1
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Montenegro YHA, Kubaski F, Trapp FB, Riegel-Giugliani M, de Souza CFM, Ribeiro EM, Lourenço CM, Cardoso-dos-Santos AC, Ribeiro MG, Kim CA, Castro MAA, Embiruçu EK, Steiner CE, Vairo FPE, Baldo G, Giugliani R, Poswar FDO. Disease progression in Sanfilippo type B: Case series of Brazilian patients. Genet Mol Biol 2024; 47:e20230285. [PMID: 38488524 PMCID: PMC10941728 DOI: 10.1590/1678-4685-gmb-2023-0285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 02/10/2024] [Indexed: 03/17/2024] Open
Abstract
Mucopolysaccharidosis type IIIB (MPS IIIB) is caused by deficiency of alpha-N-acetylglucosaminidase, leading to storage of heparan sulphate. The disease is characterized by intellectual disability and hyperactivity, among other neurological and somatic features. Here we studied retrospective data from a total of 19 MPS IIIB patients from Brazil, aiming to evaluate disease progression. Mean age at diagnosis was 7.2 years. Speech delay was one of the first symptoms to be identified, around 2-3 years of age. Behavioral alterations include hyperactivity and aggressiveness, starting around age four. By the end of the first decade, patients lost acquired abilities such as speech and ability to walk. Furthermore, as disease progresses, respiratory, cardiovascular and joint abnormalities were found in more than 50% of the patients, along with organomegaly. Most common cause of death was respiratory problems. The disease progression was characterized in multiple systems, and hopefully these data will help the design of appropriate clinical trials and clinical management guidelines.
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Affiliation(s)
- Yorran Hardman Araújo Montenegro
- Hospital de Clínicas de Porto Alegre, Serviço de Genética Médica,
Porto Alegre, RS, Brazil
- Hospital de Clínicas de Porto Alegre, Serviço de Genética Médica,
Rede MPS Brasil, Porto Alegre, RS, Brazil
| | - Francyne Kubaski
- Hospital de Clínicas de Porto Alegre, Serviço de Genética Médica,
Porto Alegre, RS, Brazil
| | - Franciele Barbosa Trapp
- Hospital de Clínicas de Porto Alegre, Serviço de Genética Médica,
Rede MPS Brasil, Porto Alegre, RS, Brazil
- Casa dos Raros, Porto Alegre, RS, Brazil
| | | | - Carolina Fischinger Moura de Souza
- Hospital de Clínicas de Porto Alegre, Serviço de Genética Médica,
Porto Alegre, RS, Brazil
- Hospital de Clínicas de Porto Alegre, Serviço de Genética Médica,
Rede MPS Brasil, Porto Alegre, RS, Brazil
- Casa dos Raros, Porto Alegre, RS, Brazil
| | | | | | | | - Márcia Gonçalves Ribeiro
- Universidade Federal do Rio de Janeiro, Instituto de Puericultura e
Pediatria Martagão Gesteira, Serviço de Genética Médica, Rio de Janeiro, RJ,
Brazil
| | - Chong Ae Kim
- Universidade de São Paulo, Faculdade de Medicina, Hospital das
Clínicas, Instituto da Criança, São Paulo, SP, Brazil
| | - Matheus Augusto Araújo Castro
- Universidade de São Paulo, Faculdade de Medicina, Hospital das
Clínicas, Instituto da Criança, São Paulo, SP, Brazil
| | - Emília Katiane Embiruçu
- Universidade Federal da Bahia, Complexo Hospitalar Universitário
Professor Edgar Santos, Departamento de Ciências da Vida, Salvador, BA,
Brazil
| | - Carlos Eduardo Steiner
- Universidade Estadual de Campinas, Faculdade de Ciências Médicas,
Departamento de Medicina Translacional, São Paulo, SP, Brazil
| | - Filippo Pinto e Vairo
- Mayo Clinic, Center for Individualized Medicine, Rochester, MN,
USA
