1
|
Onesimo R, Sforza E, Bedeschi MF, Leoni C, Giorgio V, Rigante D, De Rose C, Kuczynska EM, Romeo DM, Palmacci O, Massimi L, Porro M, Gonfiantini MV, Selicorni A, Allegri A, Maghnie M, Zampino G. How pain affect real life of children and adults with achondroplasia: A systematic review. Eur J Med Genet 2023; 66:104850. [PMID: 37758167 DOI: 10.1016/j.ejmg.2023.104850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 08/11/2023] [Accepted: 09/19/2023] [Indexed: 10/03/2023]
Abstract
The clinical features of achondroplasia can cause acute self-limited pain that can evolve into chronic pain. Pain causes a low quality of life, in terms of physical, emotional, social, and school functioning in both adult and children with achondroplasia. We conducted a systematic review according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement to describe prevalence, assessment tools, causes and management strategies of pain in this rare disease. We found that shoulder and knee pain is typically referred during infancy, while knee pain is generally referred around 5-6 years of age. The prevalence of general pain in adolescence can be as high as 90%. Chronic pain in the achondroplasia population increases with age, with up to 70% of adults reporting general pain and back pain. Recognizing the multiple determinants of acute and chronic pain in patients with achondroplasia may enable physicians to better understand and manage this burden, particularly with the advent of new drugs that may modify some of the striking features of achondroplasia.
Collapse
Affiliation(s)
- Roberta Onesimo
- Center for Rare Diseases and Birth Defects, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168, Roma, Italy.
| | | | | | - Chiara Leoni
- Center for Rare Diseases and Birth Defects, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168, Roma, Italy.
| | - Valentina Giorgio
- Center for Rare Diseases and Birth Defects, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168, Roma, Italy; Università Cattolica Del Sacro Cuore, Rome, 00168, Italy.
| | - Donato Rigante
- Center for Rare Diseases and Birth Defects, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168, Roma, Italy.
| | - Cristina De Rose
- Center for Rare Diseases and Birth Defects, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168, Roma, Italy.
| | - Eliza Maria Kuczynska
- Center for Rare Diseases and Birth Defects, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168, Roma, Italy.
| | - Domenico Marco Romeo
- Pediatric Neurology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168, Rome, Italy; Pediatric Neurology Unit, Università Cattolica Del Sacro Cuore, 00168, Rome, Italy.
| | - Osvaldo Palmacci
- Department of Orthopaedics and Traumatology, Fondazione Policlinico Universitario A. Gemelli IRCCS - Università Cattolica Del Sacro Cuore, Rome, Italy.
| | - Luca Massimi
- Neurochirurgia Pediatrica, Dipartimento di Neuroscienze, Organi di Senso e Torace, Fondazione Policlinico Universitario A. Gemelli IRCCS, Italy; Dipartimento di Neuroscienze, Università Cattolica Del Sacro Cuore, Italy.
| | - Matteo Porro
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatric Physical Medicine & Rehabilitation Service, Milan, Italy.
| | | | - Angelo Selicorni
- Department of Paediatrics, Presidio S. Fermo, ASST Lariana, Como, Italy.
| | - Anna Allegri
- Pediatric Endocrinology Unit, Department of Pediatrics, IRCCS IstitutoGianninaGaslini, 16147, Genoa, Italy.
| | - Mohamad Maghnie
- Pediatric Endocrinology Unit, Department of Pediatrics, IRCCS IstitutoGianninaGaslini, 16147, Genoa, Italy; Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, 16132, Genoa, Italy.
| | - Giuseppe Zampino
- Center for Rare Diseases and Birth Defects, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168, Roma, Italy.
| |
Collapse
|
2
|
Rodríguez-Merchán EC, Di Minno MND, Pasta G. Pain Care Management in Rare Diseases. Healthcare (Basel) 2023; 11:2628. [PMID: 37830665 PMCID: PMC10572242 DOI: 10.3390/healthcare11192628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 09/06/2023] [Indexed: 10/14/2023] Open
Abstract
In this Special Issue on "Musculoskeletal Pain Care and Management in Rare Disease", it is essential to make it clear that, while specialists in rare diseases (RDs) are often very knowledgeable about the management of the specific diseases in which they are experts, primary care physicians and other physicians who are not experts in a given disease often have very little contact with the patients who experience it [...].
