A Case Report of a Japanese Boy with Morquio A Syndrome: Effects of Enzyme Replacement Therapy Initiated at the Age of 24 Months.

Morquio A syndrome elosulfase alfa enzyme replacement therapy growth mucopolysaccharidosis type IVA spinal decompression surgery

Journal

International journal of molecular sciences
ISSN: 1422-0067
Titre abrégé: Int J Mol Sci
Pays: Switzerland
ID NLM: 101092791

Informations de publication

Date de publication:
02 Feb 2020
Historique:
received: 29 12 2019
revised: 26 01 2020
accepted: 27 01 2020
entrez: 7 2 2020
pubmed: 7 2 2020
medline: 18 11 2020
Statut: epublish

Résumé

Morquio A syndrome, mucopolysaccharidosis type IVA (MPS IVA), is a lysosomal storage disorder caused by the deficient activity of N-acetylgalactosamine-6-sulfatase (GalNac6S), due to alterations in the the patient presented for kyphosis treatment at 22 months of age. An X-ray examination revealed dysostosis multiplex. Uronic acids were elevated in the urine and the keratan sulfate (KS) fraction was predominant. The leukocyte GalNac6S enzyme activity was extremely low. The patient exhibited the c.463G > A (p.Gly155Arg) mutation in early initiation of the elosulfase alfa to our patient showed good effects on the visceral system and muscle strength, while its effect on bones appeared limited. Careful observation is necessary to ensure timely surgical intervention for skeletal disorders associated with neurological symptoms. Centralized and multidisciplinary management is essential to improve the prognosis of pediatric patients with MPS IVA.

Sections du résumé

BACKGROUND BACKGROUND
Morquio A syndrome, mucopolysaccharidosis type IVA (MPS IVA), is a lysosomal storage disorder caused by the deficient activity of N-acetylgalactosamine-6-sulfatase (GalNac6S), due to alterations in the
PATIENT METHODS
the patient presented for kyphosis treatment at 22 months of age. An X-ray examination revealed dysostosis multiplex. Uronic acids were elevated in the urine and the keratan sulfate (KS) fraction was predominant. The leukocyte GalNac6S enzyme activity was extremely low. The patient exhibited the c.463G > A (p.Gly155Arg) mutation in
CONCLUSION CONCLUSIONS
early initiation of the elosulfase alfa to our patient showed good effects on the visceral system and muscle strength, while its effect on bones appeared limited. Careful observation is necessary to ensure timely surgical intervention for skeletal disorders associated with neurological symptoms. Centralized and multidisciplinary management is essential to improve the prognosis of pediatric patients with MPS IVA.

Identifiants

pubmed: 32024277
pii: ijms21030989
doi: 10.3390/ijms21030989
pmc: PMC7037301
pii:
doi:

Substances chimiques

Chondroitinsulfatases EC 3.1.6.-
GALNS protein, human EC 3.1.6.4

Types de publication

Case Reports

Langues

eng

Sous-ensembles de citation

IM

Déclaration de conflit d'intérêts

We declare no conflict of interest. Any role of the funding sponsors in the choice of research project, design of the study, in the collection, analyses or interpretation of data.

Références

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Auteurs

Akari Nakamura-Utsunomiya (A)

Department of Pediatrics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima 7348511, Japan.

Toshio Nakamae (T)

Department of Orthopeadic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 7348551, Japan.

Reiko Kagawa (R)

Department of Pediatrics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima 7348511, Japan.

Shuhei Karakawa (S)

Department of Pediatrics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima 7348511, Japan.

Sonoko Sakata (S)

Department of Pediatrics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima 7348511, Japan.

Fumiaki Sakura (F)

Department of Pediatrics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima 7348511, Japan.

Chihiro Tani (C)

Department of Diagnostic Radiology, Hiroshima University Hospital, Hiroshima 7348551, Japan.
Department of Diagnostic Radiology, Hiroshima Citizen's Hospital, Hiroshima 7308518, Japan.

Yoshiko Matsubara (Y)

Department of Diagnostic Radiology, Hiroshima University Hospital, Hiroshima 7348551, Japan.

Takashi Ishino (T)

Department of Otolaryngology, Hiroshima University Hospital, Hiroshima 7348551, Japan.

Go Tajima (G)

Department of Pediatrics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima 7348511, Japan.
Division of Neonatal Screening, Research Institute, National Center for Child Health and Development, Tokyo 1578535, Japan.

Satoshi Okada (S)

Department of Pediatrics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima 7348511, Japan.

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