- Mayo Clinic, Department of Clinical Genomics, Rochester, MN,
USA
| | - Guilherme Baldo
- Hospital de Clínicas de Porto Alegre, Serviço de Genética Médica,
Porto Alegre, RS, Brazil
- Hospital de Clínicas de Porto Alegre, Serviço de Genética Médica,
Rede MPS Brasil, Porto Alegre, RS, Brazil
- Casa dos Raros, Porto Alegre, RS, Brazil
- Universidade Federal do Rio Grande do Sul, Departamento de
Fisiologia, Porto Alegre, RS, Brazil
- Universidade Federal do Rio Grande do Sul, Programa de
Pós-Graduação em Genética e Biologia Molecular, Porto Alegre, RS, Brazil
| | - Roberto Giugliani
- Hospital de Clínicas de Porto Alegre, Serviço de Genética Médica,
Porto Alegre, RS, Brazil
- Universidade Federal do Rio Grande do Sul, Instituto Nacional de
Genética Médica Papulacional, Porto Alegre, RS, Brazil
- Hospital de Clínicas de Porto Alegre, Serviço de Genética Médica,
Rede MPS Brasil, Porto Alegre, RS, Brazil
- Casa dos Raros, Porto Alegre, RS, Brazil
- Dasa Genômica, São Paulo, SP, Brazil
- Universidade Federal do Rio Grande do Sul, Programa de
Pós-Graduação em Genética e Biologia Molecular, Porto Alegre, RS, Brazil
| | - Fabiano de Oliveira Poswar
- Hospital de Clínicas de Porto Alegre, Serviço de Genética Médica,
Porto Alegre, RS, Brazil
- Universidade Federal do Rio Grande do Sul, Programa de
Pós-Graduação em Genética e Biologia Molecular, Porto Alegre, RS, Brazil
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2
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Montenegro YHA, de Souza CFM, Kubaski F, Trapp FB, Burin MG, Michelin-Tirelli K, Leistner-Segal S, Facchin ACB, Medeiros FS, Giugliani L, Ribeiro EM, Lourenço CM, Cardoso-Dos-Santos AC, Ribeiro MG, Kim CA, Castro MAA, Embiruçu EK, Steiner CE, Moreira MLC, Montano HQ, Baldo G, Giugliani R. Sanfilippo syndrome type B: Analysis of patients diagnosed by the MPS Brazil Network. Am J Med Genet A 2021; 188:760-767. [PMID: 34806811 DOI: 10.1002/ajmg.a.62572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 09/15/2021] [Accepted: 10/29/2021] [Indexed: 11/08/2022]
Abstract
Mucopolysaccharidosis type IIIB is a rare autosomal recessive disorder characterized by deficiency of the enzyme N-acetyl-alpha-d-glucosaminidase (NAGLU), caused by biallelic pathogenic variants in the NAGLU gene, which leads to storage of heparan sulfate and a series of clinical consequences which hallmark is neurodegeneration. In this study clinical, epidemiological, and biochemical data were obtained from MPS IIIB patients diagnosed from 2004-2019 by the MPS Brazil Network ("Rede MPS Brasil"), which was created with the goal to provide an easily accessible and comprehensive investigation of all MPS types. One hundred and ten MPS IIIB patients were diagnosed during this period. Mean age at diagnosis was 10.9 years. Patients were from all over Brazil, with a few from abroad, with a possible cluster of MPS IIIB identified in Ecuador. All patients had increased urinary levels of glycosaminoglycans and low NAGLU activity in blood. Main clinical symptoms reported at diagnosis were coarse facies and neurocognitive regression. The most common variant was p.Leu496Pro (30% of alleles). MPS IIIB seems to be relatively frequent in Brazil, but patients are diagnosed later than in other countries, and reasons for that probably include the limited awareness about the disease by health professionals and the difficulties to access diagnostic tests, factors that the MPS Brazil Network is trying to mitigate.
