DOI QR코드

DOI QR Code

Understanding and managing patients with adult rare diseases

  • Jangsup Moon (Department of Genomic Medicine, Rare Disease Center, Seoul National University Hospital)
  • 투고 : 2023.11.19
  • 심사 : 2023.12.14
  • 발행 : 2024.06.30

초록

Despite advances in the diagnosis and management of rare diseases (RDs), there remains a tendency to overlook adult RD patients. In addition to the considerable number of adult-onset RDs, advances in the diagnosis and management of pediatric RDs have led to an increase in the survival of these patients into adulthood. Adult RDs exhibit distinct features from pediatric counterparts, necessitating careful consideration during medical assessments. Given the extended life expectancy of adult RD patients, precise diagnosis and management strategies can significantly enhance patient outcomes. This review aims to provide an in-depth exploration of the characteristics unique to adult RDs. Special emphasis will be placed on the importance of cascade screening and prenatal genetic testing in the context of adult RDs, highlighting the need for a comprehensive understanding of these aspects in clinical practice.

키워드

참고문헌

  1. Nguengang Wakap S, Lambert DM, Olry A, Rodwell C, Gueydan C, Lanneau V, et al. Estimating cumulative point prevalence of rare diseases: analysis of the Orphanet database. Eur J Hum Genet 2020;28:165-73.
  2. Bryson B, Bogart K, Atwood M, Fraser K, Locke T, Pugh K, et al. Navigating the unknown: a content analysis of the unique challenges faced by adults with rare diseases. J Health Psychol 2021;26:623-35.
  3. Wright CF, FitzPatrick DR, Firth HV. Paediatric genomics: diagnosing rare disease in children. Nat Rev Genet 2018;19:253-68.
  4. Reis ES, Mastellos DC, Yancopoulou D, Risitano AM, Ricklin D, Lambris JD. Applying complement therapeutics to rare diseases. Clin Immunol 2015;161:225-40.
  5. Chari ST. Diagnosis of autoimmune pancreatitis: the evolution of diagnostic criteria for a rare disease. Clin Gastroenterol Hepatol 2017;15:1485-8.
  6. Cutolo M. Autoimmune polyendocrine syndromes. Autoimmun Rev 2014;13:85-9.
  7. Roessler HI, Knoers NVAM, van Haelst MM, van Haaften G. Drug repurposing for rare diseases. Trends Pharmacol Sci 2021;42:255-67.
  8. Kim SY, Lim BC, Lee JS, Kim WJ, Kim H, Ko JM, et al. The Korean undiagnosed diseases program: lessons from a one-year pilot project. Orphanet J Rare Dis 2019;14:68.
  9. Lim SS, Lee W, Kim YK, Kim J, Park JH, Park BR, et al. The cumulative incidence and trends of rare diseases in South Korea: a nationwide study of the administrative data from the National Health Insurance Service database from 2011-2015. Orphanet J Rare Dis 2019;14:49.
  10. Mazzucato M, Visona Dalla Pozza L, Minichiello C, Manea S, Barbieri S, Toto E, et al. The epidemiology of transition into adulthood of rare diseases patients: results from a population-based registry. Int J Environ Res Public Health 2018;15:2212.
  11. Matilla-Duenas A, Corral-Juan M, Rodriguez-Palmero Seuma A, Vilas D, Ispierto L, Morais S, et al. Rare neurodegenerative diseases: clinical and genetic update. Adv Exp Med Biol 2017;1031:443-96.
  12. Sandquist M, Davenport T, Monaco J, Lyon ME. The transition to adulthood for youth living with rare diseases. Children (Basel) 2022;9:710.
  13. Berglund A, Berko S, Lampa E, Sejersen T. Survival in patients diagnosed with SMA at less than 24 months of age in a population-based setting before, during and after introduction of nusinersen therapy. Experience from Sweden. Eur J Paediatr Neurol 2022;40:57-60.
  14. Nanetti L, Kearney M, Boesch S, Stovickova L, Ortigoza-Escobar JD, Macaya A, et al.; ERN-RND Working Group for Management of Transition. Child-to-adult transition: a survey of current practices within the European Reference Network for Rare Neurological Diseases (ERN-RND). Neurol Sci 2024;45:1007-16.
  15. Defazio G, Berardelli A. Is adult-onset dystonia a rare disease? Time for population-based studies. Mov Disord 2021;36:1119-24.
  16. Fernandez-Eulate G, Carreau C, Benoist JF, Lamari F, Rucheton B, Shor N, et al. Diagnostic approach in adult-onset neurometabolic diseases. J Neurol Neurosurg Psychiatry 2022;93:413-21.
