Cardoso-Santos Antonio, Azevedo Ana C M M, Fagondes Simone, Burin Maira G, Giugliani Roberto, Schwartz Ida V D
Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
J Pediatr (Rio J). 2008 Mar-Apr;84(2):130-5. doi: 10.2223/JPED.1743. Epub 2008 Mar 18.
To describe the profile of joint mobility and grip and pinch strength of MPS VI patients and to correlate this with urinary excretion of glycosaminoglycans (GAGs), ARSB activity, and the distance covered in a 6-minute walking test (6MWT).
This was an observational study of 28 patients with MPS VI, who had not undergone specific treatment. All patients were assessed for amplitude of joint mobility (shoulder, elbow, and knee), grip and pinch strength and urinary GAG excretion and also performed the 6MWT.
Shoulder flexion exhibited the greatest limitation, with no correlation with age, followed by knee extension and elbow flexion, both of which were correlated inversely with age. Hand grip strength was compromised in all patients, and pinch strength exhibited a positive correlation with age.
The fact that restricted shoulder flexion was not correlated with age suggests that this finding is present early on in MPS VI and that it constitutes an important clinical sign that should arouse diagnostic suspicion of this disease. The amplitude of knee extension and elbow flexion, in turn, are possible markers of disease progression since they have a negative correlation with age. Further studies are needed to confirm these hypotheses.
描述黏多糖贮积症Ⅵ型(MPS VI)患者的关节活动度、握力和捏力情况,并将其与糖胺聚糖(GAGs)的尿排泄量、芳基硫酸酯酶B(ARSB)活性以及6分钟步行试验(6MWT)中的步行距离相关联。
这是一项对28例未接受特殊治疗的MPS VI患者的观察性研究。对所有患者进行关节活动度(肩部、肘部和膝部)幅度、握力和捏力以及尿GAG排泄量的评估,并进行6MWT。
肩部前屈受限最为明显,与年龄无关,其次是膝关节伸展和肘关节屈曲,这两者均与年龄呈负相关。所有患者的手握力均受损,捏力与年龄呈正相关。
肩部前屈受限与年龄无关这一事实表明,该表现出现在MPS VI病程早期,是一个重要的临床体征,应引起对该疾病的诊断怀疑。相反,膝关节伸展和肘关节屈曲幅度可能是疾病进展的标志物,因为它们与年龄呈负相关。需要进一步研究来证实这些假设。