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Affiliation(s)
- Yorran Hardman Araújo Montenegro
- Medical Genetics Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,Post-graduate Program in Genetics and Molecular Biology, Department of Genetics/UFRGS, Porto Alegre, Brazil.,INAGEMP, Porto Alegre, Brazil.,MPS Brazil Network, Medical Genetics Service, HCPA, Porto Alegre, Brazil
| | | | - Francyne Kubaski
- Medical Genetics Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Franciele Barbosa Trapp
- Medical Genetics Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,INAGEMP, Porto Alegre, Brazil.,MPS Brazil Network, Medical Genetics Service, HCPA, Porto Alegre, Brazil
| | - Maira Graeff Burin
- Medical Genetics Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,MPS Brazil Network, Medical Genetics Service, HCPA, Porto Alegre, Brazil
| | - Kristiane Michelin-Tirelli
- Medical Genetics Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,MPS Brazil Network, Medical Genetics Service, HCPA, Porto Alegre, Brazil
| | - Sandra Leistner-Segal
- Medical Genetics Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,MPS Brazil Network, Medical Genetics Service, HCPA, Porto Alegre, Brazil
| | - Ana Carolina Brusius Facchin
- Medical Genetics Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,MPS Brazil Network, Medical Genetics Service, HCPA, Porto Alegre, Brazil
| | - Fernanda S Medeiros
- Medical Genetics Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,MPS Brazil Network, Medical Genetics Service, HCPA, Porto Alegre, Brazil
| | | | | | - Charles Marques Lourenço
- Centro Universitário Estácio, Ribeirão Preto, Brazil.,Faculdade de Medicina de São José do Rio Preto, FAMERP, São José do Rio Preto, Brazil
| | - Augusto César Cardoso-Dos-Santos
- Post-graduate Program in Genetics and Molecular Biology, Department of Genetics/UFRGS, Porto Alegre, Brazil.,INAGEMP, Porto Alegre, Brazil
| | - Márcia Gonçalves Ribeiro
- Medical Genetics Service, Instituto de Puericultura e Pediatria Martagão Gesteira/UFRJ, Rio de Janeiro, Brazil
| | - Chong Ae Kim
- Genetic Unity, Instituto da Criança HC FMUSP, São Paulo, Brazil
| | | | | | - Carlos Eduardo Steiner
- Department of Medical Genetics and Genomic Medicine, Faculdade de Ciências Médicas/UNICAMP, São Paulo, Brazil
| | | | | | - Guilherme Baldo
- Post-graduate Program in Genetics and Molecular Biology, Department of Genetics/UFRGS, Porto Alegre, Brazil
| | - Roberto Giugliani
- Medical Genetics Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,Post-graduate Program in Genetics and Molecular Biology, Department of Genetics/UFRGS, Porto Alegre, Brazil.,INAGEMP, Porto Alegre, Brazil.,MPS Brazil Network, Medical Genetics Service, HCPA, Porto Alegre, Brazil
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3
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Josahkian JA, Brusius-Facchin AC, Netto ABO, Leistner-Segal S, Málaga DR, Burin MG, Michelin-Tirelli K, Trapp FB, Cardoso-Dos-Santos AC, Ribeiro EM, Kim CA, de Siqueira ACM, Santos ML, do Valle DA, da Silva RTB, Horovitz DDG, de Medeiros PFV, de Souza CFM, Giuliani LDR, Miguel DSCG, Santana-da-Silva LC, Galera MF, Giugliani R. Genotype-phenotype studies in a large cohort of Brazilian patients with Hunter syndrome. Am J Med Genet C Semin Med Genet 2021; 187:349-356. [PMID: 33960103 DOI: 10.1002/ajmg.c.31915] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 02/25/2021] [Accepted: 04/18/2021] [Indexed: 11/05/2022]
Abstract
Mucopolysaccharidosis type II (MPS II) is an X-linked inherited disease caused by pathogenic variants in the IDS gene, leading to deficiency of the lysosomal enzyme iduronate-2-sulfatase and consequent widespread storage of glycosaminoglycans, leading to several clinical consequences, with progressive manifestations which most times includes cognitive decline. MPS II has wide allelic and clinical heterogeneity and a complex genotype-phenotype correlation. We evaluated data from 501 Brazilian patients diagnosed with MPS II from 1982 to 2020. We genotyped 280 of these patients (55.9%), which were assigned to 206 different families. Point mutations were present in 70% of our patients, being missense variants the most frequent. We correlated the IDS pathogenic variants identified with the phenotype (neuronophatic or non-neuronopathic). Except for two half-brothers, there was no discordance in the genotype-phenotype correlation among family members, nor among MPS II patients from different families with the same single base-pair substitution variant. Mothers were carriers in 82.0% of the cases. This comprehensive study of the molecular profile of the MPS II cases in Brazil sheds light on the genotype-phenotype correlation and helps the better understanding of the disease and the prediction of its clinical course, enabling the provision of a more refined genetic counseling to the affected families.
