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1型神经纤维瘤病(NF-1)的流行病学与转归:多中心三级医疗机构经验

Epidemiology and Outcomes of Neurofibromatosis Type 1 (NF-1): Multicenter Tertiary Experience.

作者信息

Almuqbil Mohammed, Alshaikh Fatimah Yaseen, Altwaijri Waleed, Baarmah Duaa, Hommady Raid Harb, Alshaikh Maryam Yaseen, Alammari Fares, Alhussain Meshal, Almotawa Reem, Alqarny Faris, Kashgari Amna, Alkhodair Rayan, Alkhater Jumanah N, Alkhater Lujeen Nasser, Alharthi Sawsan A, Alsadi Mada Abdulkarim, AlRumayyan Ahmed

机构信息

College of Medicine, King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, Saudi Arabia.

King Abdullah International Medical Research Center (KAIMRC), Ministry of National Guard, Riyadh, Saudi Arabia.

出版信息

J Multidiscip Healthc. 2024 Mar 22;17:1303-1314. doi: 10.2147/JMDH.S454921. eCollection 2024.

Abstract

PURPOSE

The aim of this manuscript was to assess the epidemiology and clinical features of Neurofibromatosis type 1 (NF-1) based on the newly published revised NF-1 diagnostic criteria and to evaluate complications of NF-1 including neurodevelopmental disorders.

PATIENTS AND METHODS

A retrospective cross-sectional observational study was conducted in the Ministry of National Guard Health Affairs (MNGHA) healthcare organization branches including four tertiary hospitals and 51 primary health care centers in different regions in Saudi Arabia. This study included all patients diagnosed with NF1 using the revised NIH diagnostic criteria published in 2021 that were registered at the electronic medical records (EMR) from 2015 to 2021.

RESULTS

A total of 184 patients fulfilled the diagnostic criteria and were included in this study. The median age at diagnosis was 11 years (IQR: 4.00-20.25). The most encountered diagnostic criteria in this study were Café-au-lait macules (85.3%), and (42.9%) were found to have two or more neurofibromas with plexiform neurofibroma being the most common subtype (23.36%), approximately (36.4%) of the patient with optic pathway glioma. Nearby (26.6%) of the patients displayed different type of tumors. Iris Lisch nodules were presented in 36.4% of patients at a median age of 12 years (IQR: 9.0-21.8). Cardiovascular abnormality was encountered in 9.8% of the patients. Around 27.7% of the patients reported headache and 11.4% of the patient suffered from different type of epilepsy. Besides, 10.5% of the patients had intellectual disability, 33.8% suffered from communication disorders, and 4.9% patients had ADHD.

CONCLUSION

The results of this study will enable practitioners to adopt a more holistic approach and prioritize numerous attributes, which they can subsequently incorporate into their therapeutic methodologies. Furthermore, the identification of these attributes will facilitate an expeditious and accurate diagnosis. Hence, the implementation of intervention during its nascent phase may result in a more advantageous consequence.

摘要

目的

本手稿旨在根据新发布的修订版1型神经纤维瘤病(NF-1)诊断标准评估NF-1的流行病学和临床特征,并评估NF-1的并发症,包括神经发育障碍。

患者与方法

在沙特阿拉伯不同地区的国民警卫队卫生事务部(MNGHA)医疗保健组织分支机构开展了一项回顾性横断面观察研究,该机构包括四家三级医院和51家初级卫生保健中心。本研究纳入了所有根据2021年发布的修订版美国国立卫生研究院(NIH)诊断标准诊断为NF1且在2015年至2021年电子病历(EMR)中登记的患者。

结果

共有184例患者符合诊断标准并纳入本研究。诊断时的中位年龄为11岁(四分位间距:4.00 - 20.25)。本研究中最常出现的诊断标准是咖啡斑(85.3%),42.9%的患者有两个或更多神经纤维瘤,丛状神经纤维瘤是最常见的亚型(23.

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