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从 212 名戈谢病患者和 16 名戈谢病专家医生的角度探讨戈谢病的诊断之旅。

Exploring the patient journey to diagnosis of Gaucher disease from the perspective of 212 patients with Gaucher disease and 16 Gaucher expert physicians.

机构信息

Lysosomal Storage Disorders Unit, Department of Haematology, Royal Free Hospital, UCL Medical School, London, UK.

Referral Centre for Lysosomal Diseases, University Hospital Paris Nord Val de Seine, Clichy, France.

出版信息

Mol Genet Metab. 2017 Nov;122(3):122-129. doi: 10.1016/j.ymgme.2017.08.002. Epub 2017 Aug 4.

Abstract

Gaucher disease (GD) is a rare hereditary disorder caused by a deficiency of the lysosomal enzyme β-glucocerebrosidase. Diagnosis is challenging owing to a wide variability in clinical manifestations and severity of symptoms. Many patients may experience marked delays in obtaining a definitive diagnosis. The two surveys reported herein aimed to explore the patient journey to diagnosis of GD from the perspectives of Gaucher expert physicians and patients. Findings from the surveys revealed that many patients experienced diagnostic delays and misdiagnoses, with nearly 1 in 6 patients stating that they were not diagnosed with GD for 7years or more after first consulting a doctor. Physicians and patients both reported multiple referrals to different specialties before a diagnosis of GD was obtained, with primary care, haematology/haematology-oncology and paediatrics the main specialties to which patients first presented. Splenomegaly, thrombocytopenia, anaemia and bone pain were reported as the most common medical problems at first presentation in both surveys. These findings support a clear need for straightforward and easy-to-follow guidance designed to assist non-specialists to identify earlier patients who are at risk of GD.

摘要

戈谢病(GD)是一种由溶酶体酶β-葡糖脑苷脂酶缺乏引起的罕见遗传性疾病。由于临床表现和症状严重程度的广泛变异性,诊断具有挑战性。许多患者可能会出现明显的延迟获得明确诊断。本文报告的两项调查旨在从戈谢病专家医生和患者的角度探讨 GD 的诊断过程。调查结果显示,许多患者经历了诊断延迟和误诊,近 1/6 的患者表示,他们在首次就诊后 7 年或更长时间才被诊断为 GD。医生和患者都报告说,在获得 GD 诊断之前,他们多次转诊到不同的专科,初级保健、血液科/血液肿瘤学和儿科是患者首次就诊的主要专科。两项调查都报告称,在首次就诊时,脾肿大、血小板减少、贫血和骨痛是最常见的医疗问题。这些发现表明,非常需要制定简单易用的指导方针,以帮助非专家医生更早地识别出患有 GD 的风险患者。

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