Karwacki Marek W, Wysocki Mariusz, Perek-Polnik Marta, Jatczak-Gaca Agnieszka
Coordinated Care Center for Neurofibromatoses and related RASopathies, Department of Pediatrics, Hematology and Oncology, Medical University of Warsaw, Poland.
Department of Paediatrics, Haematology and Oncology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Poland.
Arch Med Sci. 2019 May 17;17(5):1221-1231. doi: 10.5114/aoms.2019.85143. eCollection 2021.
Coordinated medical care offered in Poland for patients suffering from neurofibromatosis type 1 and related RASopathies combines complex multispecialty consultation with permanent supervision and the patient's oriented longitudinal care. Neurofibromatosis type 1 is one of the most common single gene disorders in the global population, observed in 1 out of 2500-3000 live births. It is a primary neoplasia disease with 100% penetration of the gene mutation but remarkable age-dependent onset of different disease signs and symptoms, outstanding clinical heterogeneity between patients even in one family and lack of genotype-phenotype correlation, a high rate of spontaneous mutation exceeding 50%, and multiple comorbidities among which increased risk of malignancy is the most important. Medical practice proved that not only patient-oriented complex but also coordinated care provided in centers of competence is indispensable for patients and the families and provides a sense of medical security to them in conjunction with public health costs rationalization.
波兰为患有1型神经纤维瘤病及相关RASopathy的患者提供的协调医疗服务,将复杂的多专科会诊与长期监督以及以患者为导向的纵向护理相结合。1型神经纤维瘤病是全球人群中最常见的单基因疾病之一,在每2500至3000例活产中就有1例出现。它是一种原发性肿瘤疾病,基因突变的发生率为100%,但不同疾病体征和症状的发病具有明显的年龄依赖性,即使在一个家庭中患者之间也存在显著的临床异质性,且缺乏基因型与表型的相关性,自发突变率超过50%,还有多种合并症,其中恶性肿瘤风险增加是最重要的。医疗实践证明,不仅以患者为导向的综合治疗,而且在专业中心提供的协调护理,对患者及其家庭来说都是必不可少的,同时在合理控制公共卫生成本的情况下,为他们提供了医疗保障感。