phenotypic and genetic characterization of a cohort of pediatric wilson disease patients威尔逊表型和遗传特征的一群小儿疾病的病人.pdfVIP

Abdel Ghaffar et al. BMC Pediatrics 2011, 11:56 /1471-2431/11/56 RESEARCH ARTICLE Open Access Phenotypic and Genetic Characterization of a Cohort of Pediatric Wilson Disease Patients 1,2* 1,2,3 1 2 2,3 Tawhida Y Abdel Ghaffar , Solaf M Elsayed , Suzan Elnaghy , Ahmed Shadeed , Ezzat S Elsobky and Hartmut Schmidt4 Abstract Background: In Egypt, Wilson disease seems to be under diagnosed and clinical data on large cohorts are limited. The aim of this study is to highlight the clinical, laboratory and genetic characteristics of this disease in our pediatric population as well as to report our experience with both treatment options and outcome. Methods: The study included 77 patients from 50 unrelated families (62 were followed up for a mean period of 58.9 ± 6.4 months and 27 were asymptomatic siblings). Data were collected retrospectively by record analysis and patient interviews. Diagnosis was confirmed by sequencing of the ATP7B gene in 64 patients Results: Our patients had unique characteristics compared to other populations. They had a younger age of onset (median: 10 years), higher prevalence of Kayser-Fleischer rings (97.6% in the symptomatic patients), low ceruloplasmin (93.5%), high rate of parental consanguinity (78.9%) as well as a more severe course. 71.42% of those on long term D-penicillamine improved or were stable during the follow up with severe side effects occurring in only 11.5%. Preemptive treatment with zinc monotherapy was an effective non-toxic alternative to D-penicillamine. Homozygous mutations were found in 85.7%, yet limited by the large number of mutations detected, it was difficult to find genotype-phenotype correlations. Missense mutations were the