Mucopolissacaridose Tipo I, Transplante de Células Hematopoiéticas e Perfil de Neurodesenvolvimento: Um Caso Clínico

Autores

  • Rafael Inácio Departamento de Pediatria / Hospital Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal https://orcid.org/0000-0003-3573-105X
  • Cláudia Bandeira de Lima Departamento de Pediatria / Hospital Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal
  • Manuela Baptista Departamento de Pediatria / Hospital Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal

DOI:

https://doi.org/10.46531/sinapse/CC/210086/2022

Palavras-chave:

Criança, Desenvolvimento Infantil, Mucopolissacaridose, Perturbações do Neurodesenvolvimento, Transplante de Células-Tronco Hematopoéticas

Resumo

Type I mucopolysaccharidosis is caused by an alpha-L-iduronidase deficit and has three phenotypic expressions. Hurler syndrome includes dysmorphias, hirsutism, hepatosplenomegaly, hydrocephalus, skeletal deformities, recurrent infections, heart abnormalities, and global developmental delay. Hematopoietic cell transplantation provides a continuous source of alpha-L-iduronidase throughout the body, including the central nervous system and, currently, appears to be the gold-standard therapy for this pathology. We present the case of a six-years-old child with the diagnosis of Hurler syndrome, submitted to hematopoietic cell transplantation and integrated in a structured support plan with special education, speech therapy and early home intervention, who presents a trend of convergence with the normality in all the development areas, except for locomotor skills and eye-hand coordination. These findings highlight the positive impact of the hematopoietic cell transplantation together with the early and structured intervention of a multidisciplinary team in the neurodevelopmental profile of children affected by Hurler syndrome.

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Referências

Mitrovic S, Gouze H, Gossec L, Schaeverbeke T, Fautrel B. Mucopolysaccharidoses seen in adults in rheumatology. Jt Bone Spine. 2017;84:663-70. doi:10.1016/j.jbspin.2017.01.008

Cimaz R, La Torre F. Mucopolysaccharidoses. Curr Rheumatol Rep. 2014;16:389.. doi:10.1007/s11926-013-0389-0

Scott HS, Bunge S, Gal A, Clarke LA, Morris CP, Hopwood JJ. Molecular genetics of mucopolysaccharidosis type I: diagnostic, clinical, and biological implications. Hum Mutat. 1995;6:288-302. doi: 10.1002/humu.1380060403.

Tomatsu S, Fujii T, Fukushi M, Oguma T, Shimada T, Maeda M, et al. Newborn screening and diagnosis of mucopolysaccharidoses. Mol Genet Metab. 2013;110:42-53. doi:10.1016/j.ymgme.2013.06.007

Suarez-Guerrero JL, Gómez Higuera PJI, Arias Flórez JS, Contreras-García GA. Mucopolisacaridosis: características clínicas, diagnóstico y de manejo. Rev Chil Pediatr. 2016;87:295-304. doi:10.1016/j.rchipe.2015.10.004

White KK. Orthopaedic aspects of mucopolysaccharidoses. Rheumatology. 2011;50:26-33. doi:10.1093/rheumatology/ ker393

Taylor M, Khan S, Stapleton M, Wang J, Chen J, Wynn R, et al. Hematopoietic stem cell transplantation for mucopolysaccharidoses: past, present, and future. Biol Blood Marrow Transplant. 2019;25:e226-46. doi:10.1016/j. bbmt.2019.02.012

Shapiro EG, Whitley CB, Eisengart JB. Beneath the floor: Re-analysis of neurodevelopmental outcomes in untreated Hurler syndrome. Orphanet J Rare Dis. 2018;13:1-8. doi:10.1186/s13023-018-0817-3

Coletti; HY, Aldenhoven; M, Yelin K, Poe MD, Kurtzberg J, Escolar ML. Long-term functional outcomes of children with Hurler syndrome treated with unrelated umbilical cord blood transplantation. JIMD Rep. 2015;20:77-86. doi:10.1007/8904_2014_395

Ivens J, Martin N. A common metric for the Griffiths Scales. Arch Dis Child. 2002;87:109-10. doi:10.1136/adc.87.2.109

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Publicado

2024-04-20

Como Citar

1.
Inácio R, Bandeira de Lima C, Baptista M. Mucopolissacaridose Tipo I, Transplante de Células Hematopoiéticas e Perfil de Neurodesenvolvimento: Um Caso Clínico. Sinapse [Internet]. 20 de Abril de 2024 [citado 31 de Outubro de 2024];22(2):83-6. Disponível em: https://sinapse.pt/index.php/journal/article/view/68

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