一例脊髓肌肉萎缩症 2 型患儿:基层医疗机构罕见的遗传病

S. M. Abu Hussain, N. A. Shibraumalisi, H. N. Miptah, Anis Safura Ramli
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摘要

脊髓性肌萎缩症(SMA)是一种神经退行性疾病,每 1 万名活产儿中就有 4 人患病。它是一种常染色体隐性遗传病,由位于 5q 染色体的存活运动神经元基因 1 (SMN1) 突变引起。SMA 共有五种类型,从 0 型到 4 型不等。根据类型的不同,SMA 可导致严重残疾和死亡。本病例报告涉及一名六个月大的男婴,他患有粗大运动发育迟缓。该病例在初级保健阶段就被发现,但却错失良机。该婴儿因失去翻身、抬臀和无支撑坐立的能力而由一名私立儿科医生转诊至一家政府医院的儿科门诊。基因检测确诊为 SMA 2 型。对父母和护理人员来说,确诊并照顾 SMA 患儿是一件改变人生的大事。基因疗法的出现可能会改变 SMA 患者的预后和治疗效果,因此如果可以提供基因疗法,就应该提供。本病例强调了患儿疾病对家庭的影响,以及多学科团队方法在管理 SMA 方面的重要性。初级保健医生在开展全面的儿童健康监测以确保早期识别方面发挥着关键作用,并在疾病发展到成年期时为患儿和家长提供全面支持。这包括提供长期的社会心理支持,以改善他们的生活质量。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A Case of Spinal Muscular Atrophy Type 2 in a Child: A Genetic Condition Rarely Detected in Primary Care
Spinal muscular atrophy (SMA) is a neurodegenerative disease affecting 4 out of 10,000 live births. It is an autosomal recessive genetic condition caused by mutations of the survival motor neuron gene 1 (SMN1), located at chromosome 5q. There are five types of SMA, from Type 0 to Type 4. Depending on the types, SMA can cause severe disability and death. This case report presents a case of a six-month old baby boy with gross motor developmental regression. There was a missed opportunity to detect this case in primary care. The baby was referred by a private paediatrician to a government hospital’s outpatient paediatric clinic for losing his ability to roll over, lift his buttocks, and sit without support. Genetic testing confirmed the diagnosis of SMA Type 2. Receiving the diagnosis and caring for a child with SMA is a life-changing event for the parents and caregivers. The availability of gene therapy may change the prognosis and outcome of patients with SMA and should be offered if available. This case highlights the impact of the child’s illness on the family and the importance of a multidisciplinary team approach in managing SMA. Primary care physicians play a key role in conducting thorough child health surveillance to ensure early identification and providing support to the child and the parents holistically as the disease progresses into adulthood. This includes providing long-term psychosocial support to improve their quality of life.
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