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Clinical spectrum of pyruvate kinase deficiency: data from the Pyruvate Kinase Deficiency Natural History Study
RF. Grace, P. Bianchi, EJ. van Beers, SW. Eber, B. Glader, HM. Yaish, JM. Despotovic, JA. Rothman, M. Sharma, MM. McNaull, E. Fermo, K. Lezon-Geyda, DH. Morton, EJ. Neufeld, S. Chonat, N. Kollmar, CM. Knoll, K. Kuo, JL. Kwiatkowski, D....
Jazyk angličtina Země Spojené státy americké
Typ dokumentu časopisecké články, multicentrická studie, práce podpořená grantem
NLK
Free Medical Journals
od 1946 do Před 1 rokem
Freely Accessible Science Journals
od 1946 do Před 1 rokem
Open Access Digital Library
od 1946-01-01
Open Access Digital Library
od 1946-01-01
ROAD: Directory of Open Access Scholarly Resources
- MeSH
- aktivace enzymů MeSH
- cholecystektomie škodlivé účinky metody MeSH
- dítě MeSH
- dospělí MeSH
- fenotyp MeSH
- genetické asociační studie * MeSH
- genotyp MeSH
- hemolytická nesférocytická kongenitální anemie diagnóza etiologie metabolismus terapie MeSH
- kojenec MeSH
- kombinovaná terapie MeSH
- krevní transfuze MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mutace MeSH
- novorozenec MeSH
- předškolní dítě MeSH
- pyruvátkinasa nedostatek metabolismus MeSH
- splenektomie škodlivé účinky metody MeSH
- určení symptomu MeSH
- vrozené poruchy metabolismu pyruvátu diagnóza etiologie metabolismus terapie MeSH
- výsledek terapie MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- kojenec MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- novorozenec MeSH
- předškolní dítě MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- práce podpořená grantem MeSH
An international, multicenter registry was established to collect retrospective and prospective clinical data on patients with pyruvate kinase (PK) deficiency, the most common glycolytic defect causing congenital nonspherocytic hemolytic anemia. Medical history and laboratory and radiologic data were retrospectively collected at enrollment for 254 patients with molecularly confirmed PK deficiency. Perinatal complications were common, including anemia that required transfusions, hyperbilirubinemia, hydrops, and prematurity. Nearly all newborns were treated with phototherapy (93%), and many were treated with exchange transfusions (46%). Children age 5 years and younger were often transfused until splenectomy. Splenectomy (150 [59%] of 254 patients) was associated with a median increase in hemoglobin of 1.6 g/dL and a decreased transfusion burden in 90% of patients. Predictors of a response to splenectomy included higher presplenectomy hemoglobin (P = .007), lower indirect bilirubin (P = .005), and missense PKLR mutations (P = .0017). Postsplenectomy thrombosis was reported in 11% of patients. The most frequent complications included iron overload (48%) and gallstones (45%), but other complications such as aplastic crises, osteopenia/bone fragility, extramedullary hematopoiesis, postsplenectomy sepsis, pulmonary hypertension, and leg ulcers were not uncommon. Overall, 87 (34%) of 254 patients had both a splenectomy and cholecystectomy. In those who had a splenectomy without simultaneous cholecystectomy, 48% later required a cholecystectomy. Although the risk of complications increases with severity of anemia and a genotype-phenotype relationship was observed, complications were common in all patients with PK deficiency. Diagnostic testing for PK deficiency should be considered in patients with apparent congenital hemolytic anemia and close monitoring for iron overload, gallstones, and other complications is needed regardless of baseline hemoglobin. This trial was registered at www.clinicaltrials.gov as #NCT02053480.
Ann and Robert H Lurie Children's Hospital of Chicago Chicago IL
Centre Hospitalier Universitaire Sainte Justine Montreal QC Canada
Children's Hospital of Michigan Wayne State University School of Medicine Detroit MI
Children's Mercy Hospital Kansas City MO
Dana Farber Boston Children's Cancer and Blood Disorder Center Boston MA
DDC Clinic for Special Needs Children Middlefield OH
Duke University Medical Center Durham NC
Fakultni Nemocnice Olomouc Olomouc Czech Republic
Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milan Italy
Klinikum Kassel GmbH Kassel Germany
Lucile Packard Children's Hospital Stanford University Palo Alto CA
McMaster University Hamilton ON Canada
Nationwide Children's Hospital The Ohio State University College of Medicine Columbus OH
Phoenix Children's Hospital Phoenix AZ
Primary Children's Hospital University of Utah Salt Lake City UT
Schwerpunktpraxis für Pädiatrische Hämatologie Onkologie Munich Germany
St Jude Children's Research Hospital Memphis TN
Texas Children's Hematology Center Baylor College of Medicine Houston TX
The University of Vermont Children's Hospital Burlington VT
Universitair Medisch Centrum Utrecht Utrecht The Netherlands
University of Massachusetts Memorial Children's Medical Center Worcester MA
University of Mississippi Medical Center Jackson MS
University of Toronto University Health Network Toronto ON Canada
Weill Cornell Medical College New York Presbyterian Hospital New York NY
Citace poskytuje Crossref.org
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