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神经病变型戈谢病:国际戈谢病协作组神经学结局登记处纳入的 131 例患者的人口统计学和临床特征。

Neuronopathic Gaucher disease: demographic and clinical features of 131 patients enrolled in the International Collaborative Gaucher Group Neurological Outcomes Subregistry.

机构信息

Clinic of Metabolic Diseases, Endocrinology and Diabetology, The Children's Memorial Health Institute, Al. Dzieci Polskich 20, 04 736, Warsaw, Poland.

出版信息

J Inherit Metab Dis. 2010 Aug;33(4):339-46. doi: 10.1007/s10545-009-9009-6. Epub 2010 Jan 19.

Abstract

OBJECTIVE

To describe demographic, genetic, and clinical characteristics of patients with neuronopathic Gaucher disease (NGD).

METHODS

All patients enrolled in the Neurological Outcomes Subregistry of the International Collaborative Gaucher Group (ICGG) Gaucher Registry as of June 2007 were identified.

RESULTS

The study cohort comprised 131 patients from 17 countries who were enrolled in the Neurological Outcomes Subregistry. The onset of neurological manifestations had occurred before 2 years of age in 47% (61 out of 131 patients), 2 years of age or older in 41% (54 out of 131), and could not be ascertained in the remaining 12% (16 out of 131). The most common manifestations were inability to look to the extreme up or down (45%, 55 out of 123), abnormally slow object tracking (43%, 53 out of 123), convergent squint (36%, 44 out of 121), and ataxia (15 to 20%, 18-27 out of 117). Seizures were reported in 19 out of 122 patients (16%), and myoclonic seizures were reported in 3 out of 121 patients (2%). The most common genotypes were L444P/L444P (76 out of 108, 70%), L444P/D409H (9 out of 108, 8%), D409H/D409H (8 out of 108, 7%), and L444P/rare allele (6 out of 108, 6%); full sequencing was not performed in all patients.

CONCLUSIONS

Neurological manifestations of GD often begin to appear before the age of 2 years. The most common neurological signs and manifestations are brainstem abnormalities and fine motor dysfunction. The most common genotype is L444P/L444P.

摘要

目的

描述神经病变型戈谢病(NGD)患者的人口统计学、遗传学和临床特征。

方法

截至 2007 年 6 月,确定了所有参加国际戈谢病协作组(ICGG)戈谢登记处神经学结果子登记处的患者。

结果

研究队列包括来自 17 个国家的 131 名患者,他们参加了神经学结果子登记处。47%(131 例中的 61 例)患者的神经表现发病年龄在 2 岁之前,41%(131 例中的 54 例)在 2 岁或 2 岁以上,其余 12%(131 例中的 16 例)无法确定。最常见的表现为无法向上或向下极端注视(45%,123 例中的 55 例)、物体跟踪异常缓慢(43%,123 例中的 53 例)、会聚性斜视(36%,121 例中的 44 例)和共济失调(15-20%,117 例中的 18-27 例)。122 例患者中有 19 例(16%)报告有癫痫发作,121 例患者中有 3 例(2%)报告有肌阵挛性癫痫发作。最常见的基因型是 L444P/L444P(108 例中的 76 例,70%)、L444P/D409H(108 例中的 9 例,8%)、D409H/D409H(108 例中的 8 例,7%)和 L444P/罕见等位基因(108 例中的 6 例,6%);并非所有患者都进行了完整的测序。

结论

戈谢病的神经表现通常在 2 岁之前开始出现。最常见的神经体征和表现是脑干异常和精细运动功能障碍。最常见的基因型是 L444P/L444P。

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