Unique medical issues in adult patients with mucopolysaccharidoses.
The mucopolysaccharidoses are a group of inherited metabolic diseases caused by deficiencies in enzymes involved in the sequential degradation of glycosaminoglycans (GAGs) leading to substrate accumulation in various tissues and organs. GAG accumulation can cause growth retardation and progressive damage to respiratory, cardiovascular, musculoskeletal, nervous, gastrointestinal, auditory, and visual systems. In the past, few people with severe phenotypic mucopolysaccharidosis (MPS) reached adulthood. However, better methods for diagnosis, multi-disciplinary care, and new therapies have extended lifespan, leading to an increasing number of patients surviving beyond childhood. The growing number of adult MPS patients poses significant challenges for clinicians who may not be familiar with the clinical manifestations of MPS. In addition, as new interventions have changed the natural history of these disorders, it is difficult to anticipate both the impact on life expectancy and other complications that may occur as these patients age. Because the MPS disorders are multi-organ diseases, their management requires a coordinated multi-disciplinary approach. Here we discuss the unique pattern of medical issues and multi-organ involvement in adult patients with MPS and identify the challenges that are associated with management of MPS. This review is based on information from an expert investigator meeting with MPS specialists held October 2-4, 2014 in Dublin, Ireland, as well as on current literature searches focusing on MPS and adults.
Montreal Children's Hospital, Montreal, Quebec, Canada. Electronic address: john.mitchell@muhc.mcgill.ca.
John
J
Mitchell
New York University School of Medicine, New York, NY, United States. Electronic address: Kenneth.Berger@nyumc.org.
Kenneth I
KI
Berger
Orthopaedics and Traumatology Hospital, Padova, Italia. Electronic address: andrea.borgo@sanita.padova.it.
Andrea
A
Borgo
University of Minnesota, Minneapolis, MN, United States. Electronic address: braun002@umn.edu.
Elizabeth A
EA
Braunlin
Lurie Children's Hospital, Chicago, IL, United States. Electronic address: bburton@luriechildrens.org.
Barbara K
BK
Burton
Faculty of Medicine, Universidad de La Sabana, Santa Clara, Chía, Cundinamarca, Colombia, and Neurosurgery Unit, Fundación Santafé de Bogotá, Bogotá, Bogota D.C., Colombia. Electronic address: Kemel11@yahoo.com.
Kemel A
KA
Ghotme
Medical University of Vienna, Vienna, Austria. Electronic address: susanne.kircher@meduniwien.ac.at.
Susanne G
SG
Kircher
St. Louis Children's Hospital, St. Louis, MO, United States. Electronic address: molterd@ent.wustl.edu.
David
D
Molter
University of Minnesota, Minneapolis, MN, United States. Electronic address: orcha001@umn.edu.
Paul J
PJ
Orchard
Salford Royal Hospital, Salford, United Kingdom. Electronic address: james.palmer@srft.nhs.uk.
James
J
Palmer
Mater Misericordiae University Hospital, Ireland. Electronic address: gpastores@mater.ie.
Gregory M
GM
Pastores
New York University School of Medicine, New York, NY, United States. Electronic address: david.rapoport@mssm.edu.
David M
DM
Rapoport
CHOC Children's Specialists, Orange, CA, United States and School of Medicine, University of California-Irvine, Orange, CA, United States. Electronic address: rawang@CHOC.org.
Raymond Y
RY
Wang
Children's Hospital Seattle, Seattle, WA, United States. Electronic address: Klane.white@seattlechildrens.org.
Klane
K
White
D000328:Adult; D003226:Congresses as Topic; D019468:Disease Management; D056947:Enzyme Replacement Therapy; D006025:Glycosaminoglycans / Q000378:metabolism; D006801:Humans; D007494:Ireland; D009083:Mucopolysaccharidoses / Q000628:therapy*; D010348:Patient Care Team; D017410:Practice Guidelines as Topic
D006025:Glycosaminoglycans
Adult; Disease management; Enzyme replacement therapy; Lysosomal storage diseases; Mucopolysaccharidoses; Review