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儿童法布里病:俄罗斯的联邦筛查计划。

Fabry disease in children: a federal screening programme in Russia.

机构信息

Institute of Paediatrics, Federal State Autonomous Institution "National Medical Research Center of Children's Health" of the Ministry of Health of the Russian Federation, Lomonosovsky prospekt, 2, b.1, 119991, Moscow, Russia.

Laboratory of Molecular Genetics and Cell Biology, Federal State Autonomous Institution "Scientific Center of Children's Health" of the Ministry of Health of the Russian Federation, Moscow, Russia.

出版信息

Eur J Pediatr. 2017 Oct;176(10):1385-1391. doi: 10.1007/s00431-017-2992-y. Epub 2017 Sep 4.

Abstract

UNLABELLED

Our objective was to examine the prevalence of Fabry disease in Russian children with chronic pain in the distal limbs. This non-interventional, multi-centre study included children 2-18 years of age with chronic recurrent unilateral or bilateral pain, burning, or acroparesthesia in the hands or feet. The presence of Fabry disease was defined by abnormal alpha-galactosidase A activity in males or alpha-galactosidase gene (GLA) mutation in females. Among 214 patients (110 males), 84.1% had bilateral limb pain and 31.8% had unilateral limb pain recorded at some time point; 61 (28.5%) patients had a positive family history possibly associated with Fabry disease. Alpha-galactosidase A activity was within the normal range in all 109 of the male patients tested. One female patient had a GLA mutation (C937G > T) and alpha-galactosidase A activity within the normal range.

CONCLUSION

We did not find definitive evidence of Fabry disease in these children with a history of chronic recurrent unilateral or bilateral limb pain or acroparesthesia. The presence of chronic limb pain does not appear to be highly predictive of a diagnosis of Fabry disease in Russian children and adolescents, suggesting that key early signs and symptoms of Fabry disease are not specific to the disease. What is Known: • Signs and symptoms of Fabry disease are seen in children < 10 years of age; pain in the distal limbs is a common early symptom. What is New: • Fabry disease was not diagnosed in this population of Russian children with a history of chronic limb pain. • The presence of acroparesthesia or chronic limb pain does not appear to be highly predictive of a diagnosis of Fabry disease in Russian children and adolescents, suggesting that these early symptoms of Fabry disease are not specific to the disease.

摘要

目的

研究俄罗斯患有四肢远端慢性疼痛的儿童中 Fabry 病的患病率。本项非干预、多中心研究纳入了年龄 2-18 岁、具有慢性复发性单侧或双侧手部或足部疼痛、烧灼感或肢端感觉异常的儿童。男性中 Fabry 病的定义为α-半乳糖苷酶 A 活性异常,女性中则为α-半乳糖苷酶基因(GLA)突变。在 214 例患者(110 例男性)中,84.1%的患者存在双侧肢体疼痛,31.8%的患者存在单侧肢体疼痛;61 例(28.5%)患者存在阳性家族史,可能与 Fabry 病有关。109 例男性患者的α-半乳糖苷酶 A 活性均在正常范围内。1 例女性患者的 GLA 突变(C937G>T),α-半乳糖苷酶 A 活性在正常范围内。

结论

我们未在这些具有慢性复发性单侧或双侧肢体疼痛或肢端感觉异常病史的儿童中发现明确的 Fabry 病证据。慢性肢体疼痛的存在似乎不能高度预测俄罗斯儿童和青少年 Fabry 病的诊断,这表明 Fabry 病的早期关键体征和症状并非该病所特有。

已知

•Fabry 病的体征和症状在 10 岁以下儿童中出现;肢体远端疼痛是常见的早期症状。

新发现

•在本研究中,俄罗斯慢性肢体疼痛儿童中未诊断出 Fabry 病。

•肢端感觉异常或慢性肢体疼痛的存在似乎不能高度预测俄罗斯儿童和青少年 Fabry 病的诊断,表明 Fabry 病的这些早期症状并非该病所特有。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0670/5602089/99f0476d5bae/431_2017_2992_Fig1_HTML.jpg

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