Hurler sendromu için kemik ilişi transplantasyonu sürecinde patent duktus arteriozus ve pulmoner hipertansiyon

Hurler syndrome (MPS I-H), which is caused by a deficiency in L-iduronidase enzyme, is a rarely seen autosomal recessive disease. Children with Hurler syndrome appear nearly normal at birth but, left untreated, show a progressive mental and physical deterioration caused by a build up of glycosaminoglycans (GAGs) in all organs of the body. Death is often caused by cardiac or respiratory failure and usually occurs before the second decade of life. In recent years, bone marrow transplantation (BMT) and enzyme replacement therapy have been employed in the management of patients with Hurler syndrome. Here we report a 2 year old girl with Hurler syndrome and severe dilated cardiomyopathy, who underwent BMT at 20 months of age from her HLA 6/6 identical paternal aunt. Patent ductus arteriosus (PDA) and worsening of pulmonary hypertension was detected during the course of BMT for Hurler syndrome.

Patent ductus arteriosus and pulmonary hypertension during the course of bone marrow transplantation for hurler syndrome

Hurler syndrome (MPS I-H), which is caused by a deficiency in L-iduronidase enzyme, is a rarely seen autosomal recessive disease. Children with Hurler syndrome appear nearly normal at birth but, left untreated, show a progressive mental and physical deterioration caused by a build up of glycosaminoglycans (GAGs) in all organs of the body. Death is often caused by cardiac or respiratory failure and usually occurs before the second decade of life. In recent years, bone marrow transplantation (BMT) and enzyme replacement therapy have been employed in the management of patients with Hurler syndrome. Here we report a 2 year old girl with Hurler syndrome and severe dilated cardiomyopathy, who underwent BMT at 20 months of age from her HLA 6/6 identical paternal aunt. Patent ductus arteriosus (PDA) and worsening of pulmonary hypertension was detected during the course of BMT for Hurler syndrome.

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  • 1. Neufeld EF, Muenzer J. The Mucopolysaccharidoses. The Metabolic and Molecular Bases of inherited Disease 2001; 8th edition: 3421-52.
  • 2. Stone JE. Urine analysis in the diagnosis of mucopolysaccharide disorders. Ann Clin Biochem 1998;35: 207-25.
  • 3. Kliegman R, Muenzer J. Mucopolysaccharidoses. Richard E. Behrman, Robert M. Kliegman, Hal B. Jenson, Nelson Textbook of Pediatrics, 17th Edition, Philedelphia: Saunders 2004: 482-86
  • 4. Muenzer J, Fisher A. Advances in the treatment of mucopolysaccharidoses type 1. N Engl J Med 2004;350: 1932-4.
  • 5. Krivit W, Peterss C, Shapiro E. Bone marrow transplantation as effective treatment of central nervous system disease in globoid cell leukodystrophy, metachromatic leukodystrophy, adrenoleukodystrophy, mannosidoses, fucosidoses, aspartylglucosaminuria, Hurler, Maroteaux- Lamy, and Sly syndromes, and Gaucher disease type III. Curr Opin Neurol 1999;12: 167-76.
  • 6. Koc ON, Day J, Nieder M, Gerson SL, Lazarus HM, Krivit W. Allogeneic mesenchymal stem cell infusion for treatment of metachromatic leukodystrophy (MLD) and Hurler syndrome (MPS-IH). Bone Marrow Transplant 2002;30: 215-22.
  • 7. Ma X, Liu Y, Tittiger M, Hennig A, Kovacs A, Popelka S, et al. Improvements in Mucopolysaccharidoses I Mice After Adult Retroviral Vector-mediated Gene Therapy with immunomodulation. Mol Ther 2007;15: 889-902.
  • 8. Chan D, Lia M, Yam MC, Lic K, Fok TF. Hurler syndrome with cor pulmonale secondary to obstructive sleep apnea treated by continuous positive airway pressure Journal of Paediatrics and Child Health 2003;39: 558-9.
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  • ISSN: 1300-2317
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 2018
  • Yayıncı: -
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