College of Medicine, University of Cincinnati, Cincinnati, OH, USA.
Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
J Child Neurol. 2020 Mar;35(4):283-290. doi: 10.1177/0883073819893159. Epub 2019 Dec 23.
To identify symptoms and health care interactions with patients with riboflavin transporter deficiency (RTD) type 2 prior to diagnosis.
Parents of children with riboflavin transporter deficiency type 2 (n = 10) were interviewed to collect data on the patient's clinical journey.
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%).
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.
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。
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。
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%)。
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。