1
|
Sciascia S, Roccatello D, Salvatore M, Carta C, Cellai LL, Ferrari G, Lumaka A, Groft S, Alanay Y, Azam M, Baynam G, Cederroth H, Cutiongco-de la Paz EM, Dissanayake VHW, Giugliani R, Gonzaga-Jauregui C, Hettiarachchi D, Kvlividze O, Landoure G, Makay P, Melegh B, Ozbek U, Puri RD, Romero VI, Scaria V, Jamuar SS, Shotelersuk V, Gahl WA, Wiafe SA, Bodamer O, Posada M, Taruscio D. Unmet needs in countries participating in the undiagnosed diseases network international: an international survey considering national health care and economic indicators. Front Public Health 2023; 11:1248260. [PMID: 37822540 PMCID: PMC10562568 DOI: 10.3389/fpubh.2023.1248260] [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] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 09/08/2023] [Indexed: 10/13/2023] Open
Abstract
Background Patients, families, the healthcare system, and society as a whole are all significantly impacted by rare diseases (RDs). According to various classifications, there are currently up to 9,000 different rare diseases that have been recognized, and new diseases are discovered every month. Although very few people are affected by each uncommon disease individually, millions of people are thought to be impacted globally when all these conditions are considered. Therefore, RDs represent an important public health concern. Although crucial for clinical care, early and correct diagnosis is still difficult to achieve in many nations, especially those with low and middle incomes. Consequently, a sizeable amount of the overall burden of RD is attributable to undiagnosed RD (URD). Existing barriers and policy aspects impacting the care of patients with RD and URD remain to be investigated. Methods To identify unmet needs and opportunities for patients with URD, the Developing Nations Working Group of the Undiagnosed Diseases Network International (DNWG-UDNI) conducted a survey among its members, who were from 20 different nations. The survey used a mix of multiple choice and dedicated open questions covering a variety of topics. To explore reported needs and analyze them in relation to national healthcare economical aspects, publicly available data on (a) World Bank ranking; (b) Current health expenditure per capita; (c) GDP per capita; (d) Domestic general government health expenditure (% of GDP); and (e) Life expectancy at birth, total (years) were incorporated in our study. Results This study provides an in-depth evaluation of the unmet needs for 20 countries: low-income (3), middle-income (10), and high-income (7). When analyzing reported unmet needs, almost all countries (N = 19) indicated that major barriers still exist when attempting to improve the care of patients with UR and/or URD; most countries report unmet needs related to the availability of specialized care and dedicated facilities. However, while the countries ranked as low income by the World Bank showed the highest prevalence of referred unmet needs across the different domains, no specific trend appeared when comparing the high, upper, and low-middle income nations. No overt trend was observed when separating countries by current health expenditure per capita, GDP per capita, domestic general government health expenditure (% of GDP) and life expectancy at birth, total (years). Conversely, both the GDP and domestic general government health expenditure for each country impacted the presence of ongoing research. Conclusion We found that policy characteristics varied greatly with the type of health system and country. No overall pattern in terms of referral for unmet needs when separating countries by main economic or health indicators were observed. Our findings highlight the importance of identifying actionable points (e.g., implemented orphan drug acts or registries where not available) in order to improve the care and diagnosis of RDs and URDs on a global scale.
