Department of Pediatrics and Medical Genetics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 100, Taiwan.
Mol Genet Metab. 2012 Sep;107(1-2):136-44. doi: 10.1016/j.ymgme.2012.07.019. Epub 2012 Jul 20.
Mucopolysaccharidosis (MPS) type VI (Maroteaux-Lamy syndrome) is a clinically heterogeneous lysosomal storage disorder. It presents significant diagnostic and treatment challenges due to the rarity of the disease and complexity of the phenotype. As information about MPS VI in Asia-Pacific countries is limited, a survey was conducted to assess current practices for diagnosis and management of MPS VI in this region. The participants were selected based on their experience in diagnosing and managing MPS patients.
The survey comprised 29 structured quantitative or qualitative questions. Follow-up consultations were undertaken to discuss the data further.
Thirteen physicians from eight countries or regions (Australia, China, Hong Kong, Japan, Malaysia, Philippines, Taiwan and Thailand) were surveyed. At the time of the survey twenty-two patients with MPS VI were directly treated by the respondents and most (~80%) had rapidly progressing disease. A wide range of medical specialists are involved in managing patients with MPS VI, the most common being orthopedic surgeons, pediatricians and geneticists. The availability/accessibility of diagnostic tools, therapies and national insurance coverage vary greatly across the countries/regions and, in some cases, between different regions within the same country. Currently, there are national MPS management groups in Australia and Japan. Australia, Taiwan and Hong Kong have local guidelines for managing MPS and local MPS registries are available in Australia, Taiwan, and Japan.
This survey highlights differences in the diagnosis and management of MPS VI between Asia-Pacific countries/regions. Important barriers to advancing the identification, understanding and treatment of MPS VI include the paucity of epidemiological information, limited access to laboratory diagnostics and therapies, low disease awareness, and a lack of monitoring and treatment guidelines. There is a clear need to facilitate communications between physicians and establish regional or national disease registries, a multidisciplinary referral network, and a centralized diagnostic and management framework.
黏多糖贮积症(MPS)VI 型(马罗泰克斯-拉米综合征)是一种临床表现高度异质的溶酶体贮积症。由于该病发病率低且表型复杂,因此在诊断和治疗方面存在重大挑战。由于亚洲太平洋地区关于 MPS VI 的信息有限,因此进行了一项调查,以评估该地区诊断和管理 MPS VI 的当前实践。参与者是根据他们在诊断和管理 MPS 患者方面的经验选择的。
该调查包括 29 个结构化的定量或定性问题。进行了随访咨询以进一步讨论数据。
来自 8 个国家或地区(澳大利亚、中国、中国香港、日本、马来西亚、菲律宾、中国台湾和泰国)的 13 名医生接受了调查。在调查时,有 22 名 MPS VI 患者由受访者直接治疗,其中大多数(约 80%)疾病进展迅速。许多不同的医学专家参与管理 MPS VI 患者,最常见的是矫形外科医生、儿科医生和遗传学家。各国/地区之间以及同一国家的不同地区之间,诊断工具、治疗方法和国家保险覆盖范围的可用性/可及性差异很大。目前,澳大利亚和日本都有国家 MPS 管理小组。澳大利亚、中国台湾和中国香港都有管理 MPS 的本地指南,澳大利亚、中国台湾和日本都有本地 MPS 登记处。
这项调查突出了亚洲太平洋国家/地区在 MPS VI 诊断和管理方面的差异。推进 MPS VI 识别、理解和治疗的重要障碍包括缺乏流行病学信息、实验室诊断和治疗方法有限、疾病意识低以及缺乏监测和治疗指南。显然需要促进医生之间的沟通,并建立区域或国家疾病登记处、多学科转诊网络以及集中的诊断和管理框架。