Collapse
Affiliation(s)
- Emérito Carlos Rodríguez-Merchán
- Department of Orthopedic Surgery, La Paz University Hospital, 28046 Madrid, Spain
- Osteoarticular Surgery Research, Hospital La Paz Institute for Health Research—IdiPAZ La Paz University Hospital—Autonomous University of Madrid, 28046 Madrid, Spain
| | | | - Gianluigi Pasta
- Department of Orthopedic Surgery, IRCCS Fondazione Policlinico San Matteo, 27100 Pavia, Italy;
| |
Collapse
|
3
|
Gagnon H, Lunde CE, Wu Z, Novais EN, Borsook D, Sieberg CB. Exploring Comorbidities in Adolescent and Young Adults with Hypermobile Ehlers-Danlos Syndrome with and without a Surgical History: A Preliminary Investigation. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1562. [PMID: 37761523 PMCID: PMC10528958 DOI: 10.3390/children10091562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 09/08/2023] [Accepted: 09/14/2023] [Indexed: 09/29/2023]
Abstract
Ehlers-Danlos Syndrome (EDS) is a rare disease affecting the skin, joints, vasculature, and internal organs. Approximately 85% of those affected are categorized as the hypermobile type (hEDS), which is associated with numerous medical and psychiatric comorbidities, including chronic pain. Additionally, approximately 71% of patients with hEDS undergo at least one surgical procedure; however, indicators for surgery and pain outcomes after surgery are poorly understood. This preliminary study used a medical chart review to identify the frequency and nature of comorbidities in a cohort of adolescents and young adult patients with hEDS and a surgical history compared to those without a surgical history. Results showed that patients diagnosed with hEDS who underwent surgery reported significantly more comorbidities (e.g., CRPS, IBS, Fibromyalgia, POTS, hypothyroidism, etc.) than those who did not have surgery. Seventy percent of individuals who presented for surgery fell within the categories of orthopedic, gastrointestinal, or laparoscopic/endometriosis-related surgeries. Identifying patients with hEDS who are at risk for needing surgery will help identify the mechanisms contributing to risk factors for poor surgical outcomes. The results of this study may be instructive in the management and care of hEDS patients undergoing surgery.
Collapse
Affiliation(s)
- Haley Gagnon
- Biobehavioral Pain Innovations Laboratory, Department of Psychiatry & Behavioral Sciences, Boston Children’s Hospital, Boston, MA 02115, USA; (H.G.); (C.E.L.); (Z.W.)
- Pain and Affective Neuroscience Center, Department of Anesthesiology, Critical Care & Pain Medicine, Boston Children’s Hospital, Boston, MA 02115, USA
| | - Claire E. Lunde
- Biobehavioral Pain Innovations Laboratory, Department of Psychiatry & Behavioral Sciences, Boston Children’s Hospital, Boston, MA 02115, USA; (H.G.); (C.E.L.); (Z.W.)
- Pain and Affective Neuroscience Center, Department of Anesthesiology, Critical Care & Pain Medicine, Boston Children’s Hospital, Boston, MA 02115, USA
- Nuffield Department of Women’s & Reproductive Health, University of Oxford, Oxford OX3 9DU, UK
| | - Ziyan Wu
- Biobehavioral Pain Innovations Laboratory, Department of Psychiatry & Behavioral Sciences, Boston Children’s Hospital, Boston, MA 02115, USA; (H.G.); (C.E.L.); (Z.W.)
- Pain and Affective Neuroscience Center, Department of Anesthesiology, Critical Care & Pain Medicine, Boston Children’s Hospital, Boston, MA 02115, USA
| | - Eduardo N. Novais
- Department of Orthopedic Surgery, Boston Children’s Hospital, Boston, MA 02115, USA;
- Department of Orthopedic Surgery, Harvard Medical School, Boston, MA 02115, USA
| | - David Borsook
- Departments of Psychiatry and Radiology, Massachusetts General Hospital, Boston, MA 02114, USA;
- Department of Anesthesiology, Harvard Medical School, Boston, MA 02115, USA
| | - Christine B. Sieberg
- Biobehavioral Pain Innovations Laboratory, Department of Psychiatry & Behavioral Sciences, Boston Children’s Hospital, Boston, MA 02115, USA; (H.G.); (C.E.L.); (Z.W.)