Collapse
Affiliation(s)
- Savino Sciascia
- Center of Excellence on Nephrologic, Rheumatologic and Rare Diseases (ERK-Net, ERN-Reconnect and RITA-ERN Member) With Nephrology and Dialysis Unit, San Giovanni Bosco Hub Hospital, ASL Città di Torino and University of Turin, Turin, Italy
| | - Dario Roccatello
- Center of Excellence on Nephrologic, Rheumatologic and Rare Diseases (ERK-Net, ERN-Reconnect and RITA-ERN Member) With Nephrology and Dialysis Unit, San Giovanni Bosco Hub Hospital, ASL Città di Torino and University of Turin, Turin, Italy
| | - Marco Salvatore
- National Center for Rare Diseases, Undiagnosed Rare Diseases Interdepartmental Unit, Istituto Superiore di Sanità, Rome, Italy
| | - Claudio Carta
- National Center for Rare Diseases, Undiagnosed Rare Diseases Interdepartmental Unit, Istituto Superiore di Sanità, Rome, Italy
| | - Laura L. Cellai
- National Center for Rare Diseases, Undiagnosed Rare Diseases Interdepartmental Unit, Istituto Superiore di Sanità, Rome, Italy
| | - Gianluca Ferrari
- National Center for Rare Diseases, Undiagnosed Rare Diseases Interdepartmental Unit, Istituto Superiore di Sanità, Rome, Italy
| | - Aimè Lumaka
- Reference Center for Rare and Undiagnosed Diseases, University of Kinshasa, Kinshasa, Democratic Republic of Congo
- Service de Génétique Humaine, University Hospitals of Liège, Liège, Belgium
| | - Stephen Groft
- National Center for Advancing Translational Sciences, National Institutes of Health, Bethesda, MD, United States
| | - Yasemin Alanay
- ACURARE-Rare and Undiagnosed Diseases Center, Acibadem University, Istanbul, Türkiye
| | - Maleeha Azam
- COMSATS University Islamabad, Islamabad, Pakistan
| | - Gareth Baynam
- Rare Care, Clinical Center of Expertise for Rare and Undiagnosed Diseases, Perth Children's Hospital, Perth, WA, Australia
| | | | - Eva Maria Cutiongco-de la Paz
- Institute of Human Genetics, National Institutes of Health, University of the Philippines Manila, Manila, Philippines
| | | | - Roberto Giugliani
- House of Rares, Medical Genetics Service, HCPA, Department Genetics UFRGS and DASA, Porto Alegre, Brazil
| | - Claudia Gonzaga-Jauregui
- International Laboratory for Human Genome Research, Universidad Nacional Autonoma de Mexico, Juriquilla, Queretaro, Mexico
| | - Dineshani Hettiarachchi
- Department of Anatomy, Genetics and Biomedical Informatics, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Oleg Kvlividze
- Georgian Foundation for Genetic and Rare Diseases (GeRaD), School of Medicine, New Vision University, Tbilisi, Georgia
| | - Guida Landoure
- Faculté de Médecine et d'Odontostomatologie, l'Université des Sciences, des Techniques et des Technologies de Bamako, Bamako, Mali
| | - Prince Makay
- Reference Center for Rare and Undiagnosed Diseases, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Béla Melegh
- Department of Medical Genetics, School of Medicine, University of Pécs, Pécs, Hungary
| | - Ugur Ozbek
- ACURARE-Rare and Undiagnosed Diseases Center, Acibadem University, Istanbul, Türkiye
| | - Ratna Dua Puri
- Institute of Medical Genetics and Genomics, Sir Ganga Ram Hospital, New Delhi, India
| | - Vanessa I. Romero
- School of Medicine, Universidad San Francisco de Quito, Quito, Ecuador
| | - Vinod Scaria
- CSIR Institute of Genomics and Integrative Biology, New Delhi, India
| | - Saumya S. Jamuar
- Genetics Service, Department of Pediatrics, KK Women’s and Children’s Hospital and Pediatric ACP, Duke-NUS Medical School, Singapore, Singapore
- SingHealth Duke-NUS Institute of Precision Medicine, Singapore, Singapore
| | - Vorasuk Shotelersuk
- Center of Excellence for Medical Genomics, Department of Pediatrics, Faculty of Medicine, King Chulalongkorn Memorial Hospital and Chulalongkorn University, Bangkok, Thailand
| | - William A. Gahl
- National Institutes of Health, National Human Genome Research Institute, Bethesda, MD, United States
| | | | - Olaf Bodamer
- Division of Genetics and Genomics, Harvard Medical School, Boston Children's Hospital, Boston, MA, United States
| | - Manuel Posada