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Affiliation(s)
- Juliana Alves Josahkian
- Department of Clinical Medicine, Hospital Universitário de Santa Maria (HUSM), Santa Maria, Rio Grande do Sul, Brazil.,Postgraduate Program in Genetics and Molecular Biology, UFRGS, Porto Alegre, Rio Grande do Sul, Brazil
| | | | - Alice Brinckmann Oliveira Netto
- Medical Genetics Service, HCPA, Porto Alegre, Rio Grande do Sul, Brazil.,National Institute on Population Medical Genetics, INAGEMP, Porto Alegre, Rio Grande do Sul, Brazil.,Graduate in Biological Sciences, UFRGS, Porto Alegre, Rio Grande do Sul, Brazil
| | - Sandra Leistner-Segal
- Medical Genetics Service, HCPA, Porto Alegre, Rio Grande do Sul, Brazil.,National Institute on Population Medical Genetics, INAGEMP, Porto Alegre, Rio Grande do Sul, Brazil
| | - Diana Rojas Málaga
- Medical Genetics Service, HCPA, Porto Alegre, Rio Grande do Sul, Brazil.,Research and Development, Grupo Fleury, São Paulo, São Paulo, Brazil
| | | | | | | | - Augusto César Cardoso-Dos-Santos
- Postgraduate Program in Genetics and Molecular Biology, UFRGS, Porto Alegre, Rio Grande do Sul, Brazil.,National Institute on Population Medical Genetics, INAGEMP, Porto Alegre, Rio Grande do Sul, Brazil
| | | | - Chong Ae Kim
- Genetic Unit, Pediatric Department, HC-FMUSP, São Paulo University, São Paulo, São Paulo, Brazil
| | | | - Mara Lucia Santos
- Neuropediatric Division, Hospital Pequeno Príncipe, Curitiba, Paraná, Brazil
| | | | | | - Dafne Dain Gandelman Horovitz
- Medical Genetics Department, National Institute of Women, Children and Adolescents Health Fernandes Figueira-Fiocruz/Reference Center for Rare Diseases, Rio de Janeiro, Rio de Janeiro, Brazil
| | | | | | - Liane de Rosso Giuliani
- Hospital Universitário Maria Aparecida Pedrossian (HUMAP), UFMS, Campo Grande, Mato Grosso do Sul, Brazil
| | | | - Luiz Carlos Santana-da-Silva
- Laboratory of Innate Errors of Metabolism, Institute of Biological Sciences, Federal University of Pará, Belém, Pará, Brazil
| | - Marcial Francis Galera
- Department of Pediatrics, Faculty of Medicine, Federal University of Mato Grosso, Cuiabá, Mato Grosso, Brazil
| | - Roberto Giugliani
- Medical Genetics Service, HCPA, Porto Alegre, Rio Grande do Sul, Brazil.,National Institute on Population Medical Genetics, INAGEMP, Porto Alegre, Rio Grande do Sul, Brazil.,Department of Genetics, UFRGS, Porto Alegre, Rio Grande do Sul, Brazil
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4
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Josahkian JA, Trapp FB, Burin MG, Michelin-Tirelli K, Magalhães APPSD, Sebastião FM, Bender F, Mari JFD, Brusius-Facchin AC, Leistner-Segal S, Málaga DR, Giugliani R. Updated birth prevalence and relative frequency of mucopolysaccharidoses across Brazilian regions. Genet Mol Biol 2021; 44:e20200138. [PMID: 33503199 PMCID: PMC7839630 DOI: 10.1590/1678-4685-gmb-2020-0138] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 12/04/2020] [Indexed: 11/21/2022] Open
Abstract
The mucopolysaccharidoses (MPS) are a group of lysosomal storage disorders caused
by 11 enzyme deficiencies, classified into seven types. Data on the birth
prevalence of each MPS type are available for only a few countries, and the
totality of cases may be underestimated. To determine the epidemiological
profile of MPS in each Brazilian region, we analyzed data collected between 1982
