Department of Pediatrics, Division of Pediatric Metabolism and Division of Pediatric Genetics, Gazi University Faculty of Medicine, 06560, Ankara, Turkey.
Department of Dermatology, Akdeniz University Faculty of Medicine, Antalya, Turkey.
Orphanet J Rare Dis. 2022 Mar 2;17(1):90. doi: 10.1186/s13023-022-02215-x.
This consensus statement by a panel of Fabry experts aimed to identify areas of consensus on conceptual, clinical and therapeutic aspects of Fabry disease (FD) and to provide guidance to healthcare providers on best practice in the management of pediatric and adult patients with FD. This consensus statement indicated the clinical heterogeneity of FD as well as a large number of pathogenic variants in the GLA gene, emphasizing a need for an individualized approach to patient care. The experts reached consensus on the critical role of a high index of suspicion in symptomatic patients and screening of certain at-risk groups to reveal timely and accurate diagnosis of FD along with an increased awareness of the treating physician about the different kinds of pathogenic variants and their clinical implications. The experts emphasized the crucial role of timely recognition of FD with minimal delay from symptom onset to definite diagnosis in better management of FD patients, given the likelihood of changing the disease's natural history, improving the patients' quality of life and the prognosis after enzyme replacement therapy (ERT) administered through a coordinated, multidisciplinary care approach. In this regard, this consensus document is expected to increase awareness among physicians about unique characteristics of FD to assist clinicians in recognizing FD with a well-established clinical suspicion consistent with pathogenic variants and gender-based heterogeneous clinical manifestations of FD and in translating this information into their clinical practice for best practice in the management of patients with FD.
这是一份由法布瑞病(Fabry disease,FD)专家小组共同制定的共识声明,旨在就 FD 的概念、临床和治疗方面的共识领域达成一致,并为医疗保健提供者提供 FD 儿科和成年患者管理方面的最佳实践指南。该共识声明指出了 FD 的临床表现异质性,以及 GLA 基因中存在大量致病性变异,强调了患者护理中需要采取个体化方法。专家组就高度怀疑症状性患者和对某些高危人群进行筛查以揭示 FD 的及时和准确诊断达成共识,同时提高了治疗医生对不同类型的致病性变异及其临床意义的认识。专家组强调了及时识别 FD 的关键作用,从症状出现到明确诊断的最小延迟,以便更好地管理 FD 患者,因为这有可能改变疾病的自然史,改善患者的生活质量和酶替代疗法(ERT)治疗后的预后,通过协调的多学科护理方法。在这方面,这份共识文件有望提高医生对 FD 独特特征的认识,帮助临床医生在具有明确的临床怀疑的情况下识别 FD,这种临床怀疑与 FD 的致病性变异和基于性别的异质性临床表现一致,并将这些信息转化为他们的临床实践,以实现 FD 患者管理的最佳实践。