Marques-da-Silva D, Francisco R, Dos Reis Ferreira V, Forbat L, Lagoa R, Videira P A, Witters P, Jaeken J, Cassiman D
UCIBIO, Departamento Ciências da Vida, Faculdade de Ciências e Tecnologia, Universidade NOVA de Lisboa, Caparica, Portugal.
Portuguese Association for CDG, Lisbon, Portugal.
JIMD Rep. 2019;44:55-64. doi: 10.1007/8904_2018_121. Epub 2018 Jul 15.
Congenital disorders of glycosylation (CDG) are ultra-rare diseases showing a great phenotypic diversity ranging from mono- to multi-organ/multisystem involvement. Liver involvement, mostly nonprogressive, is often reported in CDG patients. The main objectives of this work were (1) to better understand liver involvement in CDG patients through a liver electronic questionnaire targeting CDG families (LeQCDG) and (2) to compare responses from LeQCDG participants with literature review regarding the prevalence of liver disease and the occurrence of liver symptoms in CDG patients. The network of patient advocacy groups, families and professionals (CDG & Allies - PPAIN) developed the LeQCDG by adapting validated published questionnaires. The LeQCDG was approved by an ethics committee, and the recruitment of patients and caregivers proceeded through social media platforms. Participants were asked to report past or present liver-related symptoms (e.g. hepatomegaly, liver fibrosis and cirrhosis) and laboratory results (e.g. biochemical and/or radiological). From 11 December 2016 to 22 January 2017, 155 questionnaires were completed. Liver disease was present in 29.9% of CDG patients. Main symptoms reported included hepatomegaly, increased levels of serum transaminases, fibrosis, steatosis and cirrhosis. The data obtained in this online survey confirm findings from a recent literature review of 25 years of published evidence (r = 0.927, P = 0.02). Our questionnaire collected large amounts of meaningful, clinical and patient-oriented data in a short period of time without geographic limitations. Internet-based approaches are especially relevant in the context of ultra-rare diseases such as CDG.
先天性糖基化障碍(CDG)是一类极其罕见的疾病,其表型具有高度多样性,可累及单器官至多器官/多系统。CDG患者常出现肝脏受累,且大多为非进行性。本研究的主要目的是:(1)通过针对CDG家庭的肝脏电子问卷(LeQCDG),更好地了解CDG患者的肝脏受累情况;(2)将LeQCDG参与者的回答与关于CDG患者肝病患病率和肝脏症状发生情况的文献综述进行比较。患者权益倡导组织、家庭和专业人员网络(CDG & Allies - PPAIN)通过改编已发表的有效问卷,开发了LeQCDG。LeQCDG获得了伦理委员会的批准,患者和护理人员的招募通过社交媒体平台进行。参与者被要求报告过去或现在与肝脏相关的症状(如肝肿大、肝纤维化和肝硬化)以及实验室检查结果(如生化和/或影像学检查结果)。2016年12月11日至2017年1月22日,共完成了155份问卷。29.9%的CDG患者存在肝脏疾病。报告的主要症状包括肝肿大、血清转氨酶水平升高、纤维化、脂肪变性和肝硬化。本次在线调查获得的数据证实了最近一项对25年已发表证据的文献综述结果(r = 0.927,P = 0.02)。我们的问卷在短时间内收集了大量有意义的、以临床和患者为导向的数据,且不受地域限制。在CDG等极其罕见的疾病背景下,基于互联网的方法尤其适用。