Servicio de Neurología, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, España.
Servicio de Neurología, Hospital Universitario de la Santa Creu i Sant Pau, Barcelona, España.
Med Clin (Barc). 2019 Jul 19;153(2):82.e1-82.e17. doi: 10.1016/j.medcli.2018.10.028. Epub 2019 Jan 24.
Steinert's disease or myotonic dystrophy type 1 (MD1), (OMIM 160900), is the most prevalent myopathy in adults. It is a multisystemic disorder with dysfunction of virtually all organs and tissues and a great phenotypical variability, which implies that it has to be addressed by different specialities with experience in the disease. The knowledge of the disease and its management has changed dramatically in recent years. This guide tries to establish recommendations for the diagnosis, prognosis, follow-up and treatment of the complications of MD1.
Consensus guide developed through a multidisciplinary approach with a systematic literature review. Neurologists, pulmonologists, cardiologists, endocrinologists, neuropaediatricians and geneticists have participated in the guide.
The genetic diagnosis should quantify the number of CTG repetitions. MD1 patients need cardiac and respiratory lifetime follow-up. Before any surgery under general anaesthesia, a respiratory evaluation must be done. Dysphagia must be screened periodically. Genetic counselling must be offered to patients and relatives.
MD1 is a multisystemic disease that requires specialised multidisciplinary follow-up.
Steinert 病或 1 型肌强直性营养不良(MD1)(OMIM 160900)是成年人中最常见的肌肉疾病。它是一种多系统疾病,几乎所有器官和组织都功能失调,表型高度多样化,这意味着需要由具有疾病经验的不同专业领域来处理。近年来,对该病的认识及其管理发生了巨大变化。本指南旨在为 MD1 并发症的诊断、预后、随访和治疗制定建议。
通过多学科方法制定的共识指南,并进行了系统的文献回顾。神经病学家、肺科医生、心脏病专家、内分泌学家、神经儿科医生和遗传学家参与了指南的制定。
遗传诊断应定量 CTG 重复次数。MD1 患者需要终生进行心脏和呼吸随访。在全身麻醉下进行任何手术前,必须进行呼吸评估。应定期筛查吞咽困难。必须向患者及其亲属提供遗传咨询。
MD1 是一种需要专门多学科随访的多系统疾病。