Hereditary

遗传性
  • 文章类型: Journal Article
    在过去的5年里,心脏淀粉样变性(CA)的早期诊断和新的治疗方法已经出现,有望进行早期干预.这些包括非侵入性诊断测试和疾病改善疗法。最近,CA是最早使用基因编辑技术治疗的心肌病之一。尽管澳大利亚和新西兰的患者尚未广泛使用这些疗法,这在不久的将来可能会改变。鉴于这一领域的快速发展,在澳大利亚和新西兰的背景下看待这些进步是很重要的。本共识声明旨在更新澳大利亚和新西兰的普通医师和心脏病专家的诊断。调查,和CA的管理。
    Over the past 5 years, early diagnosis of and new treatments for cardiac amyloidosis (CA) have emerged that hold promise for early intervention. These include non-invasive diagnostic tests and disease modifying therapies. Recently, CA has been one of the first types of cardiomyopathy to be treated with gene editing techniques. Although these therapies are not yet widely available to patients in Australia and New Zealand, this may change in the near future. Given the rapid pace with which this field is evolving, it is important to view these advances within the Australian and New Zealand context. This Consensus Statement aims to update the Australian and New Zealand general physician and cardiologist with regards to the diagnosis, investigations, and management of CA.
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  • 文章类型: Journal Article
    伴侣动物,即狗,猫,和马,可能会受到多种形式的遗传性视网膜疾病的影响。在过去十年中,这类疾病的数量大幅增加,术语是非标准化的,异质,和困惑。我们在这个观点中提供了伴侣动物遗传性视网膜疾病命名的共识指南,前瞻性或回顾性。制定这些共识指南的目的是使命名标准化。我们提供了迭代命名过程的示例以及有关先前描述的疾病的拟议重命名的全面文件S1。
    Companion animals, namely dogs, cats, and horses, can be affected with many forms of hereditary retinal disease. The number of such diseases characterized in the last decade has increased substantially, and nomenclature is nonstandardized, heterogenous, and confusing. We provide in this viewpoint article consensus guidelines for naming of companion animal hereditary retinal diseases, either prospectively or retrospectively. These consensus guidelines have been developed with the purpose of standardizing nomenclature. We provide examples for the iterative nomenclature process and a comprehensive File S1 on proposed renaming of previously described diseases.
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  • 文章类型: Journal Article
    Hereditary Polyposis Syndromes are a group of rare, inherited syndromes characterized by the presence of histopathologically specific or numerous intestinal polyps and an increased risk of cancer. Some polyposis syndromes have been known for decades, but the development in genetic technologies has allowed the identification of new syndromes.. The diagnosis entails surveillance from an early age, but universal guideline on how to manage and surveille these new syndromes are lacking. This paper represents a condensed version of the recent guideline (2020) from a working group appointed by the Danish Society of Medical Genetics and the Danish Society of Surgery on recommendations for the surveillance of patients with hereditary polyposis syndromes, including rare polyposis syndromes.
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  • 文章类型: Journal Article
    DICER1综合征是一种罕见的遗传性疾病,易患多种肿瘤。开发这种综合征的监测方案具有挑战性,因为监测的临床疗效存在不确定性,对潜在利益和危害的评估各不相同。此外,越来越多的证据表明,种系DICER1致病变异与癌症外显率比以前假设的低相关.为了解决这些问题,并在欧洲协调DICER1综合征监测计划,国际儿科肿瘤学会(SIOPEHGWG)欧洲分会宿主基因组工作组和英国CanGene-CanVar项目临床指南工作组审查了当前的监测策略,并评估了其他相关文献.就一种新的监测方案和信息手册达成共识,告知患者DICER1相关肿瘤的潜在症状。监视协议包括考虑的最小程序和扩展版本。最低计划的主要建议是:从出生到20岁的年度临床检查,从出生到6岁,6个月的胸部X光和肾脏超声检查,和甲状腺超声每3年从8岁到40岁。考虑的监视程序包括其他监视程序,以及对DICER1致病变异携带者年龄以外的监测间隔的建议。必须支持患者选择最能满足其需求的监测计划。为了扩大DICER1监测方案的证据基础,需要对拟议监测建议的疗效和患者观点进行前瞻性评估。
    DICER1 syndrome is a rare genetic disorder that predisposes to a wide spectrum of tumors. Developing surveillance protocols for this syndrome is challenging because uncertainty exists about the clinical efficacy of surveillance, and appraisal of potential benefits and harms vary. In addition, there is increasing evidence that germline DICER1 pathogenic variants are associated with lower penetrance for cancer than previously assumed. To address these issues and to harmonize DICER1 syndrome surveillance programs within Europe, the Host Genome Working Group of the European branch of the International Society of Pediatric Oncology (SIOPE HGWG) and Clinical Guideline Working Group of the CanGene-CanVar project in the United Kingdom reviewed current surveillance strategies and evaluated additional relevant literature. Consensus was achieved for a new surveillance protocol and information leaflet that informs patients about potential symptoms of DICER1-associated tumors. The surveillance protocol comprises a minimum program and an extended version for consideration. The key recommendations of the minimum program are: annual clinical examination from birth to age 20 years, six-monthly chest X-ray and renal ultrasound from birth to age 6 years, and thyroid ultrasound every 3 years from age 8 to age 40 years. The surveillance program for consideration comprises additional surveillance procedures, and recommendations for DICER1 pathogenic variant carriers outside the ages of the surveillance interval. Patients have to be supported in choosing the surveillance program that best meets their needs. Prospective evaluation of the efficacy and patient perspectives of proposed surveillance recommendations is required to expand the evidence base for DICER1 surveillance protocols.
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  • 文章类型: Journal Article
    Acute treatment of hereditary angioedema due to C1 inhibitor deficiency has become available in the last 10 years and has greatly improved patients\' quality of life. Two plasma-derived C1 inhibitors (Berinert and Cinryze), a recombinant C1 inhibitor (Ruconest/Conestat alpha), a kallikrein inhibitor (Ecallantide), and a bradykinin B2 receptor inhibitor (Icatibant) are all effective. Durably good response is maintained over repeated treatments and several years. All currently available prophylactic agents are associated with breakthrough attacks, therefore an acute treatment plan is essential for every patient. Experience has shown that higher doses of C1 inhibitor than previously recommended may be desirable, although only recombinant C1 inhibitor has been subject to full dose-response evaluation. Treatment of early symptoms of an attack, with any licensed therapy, results in milder symptoms, more rapid resolution and shorter duration of attack, compared with later treatment. All therapies have been shown to be well-tolerated, with low risk of serious adverse events. Plasma-derived C1 inhibitors have a reassuring safety record regarding lack of transmission of virus or other infection. Thrombosis has been reported in association with plasma-derived C1 inhibitor in some case series. Ruconest was associated with anaphylaxis in a single rabbit-allergic volunteer, but no further anaphylaxis has been reported in those not allergic to rabbits despite, in a few cases, prior IgE sensitization to rabbit or milk protein. Icatibant is associated with high incidence of local reactions but not with systemic effects. Ecallantide may cause anaphylactoid reactions and is given under supervision. For children and pregnant women, plasma-derived C1 inhibitor has the best evidence of safety and currently remains first-line treatment.
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