and 2019 by a national reference laboratory and identified 1,652 patients. Using
data between 1994 and 2018, the birth prevalence (by 100,000 live births) for
MPS was 1.57. MPS II was the most common type of MPS in Brazil, and its birth
prevalence was 0.48 (0.94 considering only male births). Regarding the number of
cases per region, MPS II was the most frequent in the North and Center-West
(followed by MPS VI), and also in the Southeast (followed by MPS I); MPS I and
MPS II were the most common types in the South; and MPS VI was the most common
in the Northeast (followed by MPS II). The differences observed in the relative
frequencies of MPS types across Brazilian regions are likely linked to founder
effect, endogamy, and consanguinity, but other factors may be present and need
further investigation.
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Affiliation(s)
- Juliana Alves Josahkian
- Hospital Universitário de Santa Maria, Unidade de Clínica Médica, Santa Maria, RS, Brazil.,Universidade Federal do Rio Grande do Sul, Programa de Pós-Graduação em Genética e Biologia Molecular, Porto Alegre, RS, Brazil
| | - Franciele Barbosa Trapp
- Rede MPS Brasil, Porto Alegre, RS, Brazil.,Hospital de Clínicas de Porto Alegre, Serviço de Genética Médica, Porto Alegre, RS, Brazil.,Hospital de Clínicas de Porto Alegre, Centro de Pesquisa Experimental, Grupo de Pesquisa BIODISCOVERY, Porto Alegre, RS, Brazil
| | - Maira Graeff Burin
- Rede MPS Brasil, Porto Alegre, RS, Brazil.,Hospital de Clínicas de Porto Alegre, Serviço de Genética Médica, Porto Alegre, RS, Brazil.,Hospital de Clínicas de Porto Alegre, Centro de Pesquisa Experimental, Grupo de Pesquisa BIODISCOVERY, Porto Alegre, RS, Brazil
| | - Kristiane Michelin-Tirelli
- Rede MPS Brasil, Porto Alegre, RS, Brazil.,Hospital de Clínicas de Porto Alegre, Serviço de Genética Médica, Porto Alegre, RS, Brazil.,Hospital de Clínicas de Porto Alegre, Centro de Pesquisa Experimental, Grupo de Pesquisa BIODISCOVERY, Porto Alegre, RS, Brazil
| | - Ana Paula Pereira Scholz de Magalhães
- Rede MPS Brasil, Porto Alegre, RS, Brazil.,Hospital de Clínicas de Porto Alegre, Serviço de Genética Médica, Porto Alegre, RS, Brazil.,Hospital de Clínicas de Porto Alegre, Centro de Pesquisa Experimental, Grupo de Pesquisa BIODISCOVERY, Porto Alegre, RS, Brazil
| | - Fernanda Medeiros Sebastião
- Rede MPS Brasil, Porto Alegre, RS, Brazil.,Hospital de Clínicas de Porto Alegre, Serviço de Genética Médica, Porto Alegre, RS, Brazil.,Hospital de Clínicas de Porto Alegre, Centro de Pesquisa Experimental, Grupo de Pesquisa BIODISCOVERY, Porto Alegre, RS, Brazil
| | - Fernanda Bender
- Rede MPS Brasil, Porto Alegre, RS, Brazil.,Hospital de Clínicas de Porto Alegre, Serviço de Genética Médica, Porto Alegre, RS, Brazil.,Hospital de Clínicas de Porto Alegre, Centro de Pesquisa Experimental, Grupo de Pesquisa BIODISCOVERY, Porto Alegre, RS, Brazil
| | - Jurema Fátima De Mari
- Rede MPS Brasil, Porto Alegre, RS, Brazil.,Hospital de Clínicas de Porto Alegre, Serviço de Genética Médica, Porto Alegre, RS, Brazil
| | - Ana Carolina Brusius-Facchin
- Rede MPS Brasil, Porto Alegre, RS, Brazil.,Hospital de Clínicas de Porto Alegre, Serviço de Genética Médica, Porto Alegre, RS, Brazil.,Hospital de Clínicas de Porto Alegre, Centro de Pesquisa Experimental, Grupo de Pesquisa BIODISCOVERY, Porto Alegre, RS, Brazil
| | - Sandra Leistner-Segal
