Wagner C, Niemczyk J, Equit M, Curfs L, von Gontard A
Department of Child and Adolescent Psychiatry, Saarland University Hospital, 66421, Homburg, Germany.
Department of Clinical Genetics, Governor Kremers Centre, Maastricht University Medical Centre, Maastricht, The Netherlands.
Eur J Pediatr. 2017 Feb;176(2):225-232. doi: 10.1007/s00431-016-2828-1. Epub 2016 Dec 20.
Angelman syndrome (AS) is a congenital syndrome with a prevalence of 1:15,000. Individuals with AS often have severe intellectual disability, typical dysmorphic signs, and behavioral problems. The aim of the study was to investigate the rate of incontinence and associated psychological problems in children and adults with AS. Ninety children (4-18 years) and 54 adults (18-31 years) with AS were recruited through a parent support group (55.6% male, mean age 15.1 years). The Parental Questionnaire: Enuresis/Urinary Incontinence, the Incontinence Questionnaire-Pediatric Lower Urinary Tract Symptoms (ICIQ-CLUTS), as well as the Developmental Behaviour Checklist for parents (DBC-P) or for adults (DBC-A) were filled out by parents or caregivers. 85.6% of individuals with AS were affected by at least one subtype of incontinence (82.7% nocturnal enuresis (NE), 64.7% daytime urinary incontinence (DUI), and 57.1% fecal incontinence (FI)). 52.5% of the children and 32.6% of adults reached a clinically relevant DBC score. Incontinence was not associated with behavioral problems. NE and DUI were associated with genotype and epilepsy.
Children with AS have high rates of incontinence. Many adults are still affected by NE, DUI, or even FI. Screening, assessment, and treatment of incontinence in individuals with AS are recommended. What is Known: • Incontinence in persons with Angelman syndrome (AS) is associated with younger age, lower level of adaptive functioning, and epilepsy. What is New: • Children and teens with AS are at special risk for incontinence, but older persons are also affected. • Comorbid epilepsy is significantly associated not only with nocturnal enuresis (NE) but also with daytime urinary incontinence (DUI). Underlying genotype is significantly associated with incontinence.
天使综合征(AS)是一种先天性综合征,患病率为1:15000。患有AS的个体通常有严重智力障碍、典型的畸形体征和行为问题。本研究的目的是调查患有AS的儿童和成人的尿失禁发生率及相关心理问题。通过一个家长支持小组招募了90名患有AS的儿童(4至18岁)和54名成人(18至31岁)(男性占55.6%,平均年龄15.1岁)。家长或照料者填写了《家长问卷:遗尿/尿失禁》、《小儿下尿路症状失禁问卷》(ICIQ-CLUTS)以及家长版(DBC-P)或成人版(DBC-A)的《发育行为清单》。85.6%的AS患者至少受一种尿失禁亚型影响(82.7%夜间遗尿(NE)、64.7%白天尿失禁(DUI)和57.1%大便失禁(FI))。52.5%的儿童和32.6%的成人达到临床相关的DBC评分。尿失禁与行为问题无关。NE和DUI与基因型及癫痫有关。
患有AS的儿童尿失禁发生率高。许多成人仍受NE、DUI甚至FI影响。建议对患有AS的个体进行尿失禁筛查、评估和治疗。已知信息:• 天使综合征(AS)患者的尿失禁与年龄较小、适应功能水平较低及癫痫有关。新发现:• 患有AS的儿童和青少年有尿失禁的特殊风险,但老年人也会受到影响。• 合并癫痫不仅与夜间遗尿(NE)显著相关,还与白天尿失禁(DUI)显著相关。潜在基因型与尿失禁显著相关。