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1 型肌强直性营养不良、MD1 或 Steinert 病的诊断和随访临床指南。

Clinical guide for the diagnosis and follow-up of myotonic dystrophy type 1, MD1 or Steinert's disease.

机构信息

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.

出版信息

Neurologia (Engl Ed). 2020 Apr;35(3):185-206. doi: 10.1016/j.nrl.2019.01.001. Epub 2019 Apr 16.

Abstract

BACKGROUND AND OBJECTIVES

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.

MATERIAL AND METHODS

Consensus guide developed through a multidisciplinary approach with a systematic literature review. Neurologists, pulmonologists, cardiologists, endocrinologists, neuropaediatricians and geneticists have participated in the guide.

RECOMMENDATIONS

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.

CONCLUSION

MD1 is a multisystemic disease that requires specialised multidisciplinary follow-up.

摘要

背景和目的

Steinert 病或 1 型肌强直性营养不良症(MD1)(OMIM 160900)是成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的功能都受到影响,表型变异很大,这意味着它需要由具有该疾病经验的不同专业来处理。近年来,对该疾病的认识及其管理发生了巨大变化。本指南旨在为 MD1 的并发症的诊断、预后、随访和治疗制定建议。

材料和方法

通过多学科方法并进行系统文献回顾制定共识指南。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该指南的制定。

建议

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。必须向患者和亲属提供遗传咨询。

结论

MD1 是一种需要专业多学科随访的多系统疾病。

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