- Rare Diseases Research Institute (IIER), SpainUDP, Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Domenica Taruscio
- National Center for Rare Diseases, Undiagnosed Rare Diseases Interdepartmental Unit, Istituto Superiore di Sanità, Rome, Italy
| |
Collapse
|
2
|
Harvengt J, Lumaka A, Fasquelle C, Caberg JH, Mastouri M, Janssen A, Palmeira L, Bours V. HIDEA syndrome: A new case report highlighting similarities with ROHHAD syndrome. Front Genet 2023; 14:1137767. [PMID: 37035730 PMCID: PMC10073441 DOI: 10.3389/fgene.2023.1137767] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 03/03/2023] [Indexed: 04/11/2023] Open
Abstract
Context: ROHHAD syndrome presents a significant resemblance to HIDEA syndrome. The latter is caused by biallelic loss-of-function variants in the P4HTM gene and encompasses hypotonia, intellectual disabilities, eye abnormalities, hypoventilation, and dysautonomia. We report the first patient identified with HIDEA syndrome from our ROHHAD cohort. Clinical case: Our patient was a 21-month-old girl who had a history of severe respiratory infections requiring intensive care, hypotonia, abnormal eye movements, and rapid weight gain. Polysomnography identified severe central hypoventilation. During her follow-up, a significant psychomotor delay and the absence of language were gradually observed. The prolactin levels were initially increased. Hypothermia was reported at 4 years. Exome sequencing identified a new homozygous truncating P4HTM variant. Discussion: Our patient met the diagnosis criteria for ROHHAD, which included rapid weight gain, central hypoventilation appearing after 1.5 years of age, hyperprolactinemia suggesting hypothalamic dysfunction, and autonomic dysfunction manifesting as strabismus and hypothermia. However, she also presented with severe neurodevelopmental delay, which is not a classic feature of ROHHAD syndrome. HIDEA syndrome presents similarities with ROHHAD, including hypoventilation, obesity, and dysautonomia. To date, only 14% of endocrinological disturbances have been reported in HIDEA patients. Better delineation of both syndromes is required to investigate the eventual involvement of P4HTM, a regulator of calcium dynamics and gliotransmission, in ROHHAD patients. Conclusion: In the case of clinical evidence of ROHHAD in a child with abnormal neurological development or eye abnormalities, we suggest that the P4HTM gene be systematically interrogated in addition to the analysis of the PHOX2B gene. A better delineation of the natural history of HIDEA is required to allow further comparisons between features of HIDEA and ROHHAD. The clinical similarities could potentially orient some molecular hypotheses in the field of ROHHAD research.
Collapse
Affiliation(s)
- J. Harvengt
- Human Genetics Department, CHU of Liège, Liège, Belgium
- GIGA Research, University of Liège, Liège, Belgium
- *Correspondence: J. Harvengt,
| | - A. Lumaka
- Human Genetics Department, CHU of Liège, Liège, Belgium
- GIGA Research, University of Liège, Liège, Belgium
| | - C. Fasquelle
- Human Genetics Department, CHU of Liège, Liège, Belgium
- GIGA Research, University of Liège, Liège, Belgium
| | - J. H. Caberg
- Human Genetics Department, CHU of Liège, Liège, Belgium
| | - M. Mastouri
- Pediatric Department, Hospital Center of Luxembourg, Luxembourg City, Luxembourg
| | - A. Janssen
- Pediatric Department, CHU of Liège, Liège, Belgium
| | - L. Palmeira
- Human Genetics Department, CHU of Liège, Liège, Belgium
- GIGA Research, University of Liège, Liège, Belgium
| | - V. Bours
- Human Genetics Department, CHU of Liège, Liège, Belgium
- GIGA Research, University of Liège, Liège, Belgium
| |
Collapse
|
3
|
Taruscio D, Salvatore M, Lumaka A, Carta C, Cellai LL, Ferrari G, Sciascia S, Groft S, Alanay Y, Azam M, Baynam G, Cederroth H, Cutiongco-de la Paz EM, Dissanayake VHW, Giugliani R, Gonzaga-Jauregui C, Hettiarachchi D, Kvlividze O, Landoure G, Makay P, Melegh B, Ozbek U, Puri RD, Romero V, Scaria V, Jamuar SS, Shotelersuk V, Roccatello D, Gahl WA, Wiafe SA, Bodamer O, Posada M. Undiagnosed diseases: Needs and opportunities in 20 countries participating in the Undiagnosed Diseases Network International. Front Public Health 2023; 11:1079601. [PMID: 36935719 PMCID: PMC10017550 DOI: 10.3389/fpubh.2023.1079601] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 02/07/2023] [Indexed: 03/06/2023] Open