- Rede MPS Brasil, Porto Alegre, RS, Brazil.,Hospital de Clínicas de Porto Alegre, Serviço de Genética Médica, Porto Alegre, RS, Brazil.,Hospital de Clínicas de Porto Alegre, Centro de Pesquisa Experimental, Grupo de Pesquisa BIODISCOVERY, Porto Alegre, RS, Brazil
| | - Diana Rojas Málaga
- Grupo Fleury, Pesquisa e Desenvolvimento - Biologia Molecular, São Paulo, SP, Brazil
| | - Roberto Giugliani
- Universidade Federal do Rio Grande do Sul, Programa de Pós-Graduação em Genética e Biologia Molecular, Porto Alegre, RS, Brazil.,Rede MPS Brasil, Porto Alegre, RS, Brazil.,Hospital de Clínicas de Porto Alegre, Serviço de Genética Médica, Porto Alegre, RS, Brazil.,Hospital de Clínicas de Porto Alegre, Centro de Pesquisa Experimental, Grupo de Pesquisa BIODISCOVERY, Porto Alegre, RS, Brazil.,Universidade Federal do Rio Grande do Sul, Departamento de Genética, Porto Alegre, RS, Brazil.,Instituto Nacional de Genética Médica Populacional (INAGEMP), Porto Alegre, RS, Brazil.,Hospital de Clínicas de Porto Alegre, Centro de Pesquisa Clínica, Grupo de Pesquisa DRBRASIL, Porto Alegre, RS, Brazil
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5
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Vieira TA, Trapp FB, Souza CFMD, Faccini LS, Jardim LB, Schwartz IVD, Riegel M, Vargas CR, Burin MG, Leistner-Segal S, Ashton-Prolla P, Giugliani R. Information and Diagnosis Networks - tools to improve diagnosis and treatment for patients with rare genetic diseases. Genet Mol Biol 2019; 42:155-164. [PMID: 31188934 PMCID: PMC6687351 DOI: 10.1590/1678-4685-gmb-2018-0214] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 12/12/2018] [Indexed: 12/14/2022] Open
Abstract
Brazil is a country of continental dimensions and most genetic services are
concentrated in the Southeast and South, including the Medical Genetics Service
of the Hospital de Clínicas de Porto Alegre (MGS/HCPA). As many areas on the
country do not have adequate medical genetics support, networks were designed to
extend the service of the MGS/HCPA reference center. This paper presents the
information and diagnosis networks that have their headquarters at MGS/HCPA:
SIAT (National Information System on Teratogenic Agents),
SIEM (Information Service on Inborn Errors of Metabolism),
Alô Genética (Hello Genetics - Medical Genetics Information
Service for Primary Health Care Professionals); Rede MPS Brasil
(MPS-Mucopolysaccharidosis Brazil Network); Rede EIM Brasil
(IEM-Inborn Errors of Metabolism Brazil Network), Rede NPC
Brasil (Niemann-Pick C - NPC Brazil Network), Rede DLD
Brasil (LSD-Lysosomal Storage Disorders Brazil Network),
Rede DXB (MSUD-Maple Syrup Urine Disease Network),
RedeBRIM (Brazilian Network of Reference and Information in
Microdeletion Syndromes Project), Rede Neurogenética
(Neurogenetics Network), and Rede Brasileira de Câncer
Hereditário (Brazilian Hereditary Cancer Network). These tools are
very useful to provide access to a qualified information and/or diagnostic
service for specialized and non-specialized health services, bypassing
difficulties that preclude patients to access reference centers.
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Affiliation(s)
- Taiane Alves Vieira
- Medical Genetics Service, Hospital de Clinicas de Porto Alegre, Porto Alegre, RS, Brazil.,Research and Postgraduate Group - Hospital de Clinicas de Porto Alegre, Porto Alegre, RS, Brazil
| | | | | | - Lavínia Schuler Faccini
