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[匈牙利东部地区罕见病的临床与基因诊断结果(2007 - 2013年)]

[Results of clinical and genetic diagnosis of rare diseases in the Eastern region of Hungary (2007-2013)].

作者信息

Szakszon Katalin, Balogh Erzsébet, Ujfalusi Anikó, Bessenyei Beáta, P Szabó Gabriella, Balogh István, Oláh Eva

机构信息

Debreceni Egyetem, Általános Orvostudományi Kar Gyermekgyógyászati Intézet, Klinikai Genetikai Központ Debrecen Nagyerdei krt. 98. 4032.

Debreceni Egyetem, Általános Orvostudományi Kar Laboratóriumi Medicina Intézet Debrecen.

出版信息

Orv Hetil. 2014 Mar 2;155(9):348-57. doi: 10.1556/OH.2014.29690.

Abstract

INTRODUCTION

80% of rare diseases have a genetic origin, and 50% manifest themselves as congenital anomalies. Their adequate health care includes early recognition of genetic anomalies and prevention of recurrence.

AIM

The aims of the authors were to provide correct diagnoses to patients with multiple congenital anomalies with or without mental retardation attending to the outpatient clinic of the Clinical Genetics Center at the University of Debrecen in the time interval between August 1, 2007 and March 31, 2013, establish the possibility of prenatal diagnosis, assess the distribution of different genetic mechanisms in the background of rare genetic diseases, compare them with international data, and develop an algorithm for the diagnostic approach of rare genetic diseases applicable in Hungary.

METHOD

Clinical data and genetic results of patients were evaluated, and patients were categorized into one of the ten proposed etiological groups, based on which the distribution of genetic causes was defined.

RESULTS

Clinical diagnosis was achieved in 64.3% of patients, confirmed genetic diagnosis in 37.8%, while 35.7% of patients remained undiagnosed. Several dysmorphic syndromes and metabolic disorders were first diagnosed in Hungary, two of which unique in the literature.

CONCLUSIONS

In the centre of the authors the diagnostic effectiveness of chromosome aberrations exceeds the international standards, that of known microdeletions and dysmorphic syndromes meets international data, and the genetic diagnosis of mendelian disorders and submicroscopic copy number changes remain below international figures.

摘要

引言

80%的罕见病起源于遗传,50%表现为先天性异常。对其进行充分的医疗保健包括早期识别遗传异常和预防复发。

目的

作者的目的是为2007年8月1日至2013年3月31日期间在德布勒森大学临床遗传中心门诊就诊的患有或不患有智力障碍的多发性先天性异常患者提供正确诊断,确定产前诊断的可能性,评估罕见遗传病背景下不同遗传机制的分布情况,将其与国际数据进行比较,并制定一种适用于匈牙利的罕见遗传病诊断方法算法。

方法

对患者的临床数据和基因检测结果进行评估,并将患者分类到十个提议的病因组之一,据此确定遗传病因的分布。

结果

64.3%的患者实现了临床诊断,37.8%的患者确诊了基因诊断,而35.7%的患者仍未确诊。匈牙利首次诊断出几种畸形综合征和代谢紊乱,其中两种在文献中是独一无二的。

结论

在作者所在中心,染色体畸变的诊断效率超过国际标准,已知微缺失和畸形综合征的诊断效率符合国际数据,孟德尔疾病和亚微观拷贝数变化的基因诊断仍低于国际水平。

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