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糖原贮积病的最新进展:原发性肝受累。

Update on glycogen storage disease: primary hepatic involvement.

机构信息

Division of Pediatric Gastroenterology, Nutrition and Hepatology, Department of Pediatrics, University of Texas Southwestern Medical Center.

Children's Medical Center Dallas.

出版信息

Curr Opin Pediatr. 2022 Oct 1;34(5):496-502. doi: 10.1097/MOP.0000000000001158. Epub 2022 Aug 3.

Abstract

PURPOSE OF REVIEW

Glycogen storage disease is a group of disorders primarily characterized by hepatomegaly and fasting hypoglycemia. This group of disorders may also affect the muscle, kidneys, and neurodevelopment. With an overall prevalence of 1 : 20 000, GSDs are disorders that clinicians should diagnose in a timely manner because adequate management can prevent complications, such as neurodevelopmental delay and liver disease [1] . As there are numerous types of GSDs, being able to distinguish one type from another can be overwhelming. In this review, we focus on hepatic GSDs to provide a concise review of clinical presentation, diagnosis, and current management.

RECENT FINDINGS

GSDs are considered rare disorders, and one of the main challenges is the delay in diagnosis, misdiagnosis, or under diagnosis. However, with molecular genetic testing now readily available, confirming the diagnosis is no longer as difficult or invasive as it was in the past.

SUMMARY

Current therapy for this group of disorders requires maintaining stable glucose levels. Avoiding hypoglycemia, as well as hyperglycemia, is critical in managing these patients. Being able to distinguish the types of GSDs and understanding the specific treatments for each enzymatic defect will optimize patient care.

摘要

目的综述

糖原贮积病是一组主要表现为肝肿大和空腹低血糖的疾病。这些疾病还可能影响肌肉、肾脏和神经发育。糖原贮积病的总体患病率为 1∶20000,是临床医生应及时诊断的疾病,因为适当的治疗可以预防神经发育迟缓、肝病等并发症[1]。由于糖原贮积病有许多种类型,因此要区分不同类型可能会很困难。在这篇综述中,我们重点关注肝糖原贮积病,以简洁的方式综述其临床表现、诊断和当前的治疗方法。

最新发现

糖原贮积病被认为是罕见疾病,其中一个主要挑战是诊断延迟、误诊或漏诊。然而,随着分子遗传学检测现在变得易于获得,确诊不再像过去那样困难或具有侵入性。

总结

目前对这组疾病的治疗需要维持血糖水平稳定。避免低血糖和高血糖对这些患者的管理至关重要。能够区分糖原贮积病的类型并了解每种酶缺陷的具体治疗方法将优化患者的治疗效果。

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