Marelli Susan, Micaglio Emanuele, Taurino Jacopo, Salvi Paolo, Rurali Erica, Perrucci Gianluca L, Dolci Claudia, Udugampolage Nathasha Samali, Caruso Rosario, Gentilini Davide, Trifiro' Giuliana, Callus Edward, Frigiola Alessandro, De Vincentiis Carlo, Pappone Carlo, Parati Gianfranco, Pini Alessandro
Cardiovascular-Genetic Center, IRCCS Policlinico San Donato, 20097 Milan, Italy.
Arrhythmia and Electrophysiology Department, IRCCS Policlinico San Donato, 20097 Milan, Italy.
Diagnostics (Basel). 2023 Jul 5;13(13):2284. doi: 10.3390/diagnostics13132284.
Marfan syndrome (MFS) is a rare inherited autosomic disorder, which encompasses a variety of systemic manifestations caused by mutations in the Fibrillin-1 encoding gene (). Cardinal clinical phenotypes of MFS are highly variable in terms of severity, and commonly involve cardiovascular, ocular, and musculoskeletal systems with a wide range of manifestations, such as ascending aorta aneurysms and dissection, mitral valve prolapse, ectopia lentis and long bone overgrowth, respectively. Of note, an accurate and prompt diagnosis is pivotal in order to provide the best treatment to the patients as early as possible. To date, the diagnosis of the syndrome has relied upon a systemic score calculation as well as DNA mutation identification. The aim of this review is to summarize the latest MFS evidence regarding the definition, differences and similarities with other connective tissue pathologies with severe systemic phenotypes (e.g., Autosomal dominant Weill-Marchesani syndrome, Loeys-Dietz syndrome, Ehlers-Danlos syndrome) and clinical assessment. In this regard, the management of MFS requires a multidisciplinary team in order to accurately control the evolution of the most severe and potentially life-threatening complications. Based on recent findings in the literature and our clinical experience, we propose a multidisciplinary approach involving specialists in different clinical fields (i.e., cardiologists, surgeons, ophthalmologists, orthopedics, pneumologists, neurologists, endocrinologists, geneticists, and psychologists) to comprehensively characterize, treat, and manage MFS patients with a personalized medicine approach.
马方综合征(MFS)是一种罕见的常染色体显性遗传性疾病,由原纤维蛋白-1编码基因()突变引起,可导致多种全身表现。MFS的主要临床表型严重程度差异很大,通常累及心血管、眼和肌肉骨骼系统,表现范围广泛,如升主动脉瘤和夹层、二尖瓣脱垂、晶状体异位和长骨过度生长。值得注意的是,准确及时的诊断对于尽早为患者提供最佳治疗至关重要。迄今为止,该综合征的诊断依赖于系统评分计算以及DNA突变鉴定。本综述的目的是总结关于MFS的最新证据,包括其定义、与其他具有严重全身表型的结缔组织病(如常染色体显性遗传的Weill-Marchesani综合征、Loeys-Dietz综合征、埃勒斯-当洛综合征)的异同以及临床评估。在这方面,MFS的管理需要一个多学科团队,以便准确控制最严重且可能危及生命的并发症的进展。基于文献中的最新发现和我们的临床经验,我们提出一种多学科方法,涉及不同临床领域的专家(即心脏病专家、外科医生、眼科医生、骨科医生、肺科医生、神经科医生、内分泌科医生、遗传学家和心理学家),以个性化医疗方法全面描述、治疗和管理MFS患者。