  17. Schuermans N, Hemelsoet D, Terryn W, Steyaert S, Van Coster R, Coucke PJ, et al.; for UD-PrOZA. Shortcutting the diagnostic odyssey: the multidisciplinary program for undiagnosed rare diseases in adults (UD-PrOZA). Orphanet J Rare Dis 2022;17:210.
  18. Sabba C, Lenato GM, Custodero C, Suppressa P. Rare diseases in the elderly: a new perspective for the specialist in geriatrics. Geriatr Care 2019;5:8769.
  19. Burson CM, Markey KR. Genetic counseling issues in predictive genetic testing for familial adult-onset neurologic diseases. Semin Pediatr Neurol 2001;8:177-86.
  20. Balestrini S, Guerrini R, Sisodiya SM. Rare and complex epilepsies from childhood to adulthood: requirements for separate management or scope for a lifespan holistic approach? Curr Neurol Neurosci Rep 2021;21:65.
  21. Castro R, Senecat J, de Chalendar M, Vajda I, Dan D, Boncz B; EURORDIS Social Policy Advisory Group. Bridging the gap between health and social care for rare diseases: key issues and innovative solutions. Adv Exp Med Biol 2017;1031:605-27.
  22. Pushpakom S, Iorio F, Eyers PA, Escott KJ, Hopper S, Wells A, et al. Drug repurposing: progress, challenges and recommendations. Nat Rev Drug Discov 2019;18:41-58.
  23. Shah S, Dooms MM, Amaral-Garcia S, Igoillo-Esteve M. Current drug repurposing strategies for rare neurodegenerative disorders. Front Pharmacol 2021;12:768023.
  24. Suetterlin KJ, Raja Rayan D, Matthews E, Hanna MG. Mexiletine (NaMuscla) for the treatment of myotonia in non-dystrophic myotonic disorders. Expert Opin Orphan Drugs 2020;8:43-9.
  25. Vicart S, Franques J, Bouhour F, Magot A, Pereon Y, Sacconi S, et al. Efficacy and safety of mexiletine in non-dystrophic myotonias: a randomised, double-blind, placebo-controlled, cross-over study. Neuromuscul Disord 2021;31:1124-35.
  26. Liu X, Chen H, Zhong Y, Lee TY, Han W, Yu D, et al. Diet therapy in patients with rare diseases: a scoping review. J Hum Nutr Diet 2023;36:742-53.
  27. Van Calcar SC, Sowa M, Rohr F, Beazer J, Setlock T, Weihe TU, et al. Nutrition management guideline for very-long chain acyl-CoA dehydrogenase deficiency (VLCAD): an evidence- and consensus-based approach. Mol Genet Metab 2020;131:23-37.
  28. Joshi PR, Zierz S. Muscle carnitine palmitoyltransferase II (CPT II) deficiency: a conceptual approach. Molecules 2020;25:1784.
  29. Krawczak M, Cooper DN, Schmidtke J. Estimating the efficacy and efficiency of cascade genetic screening. Am J Hum Genet 2001;69:361-70.
  30. Germain DP, Moiseev S, Suarez-Obando F, Al Ismaili F, Al Khawaja H, Altarescu G, et al. The benefits and challenges of family genetic testing in rare genetic diseases-lessons from Fabry disease. Mol Genet Genomic Med 2021;9:e1666.
  31. Meschia JF, Worrall BB, Elahi FM, Ross OA, Wang MM, Goldstein ED, et al. Management of inherited CNS small vessel diseases: the CADASIL example: a scientific statement from the American Heart Association. Stroke 2023;54:e452-64.
  32. Schefelker JM, Peterson AL. Screening and management of dyslipidemia in children and adolescents. J Clin Med 2022;11:6479.
  33. Ormond KE, Blasimme A, Vayena E. Ethical aspects of pediatric genetic care: testing and treatment. Pediatr Clin North Am 2023;70:1029-46.
  34. De Rycke M, Berckmoes V. Preimplantation genetic testing for monogenic disorders. Genes (Basel) 2020;11:871.
  35. Ginoza MEC, Isasi R. Regulating preimplantation genetic testing across the world: a comparison of international policy and ethical perspectives. Cold Spring Harb Perspect Med 2020;10:a036681.
  36. Kim MJ, Park SO, Hong YS, Park EA, Lee YB, Choi BO, et al. Clinical application of genome-wide single nucleotide polymorphism genotyping and karyomapping for preimplantation genetic testing of Charcot-Marie-Tooth disease. J Genet Med 2022;19:7-13.
  37. Shaw J, Scotchman E, Chandler N, Chitty LS. Preimplantation genetic testing: non-invasive prenatal testing for aneuploidy, copy-number variants and single-gene disorders. Reproduction 2020;160:A1-11.
  38. Hershlag A. Preimplantation genetic testing for adult-onset conditions. In: King LP, Band IC, eds. Case studies in the ethics of assisted reproduction. Springer, 2023;61-9.
  39. Fahy N, Rice C, Lahiri N, Desai R, Stott J. Genetic risk for Huntington disease and reproductive decision-making: a systematic review. Clin Genet 2023;104:147-62.