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患者 2 型核黄素转运蛋白缺陷症的临床历程。

The Clinical Journey of Patients with Riboflavin Transporter Deficiency Type 2.

机构信息

College of Medicine, University of Cincinnati, Cincinnati, OH, USA.

Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.

出版信息

J Child Neurol. 2020 Mar;35(4):283-290. doi: 10.1177/0883073819893159. Epub 2019 Dec 23.

Abstract

PURPOSE

To identify symptoms and health care interactions with patients with riboflavin transporter deficiency (RTD) type 2 prior to diagnosis.

METHODS

Parents of children with riboflavin transporter deficiency type 2 (n = 10) were interviewed to collect data on the patient's clinical journey.

RESULTS

The average diagnostic delay was 27.6 months. Neurologists were the most commonly visited clinician (90%). Common symptoms during the first year of the patient's clinical journey included abnormal gait and/or ataxia (70%), nystagmus (50%), and upper body muscle weakness (40%). Prior to diagnosis, optic atrophy, sleep apnea, breath-holding spells, and dysphagia were commonly observed. Hearing loss was only reported in 40% of subjects prior to diagnosis. Riboflavin responsive megaloblastic anemia is reported for the first time. Mitochondrial disease was the most common suspected diagnosis (30%).

CONCLUSION

Despite clinical variability, common early symptoms of riboflavin transporter deficiency type 2 exist that can better allow clinicians to more rapidly identify riboflavin transporter deficiency type 2.

摘要

目的

在确诊前识别 2 型核黄素转运蛋白缺陷(RTD)患者的症状和医疗保健交互作用。

方法

对 2 型核黄素转运蛋白缺陷患儿的家长进行访谈,以收集患者临床病程的数据。

结果

平均诊断延迟为 27.6 个月。神经科医生是最常就诊的临床医生(90%)。患者临床病程的第一年中常见的症状包括异常步态和/或共济失调(70%)、眼球震颤(50%)和上半身肌无力(40%)。在诊断之前,常见的症状包括视神经萎缩、睡眠呼吸暂停、屏气发作和吞咽困难。在诊断之前,仅报告了 40%的患者存在听力损失。首次报道了核黄素反应性巨幼细胞性贫血。线粒体疾病是最常见的疑似诊断(30%)。

结论

尽管存在临床变异性,但 2 型核黄素转运蛋白缺陷存在常见的早期症状,这可以使临床医生更快地识别 2 型核黄素转运蛋白缺陷。

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