ROHHAD(NET) Syndrome: Systematic Review of the Clinical Timeline and Recommendations for Diagnosis and Prognosis
| Autor: | Marie-Christine Lebrethon, Marie-Christine Seghaye, Bours, Julie Harvengt, Meriem Mastouri, Gernay C, Nesrine Farhat |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Pediatrics Endocrinology Diabetes and Metabolism Clinical Biochemistry Adrenal Gland Neoplasms Context (language use) Disease Biochemistry Endocrinology Internal medicine medicine ROHHAD Autonomic dysregulation Humans Obesity Intensive care medicine Clinical pathology business.industry Biochemistry (medical) Ganglioneuroblastoma Dysautonomia Timeline Ganglioneuroma Hypoventilation Syndrome medicine.disease Prognosis Systematic review Autonomic Nervous System Diseases medicine.symptom business Hypothalamic Diseases |
| Zdroj: | The Journal of clinical endocrinology and metabolism. 105(7) |
| ISSN: | 1945-7197 |
| Popis: | Context Rapid-onset obesity with hypothalamic dysfunction, hypoventilation, autonomic dysregulation and neural crest tumor (ROHHHAD[NET]) is a rare and potentially fatal disease. No specific diagnostic biomarker is currently available, making prompt diagnosis challenging. Since its first definition in 2007, a complete clinical analysis leading to specific diagnosis and follow-up recommendations is still missing. Objective The purpose of this work is to describe the clinical timeline of symptoms of ROHHAD(NET) and propose recommendations for diagnosis and follow-up. Design We conducted a systematic review of all ROHHAD(NET) case studies and report a new ROHHAD patient with early diagnosis and multidisciplinary care. Methods All the articles that meet the definition of ROHHAD(NET) and provide chronological clinical data were reviewed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis individual patient data guidelines. The data were grouped into 7 categories: hypothalamic dysfunction, autonomic dysregulation, hypoventilation, NET, psychiatric symptoms, other clinical manifestations, and outcome. Results Forty-three individual patient data descriptions were analyzed. The timeline of the disease shows rapid-onset obesity followed shortly by hypothalamic dysfunction. Dysautonomia was reported at a median age of 4.95 years and hypoventilation at 5.33 years, or 2.2 years after the initial obesity. A NET was reported in 56% of the patients, and 70% of these tumors were diagnosed within 2 years after initial weight gain. Conclusion Because early diagnosis improves the clinical management and the prognosis in ROHHAD(NET), this diagnosis should be considered for any child with rapid and early obesity. We propose guidance for systematic follow-up and advise multidisciplinary management with the aim of improving prognosis and life expectancy. |
| Databáze: | OpenAIRE |
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