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法国庞贝氏症登记处。126 例成年庞贝氏症患者队列的基线特征。

The French Pompe registry. Baseline characteristics of a cohort of 126 patients with adult Pompe disease.

机构信息

Centre de référence de pathologie neuromusculaire Paris-Est, institut de myologie, groupe hospitalier Pitié-Salpêtrière, 47-83, boulevard de l'Hôpital, 75013 Paris, France.

出版信息

Rev Neurol (Paris). 2013 Aug-Sep;169(8-9):595-602. doi: 10.1016/j.neurol.2013.07.002. Epub 2013 Sep 3.

Abstract

Pompe disease is a rare autosomal recessive muscle lysosomal glycogenosis, characterised by limb-girdle muscle weakness and frequent respiratory involvement. The French Pompe registry was created in 2004 with the initial aim of studying the natural history of French patients with adult Pompe disease. Since the marketing in 2006 of enzyme replacement therapy (alglucosidase alfa, Myozyme(®)), the French Pompe registry has also been used to prospectively gather the biological and clinical follow-up data of all adult patients currently treated in France. This report describes the main clinical and molecular features, at the time of inclusion in the French registry, of 126 patients followed up in 21 hospital-based neuromuscular or metabolic centres. Sixty-five men and 61 women have been included in the registry. Median age at inclusion was 49 years, and the median age at onset of progressive limb weakness was 35 years. Fifty-five percent of the patients were walking without assistance, 24% were using a stick or a walking frame, and 21% were using a wheelchair. Forty-six percent of the patients needed ventilatory assistance, which was non-invasive in 35% of the cases. When performed, muscle biopsies showed specific features of Pompe disease in less than two-thirds of the cases, confirming the importance of acid alpha-glucosidase enzymatic assessment to establish the diagnosis. Molecular analysis detected the common c.-32-13T>G mutation, in at least one allele, in 90% of patients. The French Pompe registry is so far the largest country-based prospective study of patients with Pompe disease, and further analysis will be performed to study the impact of enzyme replacement therapy on the progression of the disease.

摘要

庞贝病是一种罕见的常染色体隐性肌肉溶酶体糖原贮积症,其特征为肢体带肌无力和频繁的呼吸受累。法国庞贝病登记处成立于 2004 年,最初的目的是研究法国成年庞贝病患者的自然病史。自 2006 年酶替代疗法(阿糖苷酶α,Myozyme(®))上市以来,法国庞贝病登记处还用于前瞻性收集目前在法国接受治疗的所有成年患者的生物学和临床随访数据。本报告描述了在纳入法国登记处时,126 名在 21 家医院神经肌肉或代谢中心接受随访的患者的主要临床和分子特征。登记处共纳入 65 名男性和 61 名女性患者。纳入时的中位年龄为 49 岁,进行性肢体无力的中位发病年龄为 35 岁。55%的患者无需辅助即可行走,24%的患者使用手杖或助行架,21%的患者使用轮椅。46%的患者需要通气支持,其中 35%的患者使用无创通气。当进行肌肉活检时,不到三分之二的病例显示出庞贝病的特定特征,这证实了酸性α-葡萄糖苷酶酶活性评估对确立诊断的重要性。分子分析发现 90%的患者至少有一个等位基因存在常见的 c.-32-13T>G 突变。法国庞贝病登记处是迄今为止最大的基于国家的庞贝病患者前瞻性研究,进一步的分析将用于研究酶替代疗法对疾病进展的影响。

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