- Medical Genetics Service, Hospital de Clinicas de Porto Alegre, Porto Alegre, RS, Brazil.,Department of Genetics - Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Laura Bannach Jardim
- Medical Genetics Service, Hospital de Clinicas de Porto Alegre, Porto Alegre, RS, Brazil.,Department of Internal Medicine - Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Ida Vanessa Doederlein Schwartz
- Medical Genetics Service, Hospital de Clinicas de Porto Alegre, Porto Alegre, RS, Brazil.,Department of Genetics - Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Mariluce Riegel
- Medical Genetics Service, Hospital de Clinicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Carmen Regla Vargas
- Medical Genetics Service, Hospital de Clinicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Maira Graeff Burin
- Medical Genetics Service, Hospital de Clinicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Sandra Leistner-Segal
- Medical Genetics Service, Hospital de Clinicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Patrícia Ashton-Prolla
- Medical Genetics Service, Hospital de Clinicas de Porto Alegre, Porto Alegre, RS, Brazil.,Research and Postgraduate Group - Hospital de Clinicas de Porto Alegre, Porto Alegre, RS, Brazil.,Department of Genetics - Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Roberto Giugliani
- Medical Genetics Service, Hospital de Clinicas de Porto Alegre, Porto Alegre, RS, Brazil.,Department of Genetics - Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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6
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Bravo H, Neto EC, Schulte J, Pereira J, Filho CS, Bittencourt F, Sebastião F, Bender F, de Magalhães APS, Guidobono R, Trapp FB, Michelin-Tirelli K, Souza CF, Rojas Málaga D, Pasqualim G, Brusius-Facchin AC, Giugliani R. Investigation of newborns with abnormal results in a newborn screening program for four lysosomal storage diseases in Brazil. Mol Genet Metab Rep 2017; 12:92-97. [PMID: 28721335 PMCID: PMC5498414 DOI: 10.1016/j.ymgmr.2017.06.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 06/15/2017] [Accepted: 06/16/2017] [Indexed: 12/27/2022] Open
Abstract
Lysosomal storage diseases (LSDs) are genetic disorders, clinically heterogeneous, mainly caused by defects in genes encoding lysosomal enzymes that degrade macromolecules. Several LSDs already have specific therapies that may improve clinical outcomes, especially if introduced early in life. With this aim, screening methods have been established and newborn screening (NBS) for some LSDs has been developed. Such programs should include additional procedures for the confirmation (or not) of the cases that had an abnormal result in the initial screening. We present here the methods and results of the additional investigation performed in four babies with positive initial screening results in a program of NBS for LSDs performed by a private laboratory in over 10,000 newborns in Brazil. The suspicion in these cases was of Mucopolysaccharidosis I - MPS I (in two babies), Pompe disease and Gaucher disease (one baby each). One case of pseudodeficiency for MPS I, 1 carrier for MPS I, 1 case of pseudodeficiency for Pompe disease and 1 carrier for Gaucher disease were identified. This report illustrates the challenges that may be encountered by NBS programs for LSDs, and the need of a comprehensive protocol for the rapid and precise investigation of the babies who have an abnormal screening result.
