We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Editor's Correspondence |

Recommendations for Diagnosis, Evaluation, and Monitoring of Patients With Gaucher Disease

Deborah Elstein, PhD; Ayala Abrahamov, MD; Irith Hadas-Halpern, MD; Ari Zimran, MD
Arch Intern Med. 1999;159(11):1254. doi:.
Text Size: A A A
Published online


In a recent issue of the ARCHIVES, Charrow et al,1 as US regional coordinators for the International Collaborative Gaucher Group (ICGG) registry, present their recommendations for diagnosis, evaluation, and monitoring of patients with Gaucher disease. As the largest referral clinic for Gaucher disease outside the United States, our recommendations regarding monitoring differ to some extent from those enumerated in the above-mentioned article. We feel that the recommendation to use magnetic resonance imaging (MRI) or computed tomography (CT) for repeated evaluation of visceral involvement is probably unnecessary outside the constraints of a clinical trial. Ultrasound is highly accurate, universally available, inexpensive, involves no exposure to radiation, and the measurements can be easily converted for comparison to MRI2 and CT.3 Similarly, the recommendations for technetium Tc 99m sulfur colloid nuclear scanning and quantitative chemical shift MRI for routine bone assessment are problematic, not being universally available, and not clearly adding to the clinical appraisal of the patient. For skeletal involvement, we prefer dual energy x-ray absorptiometry in all adult patients as a measure of bone mass density at annual intervals. Plain radiography is performed at baseline and then only again as dictated by clinical events, in that 24 to 42 months are needed to evince radiographic documentation of improvement owing to enzyme treatment.4,5

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
PubMed Articles