Abstract
Introduction Rare diseases (RD) are a health priority worldwide, overall affecting hundreds of millions of people globally. Early and accurate diagnosis is essential to support clinical care but remains challenging in many countries, especially the low- and medium-income ones. Hence, undiagnosed RD (URD) account for a significant portion of the overall RD burden. Methods In October 2020, the Developing Nations Working Group of the Undiagnosed Diseases Network International (DNWG-UDNI) launched a survey among its members, belonging to 20 countries across all continents, to map unmet needs and opportunities for patients with URD. The survey was based on questions with open answers and included eight different domains. Conflicting interpretations were resolved in contact with the partners involved. Results All members responded to the survey. The results indicated that the scientific and medical centers make substantial efforts to respond to the unmet needs of patients. In most countries, there is a high awareness of RD issues. Scarcity of resources was highlighted as a major problem, leading to reduced availability of diagnostic expertise and research. Serious equity in accessibility to services were highlighted both within and between participating countries. Regulatory problems, including securing informed consent, difficulties in sending DNA to foreign laboratories, protection of intellectual property, and conflicts of interest on the part of service providers, remain issues of concern. Finally, most respondents stressed the need to strengthen international cooperation in terms of data sharing, clinical research, and diagnostic expertise for URD patients in low and medium income countries. Discussion The survey highlighted that many countries experienced a discrepancy between the growing expertise and scientific value, the level of awareness and commitment on the part of relevant parties, and funding bodies. Country-tailored public health actions, including general syllabus of medical schools and of the education of other health professionals, are needed to reduce such gaps.
Collapse
Affiliation(s)
- Domenica Taruscio
- National Centre for Rare Diseases, Istituto Superiore di Sanità, Rome, Italy
- *Correspondence: Domenica Taruscio
| | - Marco Salvatore
- National Centre for Rare Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Aimè Lumaka
- Reference Center for Rare and Undiagnosed Diseases, University of Kinshasa, Kinshasa, Democratic Republic of Congo
- Service de Génétique Humaine, University Hospitals of Liège, Liège, Belgium
| | - Claudio Carta
- National Centre for Rare Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Laura L. Cellai
- National Centre for Rare Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Gianluca Ferrari
- National Centre for Rare Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Savino Sciascia
- Center of Excellence on Nephrologic, Rheumatologic and Rare Diseases (ERK-Net, ERN-Reconnect and RITA-ERN Member) With Nephrology and Dialysis Unit, San Giovanni Bosco Hub Hospital, University of Turin, Turin, Italy
| | - Stephen Groft
- National Center for Advancing Translational Sciences, National Institutes of Health, Bethesda, MD, United States
| | - Yasemin Alanay
- ACURARE-Rare and Undiagnosed Diseases Center, Acibadem University, Istanbul, Turkey
| | - Maleeha Azam
- COMSATS University Islamabad, Islamabad, Pakistan
| | - Gareth Baynam
- Rare Care, Clinical Centre of Expertise for Rare and Undiagnosed Diseases, Perth Children's Hospital, Perth, WA, Australia
| | | | - Eva Maria Cutiongco-de la Paz
- Institute of Human Genetics, National Institutes of Health, University of the Philippines Manila, Manila, Philippines
| | | | - Roberto Giugliani
- House of Rares, Medical Genetics Service, HCPA, Department Genetics UFRGS and DASA, Porto Alegre, Brazil
| | - Claudia Gonzaga-Jauregui
