title: [Diagnostic management of patients with rare genetic diseases: example of five pathologies].
abstract: BACKGROUND
  Orphan diseases are serious and unknown chronic diseases, for which a rapid diagnosis may provide a better access to healthcare. The aim of this study was to describe the procedures of diagnosis for patients with such ailments.
  
  
  METHODS
  Self-administered questionnaires describing patient's behavior, medical examinations until the final diagnosis, as well as received medical care and financial support, were directly sent to the patients through patient associations and special examinations dedicated to rare diseases.
  
  
  RESULTS
  532 patients were included, suffering from 5 different diseases. Although the average delay between the appearance of symptoms and diagnosis is 2 years and 8 months, this hides great disparities (from 0 to 40 years) and half of the patients were diagnosed within 4 months. The study shows that the diagnosis management is influenced by the illness and its symptoms as well as by the characteristics of the first medical examination.
  
  
  CONCLUSIONS
  The diagnosis management of patients with rare diseases is strongly determined by personnel initiatives or exceptional opportunities, rather than by a real organisational strategy of the healthcare system.
authors.affiliation: CREGAS - INSERM U 537, Hôpital de Bicêtre, 80, rue du Général Leclerc, 94275 Le Kremlin-Bicêtre Cedex, France.
authors.forename: V
authors.initials: V
authors.lastname: Godet
authors.forename: I
authors.initials: I
authors.lastname: Hirtzlin
authors.forename: N
authors.initials: N
authors.lastname: Costet
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D001294:Attitude to Health; D002648:Child; D002908:Chronic Disease; D005260:Female; D005602:France / Q000453:epidemiology; D030342:Genetic Diseases, Inborn / Q000175:diagnosis* / Q000453:epidemiology / Q000235:genetics; D006801:Humans; D008297:Male; D008659:Metabolic Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000235:genetics; D009800:Oculocerebrorenal Syndrome / Q000175:diagnosis* / Q000453:epidemiology / Q000235:genetics; D010013:Osteogenesis Imperfecta / Q000175:diagnosis* / Q000453:epidemiology / Q000235:genetics; D011787:Quality of Health Care; D012111:Residence Characteristics / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D013997:Time Factors; D005879:Tourette Syndrome / Q000175:diagnosis* / Q000453:epidemiology / Q000235:genetics; D006623:von Hippel-Lindau Disease / Q000175:diagnosis* / Q000453:epidemiology / Q000235:genetics