title: Implementing evidence-driven individualized treatment plans within Morquio A Syndrome.
abstract: Morquio A Syndrome (mucopolysaccharidosis IVA [MPS IVA]) is an inherited, autosomal recessive lysosomal storage disorder that occurs in ~1 in 200,000 to 300,000 live births.(1) (Online access http://www.elseviercme.com/559) Individuals with Morquio A Syndrome have mutations in the gene that encodes N-acetylgalactosamine-6-sulfate sulfatase (GALNS), an enzyme responsible for the metabolism of the glycosaminoglycans (GAGs) keratin sulfate and chondroitin-6-sulfate.(2-4) Reduced activity or lack of GALNS leads to cellular and tissue accumulation of these GAGs to result in progressive, multisystem dysfunction and impaired functional capacity.(5) Individuals with Morquio A Syndrome suffer from a broad spectrum of impairment, including a variety of widespread skeletal abnormalities, respiratory compromise, valvular heart disease, visual and auditory impairments, and dental abnormalities.(6-8) Cognition is not typically affected.(9) Morquio A Syndrome exhibits extensive allelic heterogeneity, which results in extensive clinical heterogeneity.(2-4) This educational intervention on the management of patients with Morquio A Syndrome provides updated information and guidelines concerning the early and accurate diagnosis as well as an earlier intervention to improve patient outcomes. The activity is based on a live satellite symposium conducted during the 2015 official ACMG Annual Clinical Genetics Meeting program. Recent advances in the science of enzyme replacement therapies have presented opportunities for pharmacological interventions that improve quality of life. Clinicians will be updated on the clinical trial data and practical solutions for applying newer therapeutics to daily practice. Strategies to manage cardiopulmonary comorbidities and recommendations for the ideal clinical care model will wrap up this informative and up-to-date review of Morquio A Syndrome. This CME activity is also available through the Website of Molecular Genetics and Metabolism. Click on the CME button in the navigation bar for full access. Or access: http://www.elseviercme.com/559.
authors.affiliation: Medical Genetics, University of British Columbia, British Columbia, Canada; Provincial Medical Genetics Program, Children's and Women's Health Center of BC, British Columbia, Canada.
authors.forename: Lorne A
authors.initials: LA
authors.lastname: Clarke
authors.affiliation: Gastroenterology, UCSF Benioff Children's Hospital, Oakland Campus, Oakland, California, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Harmatz
authors.affiliation: Pulmonary Medicine, UCSF Benioff Children's Hospital, Oakland Campus, Oakland, California, USA.
authors.forename: Edward W
authors.initials: EW
authors.lastname: Fong
mesh_terms: D002811:Chondroitinsulfatases / Q000627:therapeutic use; D002985:Clinical Protocols; D056947:Enzyme Replacement Therapy; D006801:Humans; D009085:Mucopolysaccharidosis IV / Q000188:drug therapy* / Q000235:genetics; D057285:Precision Medicine; D011788:Quality of Life
chemical_list: D002811:Chondroitinsulfatases; C102295:GALNS protein, human