Consensus guidelines on managing Rett syndrome across the lifespan

被引:59
|
作者
Fu, Cary [1 ]
Armstrong, Dallas [2 ,3 ]
Marsh, Eric [2 ,3 ]
Lieberman, David [4 ]
Motil, Kathleen [5 ,6 ]
Witt, Rochelle [4 ]
Standridge, Shannon [7 ,8 ]
Nues, Paige [9 ]
Lane, Jane [10 ]
Dinkel, Tristen [11 ]
Coenraads, Monica [12 ]
von Hehn, Jana [12 ]
Jones, Mary [13 ]
Hale, Katie [13 ]
Suter, Bernhard [14 ,15 ]
Glaze, Daniel [14 ,15 ]
Neul, Jeffrey [16 ,17 ]
Percy, Alan [18 ]
Benke, Timothy [11 ,19 ]
机构
[1] Vanderbilt Univ Sch Med, Pediat & Neurol, Nashville, TN USA
[2] Childrens Hosp Philadelphia, Neurol, Philadelphia, PA 19104 USA
[3] Univ Penn, Perelman Sch Med, Neurol, Philadelphia, PA 19104 USA
[4] Boston Childrens Hosp, Neurol, Boston, MA USA
[5] Baylor Coll Med, Pediat, Houston, TX 77030 USA
[6] USDA ARS, Childrens Nutr Res Ctr, Houston, TX USA
[7] Univ Cincinnati, Coll Med, Pediat, Cincinnati, OH USA
[8] Cincinnati Childrens Hosp Med Ctr, Neurol, Cincinnati, OH 45229 USA
[9] Int Rett Syndrome Fdn, Cincinnati, OH USA
[10] Univ Alabama Birmingham, Med Sch Birmingham, Civitan Int Res Ctr, Birmingham, AL USA
[11] Childrens Hosp Colorado, Neurol, Aurora, CO USA
[12] Rett Syndrome Res Trust, New York, NY USA
[13] UCSF Benioff Childrens Hosp Oakland, Pediat Med, Oakland, CA USA
[14] Baylor Coll Med, Pediat & Neurol, Houston, TX 77030 USA
[15] Texas Childrens Hosp, Neurol, Houston, TX 77030 USA
[16] Vanderbilt Kennedy Ctr, Nashville, TN USA
[17] Vanderbilt Univ Sch Med, Pediat Pharmacol & Special Educ, Nashville, TN USA
[18] Univ Alabama Birmingham, Med Sch Birmingham, Pediat Neurol Neurobiol Genet & Psychol, Birmingham, AL USA
[19] Univ Colorado, Denver Sch Med, Pharmacol, Neurol,Otolaryngol,Pediat, Aurora, CO USA
关键词
neurology; genetics; syndrome; rehabilitation; gastroenterology; QUALITY-OF-LIFE; MECP2; MUTATION; CLINICAL SEVERITY; DISEASE SEVERITY; GIRLS; SCOLIOSIS; CHILDREN; MANAGEMENT; PHENOTYPE; WOMEN;
D O I
10.1136/bmjpo-2020-000717
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
BackgroundRett syndrome (RTT) is a severe neurodevelopmental disorder with complex medical comorbidities extending beyond the nervous system requiring the attention of health professionals. There is no peer-reviewed, consensus-based therapeutic guidance to care in RTT. The objective was to provide consensus on guidance of best practice for addressing these concerns.MethodsInformed by the literature and using a modified Delphi approach, a consensus process was used to develop guidance for care in RTT by health professionals.ResultsTypical RTT presents early in childhood in a clinically recognisable fashion. Multisystem comorbidities evolve throughout the lifespan requiring coordination of care between primary care and often multiple subspecialty providers. To assist health professionals and families in seeking best practice, a checklist and detailed references for guidance were developed by consensus.ConclusionsThe overall multisystem issues of RTT require primary care providers and other health professionals to manage complex medical comorbidities within the context of the whole individual and family. Given the median life expectancy well into the sixth decade, guidance is provided to health professionals to achieve current best possible outcomes for these special-needs individuals.
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页数:14
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