- International Laboratory for Human Genome Research, Universidad Nacional Autonoma de Mexico, Juriquilla, Queretaro, Mexico
| | - Dineshani Hettiarachchi
- Department of Anatomy, Genetics and Biomedical Informatics, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Oleg Kvlividze
- Georgian Foundation for Genetic and Rare Diseases (GeRaD), School of Medicine, New Vision University, Tbilisi, Georgia
| | - Guida Landoure
- Faculté de Médecine et d'Odontostomatologie, l'Université des Sciences, des Techniques et des Technologies de Bamako, Bamako, Mali
| | - Prince Makay
- Reference Center for Rare and Undiagnosed Diseases, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Béla Melegh
- Department of Medical Genetics, School of Medicine, University of Pécs, Pécs, Hungary
| | - Ugur Ozbek
- ACURARE-Rare and Undiagnosed Diseases Center, Acibadem University, Istanbul, Turkey
| | - Ratna Dua Puri
- Institute of Medical Genetics and Genomics, Sir Ganga Ram Hospital, New Delhi, India
| | - Vanessa Romero
- School of Medicine, Universidad San Francisco de Quito, Quito, Ecuador
| | - Vinod Scaria
- CSIR Institute of Genomics and Integrative Biology, New Delhi, India
| | - Saumya S. Jamuar
- Singhealth Duke-NUS Genomic Medicine Centre, KK Women's and Children's Hospital, Singapore, Singapore
- SingHealth Duke-NUS Institute of Precision Medicine, Singapore, Singapore
| | - Vorasuk Shotelersuk
- Center of Excellence for Medical Genomics, Department of Pediatrics, Faculty of Medicine, King Chulalongkorn Memorial Hospital and Chulalongkorn University, Bangkok, Thailand
| | - Dario Roccatello
- Center of Excellence on Nephrologic, Rheumatologic and Rare Diseases (ERK-Net, ERN-Reconnect and RITA-ERN Member) With Nephrology and Dialysis Unit, San Giovanni Bosco Hub Hospital, University of Turin, Turin, Italy
| | - William A. Gahl
- National Institutes of Health, National Human Genome Research Institute, Bethesda, MD, United States
| | | | - Olaf Bodamer
- Division of Genetics and Genomics, Harvard Medical School, Boston Children's Hospital, Boston, MA, United States
| | - Manuel Posada
- Rare Diseases Research Institute (IIER), SpainUDP, Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| |
Collapse
|
4
|
Lumaka A, Cosemans N, Lulebo Mampasi A, Mubungu G, Mvuama N, Lubala T, Mbuyi-Musanzayi S, Breckpot J, Holvoet M, de Ravel T, Van Buggenhout G, Peeters H, Donnai D, Mutesa L, Verloes A, Lukusa Tshilobo P, Devriendt K. Facial dysmorphism is influenced by ethnic background of the patient and of the evaluator. Clin Genet 2017; 92:166-171. [PMID: 27925162 DOI: 10.1111/cge.12948] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [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: 06/25/2016] [Revised: 11/26/2016] [Accepted: 11/28/2016] [Indexed: 11/29/2022]
Abstract
The evaluation of facial dysmorphism is a critical step toward reaching a diagnostic. The aim of the present study was to evaluate the ability to interpret facial morphology in African children with intellectual disability (ID). First, 10 experienced clinicians (five from Africa and five from Europe) rated gestalt in 127 African non-Down Syndrome (non-DS) patients using either the score 2 for 'clearly dysmorphic', 0 for 'clearly non dysmorphic' or 1 for 'uncertain'. The inter-rater agreement was determined using kappa coefficient. There was only fair agreement between African and European raters (kappa-coefficient = 0.29). Second, we applied the FDNA Face2Gene solution to assess Down Syndrome (DS) faces. Initially, Face2Gene showed a better recognition rate for DS in Caucasian (80%) compared to African (36.8%). We trained the Face2Gene with a set of African DS and non-DS photographs. Interestingly, the recognition in African increased to 94.7%. Thus, training improved the sensitivity of Face2Gene. Our data suggest that human based evaluation is influenced by ethnic background of the evaluator. In addition, computer based evaluation indicates that the ethnic of the patient also influences the evaluation and that training may increase the detection specificity for a particular ethnic.
