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Paediatria Croatica
Article . 2020 . Peer-reviewed
License: CC BY
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Pompeova bolest – progresivna multiorganska bolest: dijagnostički i terapijski izazovi

Authors: Danijela Petković Ramadža;

Pompeova bolest – progresivna multiorganska bolest: dijagnostički i terapijski izazovi

Abstract

Pompeova bolest je progresivna multiorganska bolest koja nastaje zbog nedostatka lizosomskog enzima kisele alfa-glukozidaze teposljedičnog nakupljanja glikogena i kaskade patoloških procesa. Klinički se očituje rasponom fenotipova, od fatalnog infantilnogdo blažih oblika bolesti. Infantilni oblik je obilježen progresivnom hipertrofi čnom kardiomiopatijom, propadanjem mišića i, ako sene liječi, neizbježnom smrću najčešće u prvoj godini života. Enzimskim nadomjesnim liječenjem postignuti su izvanredni rezultati:promijenjen je prirodni tijek bolesti i izbjegnuta rana smrt. Preživljenjem djece s infantilnim oblikom razotkrio se novi fenotip. Pacijenti razvijaju nove znakove bolesti i brojne poteškoće za koje tek treba pronaći novo terapijsko rješenje. Kasni oblik bolesti kliničkimože biti vrlo raznolik. Premda su slabost mišića koštanog sustava i onih dišnih vodeći simptomi, riječ je o multiorganskoj bolesti.Karakteristični klinički trijas (slabost pojasne, paravertebralne i dišne muskulature) razvija se u kasnijim fazama bolesti, dok su u ranim fazama često prisutni samo neki od navedenih ili drugi, netipični, simptomi i znakovi. Zbog toga se bolest kasno prepoznaje igubi se dragocjeno vrijeme za početak liječenja, koje je najučinkovitije ako se započne u početnim fazama bolesti. Jednostavan putdo dijagnoze je mjerenje aktivnosti enzima kisele alfa-glukozidaze iz suhe kapi krvi, što je uputno učiniti u svih osoba s pozitivnomobiteljskom anamnezom, nejasno povišenom kreatin kinazom i drugim znakovima Pompeove bolesti. Rezultati dugogodišnje primjene enzimske nadomjesne terapije u bolesnika s kasnim oblikom pokazali su da liječenje usporava bolest, stabilizira plućnufunkciju i pokretljivost te produljuje život bolesnika. S obzirom na ograničenja u učinkovitosti dostupne terapije i novootkrivena klinička obilježja, razvijaju se novi modaliteti liječenja.

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    popularity
    This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
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    influence
    This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
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    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
    Average
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
Average
Average
hybrid