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拉丁美洲与世界其他地区黏多糖贮积症 I 型患者的临床表现和治疗。

Clinical manifestations and treatment of mucopolysaccharidosis type I patients in Latin America as compared with the rest of the world.

机构信息

Genzyme do Brazil, Av. Francisco Matarazzo, 1400, Edifício Milano - 10° andar, 05001-903, São Paulo, SP, Brazil.

出版信息

J Inherit Metab Dis. 2011 Oct;34(5):1029-37. doi: 10.1007/s10545-011-9336-2. Epub 2011 May 4.

Abstract

BACKGROUND

Mucopolysaccharidosis I (MPS I) comprises a spectrum of clinical manifestations and is divided into three phenotypes reflecting clinical severity: Hurler, Hurler-Scheie, and Scheie syndromes. There may be important variations in clinical manifestations of this genetic disease in patients residing in different regions of the world.

METHODS

Using data from the MPS I Registry (as of September 2009), we evaluated patients from Latin America (n = 118) compared with patients from the rest of the world [ROW (n = 727)].

RESULTS

Phenotype distribution differed among patients in Latin America compared to ROW (Hurler 31 vs. 62%, Hurler-Scheie 36 vs. 21%, Scheie 10 vs. 11%, and unknown 22 vs. 6%). The frequency of certain symptoms, such as cardiac valve abnormalities, sleep impairment, and joint contractures, also differed between Latin America and ROW for some phenotypes. Median age at MPS I diagnosis was earlier in the ROW than Latin America for all phenotypes, and age at first treatment for Hurler and Hurler-Scheie patients was also earlier in the ROW. Hurler patients in Latin America showed a gap of 3.1 years between median ages of diagnosis and first treatment compared to only 0.5 years in the ROW. Treatment allocation in Latin America compared to ROW was as follows: enzyme replacement therapy (ERT) only, 80 vs. 45%; hematopoietic stem cell transplantation (HSCT) only, 0.9 vs. 27%; both ERT and HSCT, 0 vs. 16%; and neither treatment, 19 vs. 13%.

CONCLUSION

These data highlight important differences in MPS I patients between Latin America and ROW in terms of phenotypic distribution, clinical manifestations, and treatment practices.

摘要

背景

黏多糖贮积症 I 型(MPS I)表现出一系列临床表现,并分为反映临床严重程度的三种表型:Hurler、Hurler-Scheie 和 Scheie 综合征。这种遗传性疾病在世界不同地区的患者中可能有重要的临床表现差异。

方法

使用 MPS I 登记处(截至 2009 年 9 月)的数据,我们评估了来自拉丁美洲(n=118)的患者与来自世界其他地区(ROW,n=727)的患者。

结果

与 ROW 相比,拉丁美洲患者的表型分布不同(Hurler 31%对 62%,Hurler-Scheie 36%对 21%,Scheie 10%对 11%,未知 22%对 6%)。某些症状的频率,如心脏瓣膜异常、睡眠障碍和关节挛缩,在某些表型中也在拉丁美洲和 ROW 之间存在差异。所有表型中,ROW 患者的 MPS I 诊断年龄中位数均早于拉丁美洲,Hurler 和 Hurler-Scheie 患者的首次治疗年龄也早于拉丁美洲。与 ROW 相比,拉丁美洲的 Hurler 患者在诊断年龄中位数和首次治疗年龄中位数之间存在 3.1 年的差距,而 ROW 仅为 0.5 年。拉丁美洲与 ROW 的治疗分配如下:仅酶替代疗法(ERT),80%对 45%;仅造血干细胞移植(HSCT),0.9%对 27%;ERT 和 HSCT 联合应用,0%对 16%;两种治疗均未应用,19%对 13%。

结论

这些数据突出了拉丁美洲和 ROW 之间 MPS I 患者在表型分布、临床表现和治疗实践方面的重要差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1392/3173625/161ba5c83246/10545_2011_9336_Fig1_HTML.jpg

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