Echocardiographic findings in pediatric patients with Mucopolysaccharidosis IV-A with mutation c.901G>T in the GALNS gene in a fourth level health center in Colombia between 2012-2019
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Keywords

Mucopolysaccharidosis IV
Lysosomal Storage Diseases
Heart disease
Echocardiography

How to Cite

Romo-Erazo, L., Pérez-Restrepo, R., Orozco-Hernández, J. P., Estrada-Álvarez, J. M., & Porras-Hurtado, G. L. (2022). Echocardiographic findings in pediatric patients with Mucopolysaccharidosis IV-A with mutation c.901G>T in the GALNS gene in a fourth level health center in Colombia between 2012-2019. Médicas UIS, 35(3), 19–25. https://doi.org/10.18273/revmed.v35n3-2022002

Abstract

Mucopolysaccharidosis IV-A is a rare lysosomal storage disorder, whose most evident clinical manifestation is multiple dysostosis. Multiorgan disorders have been described in this type of patients, however, the Cardiovascular manifestations have not been described with greater emphasis. The main objective of this research was to describe the echocardiogra- phic findings in pediatric patients with type IV-A mucopolysaccharidosis with c.901G>T mutation in the GALNS gene. A descriptive case series study was carried out, which included patients with a confirmed diagnosis (clinical, biochemical and molecular) of mucopolysaccharidosis type IV-A; the patients were attended a hospital institution in Pereira, Colombia, between 2012 and 2019, where echocardiographic parameters were evaluated. Ten patients with ages ranging from 3 to 18 years, average 10, were included. The cardiac abnormalities identified were trivial mitral regurgitation in 4 of 10 patients, aortic annulus dilation in 9 of 10, dilatation of the ascending aorta, dilatation of the transverse arch and aortic isthmus in 1 of 10, slightly thickened subaortic area without stenosis and mild concentric left ventricular hypertrophy in 1 of 10 patients. Ventricular function was normal in all patients. The most frequent echocardiographic findings were dilatation of the aortic annulus and trivial regurgitation of the mitral valve, additionally, thickened mitral and aortic valves and left ventricular hypertrophy may be found, so periodic evaluation by pediatric cardiology is important.

https://doi.org/10.18273/revmed.v35n3-2022002
PDF (Español (España))

References

Malm G, Lund AM, Månsson JE, Heiberg A. Mucopolysaccharidoses in the Scandinavian countries: incidence and prevalence. Acta Paediatr. 2008;97(11):1577–1581.

Nelson J. Incidence of the mucopolysaccharidoses in Northern Ireland. Hum Genet. 1997;101(3):355–358.

Gómez AM, García-Robles R, Suárez-Obando FJB. Estimación de las frecuencias de las mucopolisacaridosis y análisis de agrupamiento espacial en los departamentos de Cundinamarca y Boyacá. Biomedica. 2012;32(4):602–609.

Boffi L, Russo P, Limongelli G. Early diagnosis and management of cardiac manifestations in mucopolysaccharidoses: a practical guide for paediatric and adult cardiologists. Ital J Pediatr. 2018;44(S2):122.

Kato Z, Fukuda S, Tomatsu S, Vega H, Yasunaga T, Yamagishi A. A novel common missense mutation G301C in the N-acetylgalactosamine-6- sulfate sulfatase gene in mucopolysaccharidosis IVA. Hum Genet. 1997;101(1):97–101.

John RM, Hunter D, Swanton RH. Echocardiographic abnormalities in type Iv mucopolysaccharidosis. Arch Dis Child. 1990;65(7):746–749.

Kampmann C, Abu-Tair T, Gökce S, Lampe C, Reinke J, Mengel E, et al. Heart and Cardiovascular Involvement in Patients with Mucopolysaccharidosis Type IVA (Morquio-A Syndrome). PLOS ONE. 2016;11(9):e0162612.

Braunlin EA, Harmatz PR, Scarpa M, Furlanetto B, Kampmann C, Loehr JP, et al. Cardiac disease in patients with mucopolysaccharidosis: presentation, diagnosis and management. J Inherit Metab Dis. 2011;34(6):1183–1197.

Ireland MA, Rowlands DB. Mucopolysaccharidosis type IV as a cause of mitral stenosis in an adult. Br Heart J. 1981;46(1):113.

Barry MO, Beardslee MA, Braverman AC. Morquio’s syndrome: severe aortic regurgitation and late pulmonary autograft failure. J Heart Valve Dis. 2006;15(6):839–842.

Lin HY, Chen MR, Lin SM, Hung CL, Niu DM, Chuang CK, et al. Cardiac features and effects of enzyme replacement therapy in Taiwanese patients with Mucopolysaccharidosis IVA. Orphanet J Rare Dis. 2018;13(1):148.

Hendriksz CJ, Berger KI, Giugliani R, Harmatz P, Kampmann C, Mackenzie WG, et al. International guidelines for the management and treatment of Morquio A syndrome. Am J Med Genet A. 2015;167(1):11–25.

Tomatsu S, Montano AM, Oikawa H, Smith M, Barrera L, Chinen Y, et al. Mucopolysaccharidosis type IVA (Morquio A disease): clinical review and current treatment. Curr Pharm Biotechnol. 2011;12(6):931–945.

Agarwal N, Taneja S. Acquired heart disease in children is not necessarily rheumatic. Trop Doct. 2019;49(3):181–184.

Tapiero-Rodríguez SM, Acosta Guio JC, Porras-Hurtado GL, García N, Solano M, Pachajoa H, et al. Determination of genotypic and clinical characteristics of Colombian patients with mucopolysaccharidosis IVA. Appl Clin Genet. 2018;11:45–57.

Pettersen MD, Du W, Skeens ME, Humes RA. Regression equations for calculation of z scores of cardiac structures in a large cohort of healthy infants, children, and adolescents: an echocardiographic study. J Am Soc Echocardiogr. 2008;21(8):922–934.

Faisal W, Tang HM, Tiley S, Kukard C. Not all body surface area formulas are the same, but does it matter?. J Glob Oncol. 2016;2(6):436.

StataCorp.Stata Statistial Software:Release 14.College Station,TX: StatCorp LP. 2015.

Leong HY, Abdul Azize NA, Chew HB, Keng WT, Thong MK, Mohd Khalid MKN, et al. Clinical, biochemical and genetic profiles of patients with mucopolysaccharidosis type IVA (Morquio A syndrome) in Malaysia: the first national natural history cohort study. Orphanet J Rare Dis. 2019;14(1):143.

Alizad A, Seward JB. Echocardiographic features of genetic diseases: part 4. Connective tissue. J Am Soc Echocardiogr.2000;13(4):325–330.

Nakanishi K, Kawasaki S, Amano A.Ventricular septal defect closure in a patient with achondroplasia. Cardiol Young.2017;27(1):184–185.

Hoover‐Fong J, Alade AY, Ain M, Berkowitz I, Bober M, Carter E, et al. Blood pressure in adults with short stature skeletal dysplasias.Am J Med Genet A.2020;182(1):150–161.

Akyol MU, Alden TD, Amartino H, Ashworth J, Belani K, Berger KI, et al.Recommendations for the management of MPS IVA: systematic evidence- and consensus-based guidance.Orphanet J Rare Dis. 2019;14:1-25.

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