Collapse
Affiliation(s)
- A Lumaka
- Center for Human Genetics, University Hospitals Leuven, Leuven, Belgium.,Center for Human Genetics, Faculty of Medicine, University of Kinshasa, Kinshasa, DR Congo.,Department of Paediatrics, Faculty of Medicine, University of Kinshasa, Kinshasa, DR Congo.,Institut National de Recherche Biomédicale, Kinshasa, DR Congo
| | - N Cosemans
- Center for Human Genetics, University Hospitals Leuven, Leuven, Belgium
| | - A Lulebo Mampasi
- School of Public Health, Faculty of Medicine, University of Kinshasa, Kinshasa, DR Congo
| | - G Mubungu
- Center for Human Genetics, Faculty of Medicine, University of Kinshasa, Kinshasa, DR Congo.,Department of Paediatrics, Faculty of Medicine, University of Kinshasa, Kinshasa, DR Congo
| | - N Mvuama
- School of Public Health, Faculty of Medicine, University of Kinshasa, Kinshasa, DR Congo
| | - T Lubala
- Sendwe University Hospitals, University of Lubumbashi, Lubumbashi, DR Congo
| | - S Mbuyi-Musanzayi
- Sendwe University Hospitals, University of Lubumbashi, Lubumbashi, DR Congo
| | - J Breckpot
- Center for Human Genetics, University Hospitals Leuven, Leuven, Belgium
| | - M Holvoet
- Center for Human Genetics, University Hospitals Leuven, Leuven, Belgium
| | - T de Ravel
- Center for Human Genetics, University Hospitals Leuven, Leuven, Belgium
| | - G Van Buggenhout
- Center for Human Genetics, University Hospitals Leuven, Leuven, Belgium
| | - H Peeters
- Center for Human Genetics, University Hospitals Leuven, Leuven, Belgium
| | - D Donnai
- Manchester Centre for Genomic Medicine, Saint Mary's Hospital, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | - L Mutesa
- Center for Human Genetics, College of Medicine and Health Sciences, University of Rwanda, Butare, Rwanda
| | - A Verloes
- Département de Génétique, CHU Paris - Hôpital Robert Debré, Paris, France
| | - P Lukusa Tshilobo
- Center for Human Genetics, University Hospitals Leuven, Leuven, Belgium.,Center for Human Genetics, Faculty of Medicine, University of Kinshasa, Kinshasa, DR Congo.,Department of Paediatrics, Faculty of Medicine, University of Kinshasa, Kinshasa, DR Congo.,Institut National de Recherche Biomédicale, Kinshasa, DR Congo
| | - K Devriendt
- Center for Human Genetics, University Hospitals Leuven, Leuven, Belgium
| |
Collapse
|
5
|
Lumaka A, Bone D, Lukoo R, Mujinga N, Senga I, Tady B, Matthijs G, Lukusa TP. Werdnig-Hoffmann disease: report of the first case clinically identified and genetically confirmed in central Africa (Kinshasa-Congo). Genet Couns 2009; 20:349-358. [PMID: 20162870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Werdnig-Hoffmann Disease: Report of the first case clinically identified and genetically confirmed in Central Africa (Kinshasa-Congo): Type 1 spinal muscular atrophy (SMA1) or Werdnig-Hoffman disease is rarely described in black populations. We report on one black patient diagnosed in Kinshasa. This patient was referred to Paediatric consultation at the age of 5 months 1/2 with extreme hypotonia progressing since birth, severe muscular weakness in his trunk and proximal parts of the extremities, ASD type II, and repeated episodes of pulmonary infections. He died of severe respiratory failure at the age of 10 months. EMG analysis revealed motor neuron a defect without nerve conduction anomaly, suggesting the diagnosis of spinal muscular atrophy disease. The diagnosis of SMA1 was definitely confirmed by a quantitative PCR-based testing that demonstrated homozygous deletion of SMN1, the primary disease-causing gene for spinal muscular atrophy, while two normal SMN2 alleles were present. There was a history of similar clinical symptomatology in a patient's older brother, suggesting a familial involvement. To the best of our knowledge, this is the first documented Werdnig-Hoffman case ever reported from Central Africa people.
Collapse
Affiliation(s)
- A Lumaka
- Département de Pédiatrie, Cliniques Universitaires de Kinshasa, Commune de Lemba, République Démocratique du Congo
| | | | | | | | | | | | | | | |
Collapse
|