- Pain and Affective Neuroscience Center, Department of Anesthesiology, Critical Care & Pain Medicine, Boston Children’s Hospital, Boston, MA 02115, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA
| |
Collapse
|
4
|
Kaywanga F, Alimohamed MZ, David AB, Maeda D, Mbarak S, Mavura T, Nkya S, Ishengoma DS. Rare diseases in Tanzania: a National Call for Action to address policy and urgent needs of individuals with rare diseases. Orphanet J Rare Dis 2022; 17:343. [PMID: 36064429 PMCID: PMC9446714 DOI: 10.1186/s13023-022-02498-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 08/18/2022] [Indexed: 11/30/2022] Open
Abstract
A rare disease is generally defined as a condition which affects about 1 among 2000 people and currently, there are approximately 5000–8000 rare diseases (RDs) affecting over 400 million people world-wide. Although RDs may arise from different causes such as infections and environmental factors, about 80% are caused by genetic abnormalities. In Tanzania, there are no reports of the types of RDs, their incidence, distribution and numbers of individuals affected. In addition, there have been no strategies to map RDs in the country and develop a definition that fits the local context. Public awareness and understanding of RDs are very limited, and these lead to poor management and stigmatisation of patients. To address the ongoing problems, Tanzania joined other countries world-wide and global partners to commemorate the rare diseases day (RDD) for the first time in 2016 and subsequently every year. Unlike previous years where the RDD was organised by Ali Kimara Rare Diseases Foundation (AKRDF) with few partners, in 2020, a bigger event was co-hosted by Ali AKRDF and Tanzania Human Genetics Organization together with government representatives and other multiple partners. The organisers, government representatives and participants proposed a national “Call for Action” with the overall goal of improving the lives of patients/individuals with RDs. The call focuses and aims to address 17 strategic issues that are broadly categorised into four areas. These include generating demographic data of individuals with RDs; advocating for policies and guidelines for diagnosis, care, treatment and health financing; developing policies supporting public education, awareness and advocacy; and strengthening research, innovation and public–private partnerships. If adopted and implemented, the potential impacts of these recommendations will include improved access to adequate and high-quality health and education services, and policies and guidelines to address the current and future challenges facing individuals with RDs and their families.
Collapse
Affiliation(s)
- Frida Kaywanga
- Department of Haematology and Blood Transfusion, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.,Tanzania Human Genetics Organization, Dar es Salaam, Tanzania
| | - Mohamed Zahir Alimohamed
- Department of Haematology and Blood Transfusion, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.,Tanzania Human Genetics Organization, Dar es Salaam, Tanzania.,Shree Hindu Mandal Hospital, Dar es Salaam, Tanzania.,Department of Genetics, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - Aneth Bella David
- Tanzania Human Genetics Organization, Dar es Salaam, Tanzania.,Department of Molecular Biology and Biotechnology, University of Dar Es Salaam, Dar es Salaam, Tanzania.,Plant Protection Department, Swedish University of Agricultural Sciences, Alnarp, Sweden
| | - Daniel Maeda
- Tanzania Human Genetics Organization, Dar es Salaam, Tanzania.,Department of Molecular Biology and Biotechnology, University of Dar Es Salaam, Dar es Salaam, Tanzania
| | - Sharifa Mbarak
- Ali Kimara Rare Diseases Foundation, Dar es Salaam, Tanzania
| | - Togolani Mavura
- Ali Kimara Rare Diseases Foundation, Dar es Salaam, Tanzania.,Jakaya Mrisho Kikwete Foundation, Dar es Salaam, Tanzania
| | - Siana Nkya
- Department of Haematology and Blood Transfusion, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.,Tanzania Human Genetics Organization, Dar es Salaam, Tanzania.,Dar es Salaam University College of Education, University of Dar es Salaam, Dar es Salaam, Tanzania
| | - Deus S Ishengoma
- Tanzania Human Genetics Organization, Dar es Salaam, Tanzania. .,National Institute for Medical Research, 3 Baraka Obama Drive, P. O Box 9653, 11101, Dar es Salaam, Tanzania. .,Faculty of Pharmaceutical Sciences, Monash University, Melbourne, Australia. .,Harvard T.H Chan School of Public Health, Boston, MA, USA.
| |
Collapse
|