Navegando por Assunto "Classical homocystinuria"

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Diagnosis and management of classica homocystinuria in Brazil: a summary of 72 late-diagnosed patients
(Latin American Society Inborn Errors and Neonatal Screening, 2019-02) POLONI, Soraia; HOSS, Giovana Regina Weber; SPERB-LUDWIG, Fernanda; BORSATTO, Taciane; RODOVALHO-DORIQUI, Maria Juliana; LEÃO, Emília Katiane Embiruçu de Araújo; BOA-SORTE, Ney Cristian Amaral; LOURENÇO, Charles Marques; AE KIM, Chong; ROCHA, Hélio Fernandes da; RIBEIRO, Márcia Goncalves; STEINER, Carlos Eduardo; MORENO, Carolina Araujo; BERNARDI, Pricila; VALADARES, Eugênia Ribeiro; ARTIGALÁS, Osvaldo Alfonso Pinto; CARVALHO, Gerson da Silva; WANDERLEY, Hector Yuri Conti; SILVA, Luiz Carlos Santana da; SCHWARTZ, Ida Vanessa Doederlein; SOUZA, Carolina Fischinger Moura de; D'ALMEIDA, Vânia; BLOM, Henk J.
This study described a broad clinical characterization of classical homocystinuria (HCU) in Brazil. This was a cross-sectional, observational study including clinical and biochemical data from 72 patients (60 families) from Brazil (South, n = 13; Southeast, n = 37; Northeast, n = 8; North, n = 1; and Midwest, n = 1). Parental consanguinity was reported in 42% of families. Ocular manifestations were the earliest detected symptom (53% of cases), the main reason for diagnostic suspicion (63% of cases), and the most prevalent manifestation at diagnosis (67% of cases). Pyridoxine responsiveness was observed in 14% of patients. Only 22% of nonresponsive patients on treatment had total homocysteine levels <100 mmol/L. Most commonly used treatment strategies were pyridoxine (93% of patients), folic acid (90%), betaine (74%), vitamin B12 (27%), and low-methionine diet + metabolic formula (17%). Most patients diagnosed with HCU in Brazil are late diagnosed, express a severe phenotype, and poor metabolic control. Milder forms of HCU are likely underrepresented due to underdiagnosis.