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Affiliation(s)
- Heydy Bravo
- Post-Graduate Program of Genetics and Molecular Biology, UFRGS, Av. Bento Gonçalves 9500, 91501-970 Porto Alegre, RS, Brazil
| | | | - Jaqueline Schulte
- CTN Diagnósticos, Av. Ipiranga 5000, Porto Alegre, RS 90610-000, Brazil
| | - Jamile Pereira
- CTN Diagnósticos, Av. Ipiranga 5000, Porto Alegre, RS 90610-000, Brazil
| | | | - Fernanda Bittencourt
- Medical Genetics Service, HCPA, Rua Ramiro Barcelos 2350, Porto Alegre, RS 90035-903, Brazil
| | - Fernanda Sebastião
- Medical Genetics Service, HCPA, Rua Ramiro Barcelos 2350, Porto Alegre, RS 90035-903, Brazil
| | - Fernanda Bender
- Medical Genetics Service, HCPA, Rua Ramiro Barcelos 2350, Porto Alegre, RS 90035-903, Brazil
| | | | - Régis Guidobono
- Medical Genetics Service, HCPA, Rua Ramiro Barcelos 2350, Porto Alegre, RS 90035-903, Brazil
| | - Franciele Barbosa Trapp
- Medical Genetics Service, HCPA, Rua Ramiro Barcelos 2350, Porto Alegre, RS 90035-903, Brazil
| | | | - Carolina F.M. Souza
- Medical Genetics Service, HCPA, Rua Ramiro Barcelos 2350, Porto Alegre, RS 90035-903, Brazil
| | - Diana Rojas Málaga
- Post-Graduate Program of Genetics and Molecular Biology, UFRGS, Av. Bento Gonçalves 9500, 91501-970 Porto Alegre, RS, Brazil
| | - Gabriela Pasqualim
- Post-Graduate Program of Genetics and Molecular Biology, UFRGS, Av. Bento Gonçalves 9500, 91501-970 Porto Alegre, RS, Brazil
- Gene Therapy Center, Experimental Research Center, HCPA, Rua Ramiro Barcelos 2350, Porto Alegre, RS 90035-903, Brazil
| | | | - Roberto Giugliani
- Post-Graduate Program of Genetics and Molecular Biology, UFRGS, Av. Bento Gonçalves 9500, 91501-970 Porto Alegre, RS, Brazil
- Medical Genetics Service, HCPA, Rua Ramiro Barcelos 2350, Porto Alegre, RS 90035-903, Brazil
- Post-Graduate Program in Medical Sciences, UFRGS, Rua Ramiro Barcelos 2400, 90035-003 Porto Alegre, RS, Brazil
- Gene Therapy Center, Experimental Research Center, HCPA, Rua Ramiro Barcelos 2350, Porto Alegre, RS 90035-903, Brazil
- Corresponding author at: Medical Genetics Service, HCPA, Rua Ramiro Barcelos 2350, Porto Alegre, RS, Brazil.Medical Genetics ServiceHCPARua Ramiro Barcelos 2350Porto AlegreRSBrazil
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