Medical histories and physical examinations were obtained on all patients. Height and weight Z scores were determined using normative growth data from the Centers for Disease Control (www.cdc.gov/nccdphp/dnpa/growthcharts/sas.htm ). Neurologic examination included assessment of motor and sensory function, cranial nerves, and cognitive status. Ophthalmologic examination, including fundoscopy and retinal photographs, was performed at each site and the findings were reviewed centrally by a single examiner (Dr. Brodie). Routine clinical laboratory studies included blood chemistries, liver function tests, hematology, insulin-like growth factor 1 (IGF-1) and binding protein , thyrotropin, fasting lipid profile, and urinalysis. Specialized testing included SMPD1 and chitotriosidase (chitinase, CHIT1) genotyping, chitotriosidase activity, and sphingomyelin levels in plasma and peripheral blood mononuclear cells.
Cardiopulmonary status was assessed by electrocardiography (ECG), two-dimensional echocardiography, and pulmonary function testing (forced vital capacity, FVC; forced expiratory volume in 1 second, FEV1; and diffusing capacity of the lung, DLCO) by standard clinical techniques. Sub-maximal exercise tolerance was assessed by the 6-minute walk test (6MWT),8 (link) and the values of two tests performed on separate days were averaged. Maximal exercise tolerance was assessed by cycle ergometry with continuous measurements of workload, oxygen (O2) uptake, carbon dioxide output, and tidal volume. FVC, FEV1, DLCO, maximum O2 uptake, and maximum carbon dioxide output were expressed as a percentage of predicted values.
Cardiopulmonary status was assessed by electrocardiography (ECG), two-dimensional echocardiography, and pulmonary function testing (forced vital capacity, FVC; forced expiratory volume in 1 second, FEV1; and diffusing capacity of the lung, DLCO) by standard clinical techniques. Sub-maximal exercise tolerance was assessed by the 6-minute walk test (6MWT),8 (link) and the values of two tests performed on separate days were averaged. Maximal exercise tolerance was assessed by cycle ergometry with continuous measurements of workload, oxygen (O2) uptake, carbon dioxide output, and tidal volume. FVC, FEV1, DLCO, maximum O2 uptake, and maximum carbon dioxide output were expressed as a percentage of predicted values.