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

Joel Charrow, MD; Joan A. Esplin, MD; Paige Kaplan, MD; Edwin H. Kolodny, MD; Gregory M. Pastores, MD; C. Ronald Scott, MD; Rebecca S. Wappner, MD; Neal J. Weinreb, MD; Jeffrey S. Wisch, MD
Arch Intern Med. 1999;159(11):1254. doi:.
Text Size: A A A
Published online


In reply

We appreciate the comments of Elstein et al and recognize their considerable experience in the evaluation, monitoring, and treatment of individuals with Gaucher disease. With respect to estimation of liver and spleen volume, they have demonstrated that organ volumes can be accurately estimated from linear ultrasound measurements. Despite their success with this modality, we believe there are important advantages to the use of MRI and CT for this purpose. Both MRI and CT provide more detailed information about parenchymal changes (eg, infarcts, fibrosis, scarring) in the liver and spleen, which are frequently observed in patients with Gaucher disease. Recognition of parenchymal lesions can be important for understanding subsequent changes in organ volume, the general progress of the disease, and the presence of other concurrent disorders. Magnetic resonance imaging and CT also enable accurate measurement of organ volumes when the organ contours are highly irregular and their shapes do not conform to the models used for converting linear measurements to volumes. Finally, while estimation of organ volume from ultrasound is reliable in their center, it is not clear how accurate or reproducible such estimations would be when performed in a variety of different centers by different technicians. As the authors note, ultrasound examination avoids repeated exposure to ionizing radiation, and for this same reason, and the superior resolution, we prefer MRI to CT, when it is available.

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