glucopsychosine (glucosylsphingosine: lyso-GL1). Gaucher disease is caused by disease-causing variants in the GBA gene and presents with a markedly variable phenotype, ranging from a perinatal lethal disorder to mildly symptomatic. It has historically been categorized into 3 types (GD1, GD2 and GD3) based on the presence and progression of neuropathic features. All types of Gaucher disease include hepatosplenomegaly and hematological abnormalities.
Gaucher disease type I is the most common form, representing more than 90% of cases. It is generally characterized by bone disease, hepatosplenomegaly, anemia and thrombocytopenia, coagulation abnormalities, lung disease, but no central nervous system involvement. Gaucher disease types II and III are characterized by the presence of primary neurologic disease, although in practice, assigning a type in infancy can sometimes be challenging due to overlapping clinical features. In addition, type II typically presents with limited psychomotor development, hepatosplenomegaly, and lung disease, resulting in death usually between 2 and 4 years of age. Individuals with Gaucher disease type III may present prior to 2 years of age, but the progression is not as rapid, and patients may survive into the third and fourth decade. Additional subtypes of Gaucher disease include a perinatal lethal form associated with skin abnormalities and nonimmune hydrops fetalis, and a cardiovascular form presenting with calcification of the aortic and mitral valves, mild splenomegaly, corneal opacities, and gaze impairment.
Treatment is available in the form of enzyme replacement therapy (ERT) and substrate reduction therapy (SRT) for types I and III. Some patients with chronic and progressive neurologic symptoms despite ERT or SRT may be candidates for bone marrow transplant or a multifaceted approach. Currently, only supportive therapy is available for type II because of the inability of enzyme provided by replacement therapy to cross the blood-brain barrier.
The incidence of GD is variable, with a higher occurrence in populations with known founder variants such as the Ashkenazi Jewish population.
A diagnostic workup for GD may demonstrate the characteristic finding of Gaucher cells on bone marrow examination, other hematologic abnormalities, and hepatosplenomegaly. The diagnosis can be confirmed by the demonstration of reduced or absent acid beta-glucosidase activity in leukocytes (GBAW / Beta-Glucosidase, Leukocytes) or dried blood spots (PLSD / Lysosomal and Peroxisomal Disorders Screen, Blood Spot) and molecular genetic analysis of the GBA gene (GBAZ / Gaucher Disease, Full Gene Analysis, Varies). Lyso GL-1 is a sensitive and specific biomarker for Gaucher disease, and an elevation of lyso GL-1 in blood supports the diagnosis. Lyso GL-1 has also been shown to be helpful in monitoring mildly symptomatic individuals for disease progression and in determining treatment response.
Cutoff: < or =0.040 nmol/mL
An elevation of glucopsychosine (glucosylsphingosine: lyso-GL1) is indicative of Gaucher disease.
Some patients with Gaucher disease may have normal concentrations of glucopsychosine (lyso-GL1).
1. Newborn Screening ACT Sheet [Decreased beta-glucocerebrosidase] Gaucher Disease. American College of Medical Genetics and Genomics; 2022. Revised March 2022. Accessed November 14, 2024. Available at www.acmg.net/PDFLibrary/Gaucher.pdf
2. Hughes DA, Pastores GM. Gaucher Disease. In: Adam MP, Feldman J, Mirzaa GM, et al. eds. GeneReviews. [Internet]. University of Washington, Seattle; 2000. Updated December 7, 2023. Accessed November 14, 2024. Available at www.ncbi.nlm.nih.gov/books/NBK1269/
3. Kishnani PS, Al-Hertani W, Balwani M, et al. Screening, patient identification, evaluation, and treatment in patients with Gaucher disease: Results from a Delphi consensus. Mol Genet Metab. 2022;135(2):154-162. doi:10.1016/j.ymgme.2021.12.009
4. Grabowski GA, Petsko GA, Kolodny EH. The Online Metabolic and Molecular Bases of Inherited Disease. McGraw-Hill Education; 2019. Accessed November 14, 2024. Available at https://ommbid.mhmedical.com/content.aspx?sectionid=225546056&bookid=2709 Gaucher disease. In: Valle DL, Antonarakis S, Ballabio A, Beaudet AL, Mitchell GA, eds.
5. Murugesan V, Chuan WL, Liu J, et al. Glucosylsphingosine is a key biomarker of Gaucher disease. Am J Hematol. 2016;91(11)1082-1089
6. Saville JT, McDermott BK, Chin SJ, Fletcher JM, Fuller M. Expanding the clinical utility of glucosylsphingosine for Gaucher disease. J Inherit Metab Dis. 2020;43(3):558-563
7. Daykin EC, Ryan E, Sidransky E. Diagnosing neuronopathic Gaucher disease: New considerations and challenges in assigning Gaucher phenotypes. Mol Genet Metab. 2021;132(2):49-58. doi:10.1016/j.ymgme.2021.01.002
Whole blood is spotted on filter paper and dried overnight. A 3-mm dried blood spot is extracted with internal standard. The extract is subjected to liquid chromatography tandem mass spectrometry (LC-MS/MS) analysis. The MS/MS is operated in the multiple reaction monitoring positive mode to follow the precursor to product species transitions for each analyte and internal standard. The ratio of the extracted peak areas to internal standard determined by the LC-MS/MS is used to calculate the concentration of in the sample.(Unpublished Mayo method)
Tuesday
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.
82542
Test Id | Test Order Name | Order LOINC Value |
---|---|---|
GPSYW | Glucopsychosine, B | 92751-7 |
Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
---|---|---|
BA4357 | Interpretation (GPSYW) | 59462-2 |
BA4356 | Glucopsychosine | 92751-7 |
BA4358 | Reviewed By | 18771-6 |