4 research outputs found
Review of Clinical Recommendations for Kawasaki Disease/Syndrome
The article presents the detailed key provisions of the clinical recommendations on providing medical care to children with Kawasaki syndrome/illness, developed by the professional association of pediatric specialists β the Union of Pediatricians of Russia. The current data on the prevalence of pathology is presented, the characteristic diagnostic signs of the disease are given that allow to make a diagnosis as soon as possible and immediately appoint a specific treatment. Therapeutic measures carried out in the required volume determine the further prognosis. The comprehensive approach to the management of pediatric patients with this nosology presented in the article will ensure a high level of medical care quality provided to children with Kawasaki syndrome
ΠΠ±Π·ΠΎΡ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°ΡΠΈΠΉ ΠΏΠΎ Π±ΠΎΠ»Π΅Π·Π½ΠΈ/ΡΠΈΠ½Π΄ΡΠΎΠΌΡ ΠΠ°Π²Π°ΡΠ°ΠΊΠΈ
The article presents the detailed key provisions of the clinical recommendations on providing medical care to children with Kawasaki syndrome/illness, developed by the professional association of pediatric specialists β the Union of Pediatricians of Russia. The current data on the prevalence of pathology is presented, the characteristic diagnostic signs of the disease are given that allow to make a diagnosis as soon as possible and immediately appoint a specific treatment. Therapeutic measures carried out in the required volume determine the further prognosis. The comprehensive approach to the management of pediatric patients with this nosology presented in the article will ensure a high level of medical care quality provided to children with Kawasaki syndrome.Π ΡΡΠ°ΡΡΠ΅ ΠΏΠΎΠ΄ΡΠΎΠ±Π½ΠΎ ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½Ρ ΠΊΠ»ΡΡΠ΅Π²ΡΠ΅ ΠΏΠΎΠ»ΠΎΠΆΠ΅Π½ΠΈΡ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°ΡΠΈΠΉ ΠΏΠΎ ΠΎΠΊΠ°Π·Π°Π½ΠΈΡ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΎΠΉ ΠΏΠΎΠΌΠΎΡΠΈ Π΄Π΅ΡΡΠΌ Ρ ΡΠΈΠ½Π΄ΡΠΎΠΌΠΎΠΌ/Π±ΠΎΠ»Π΅Π·Π½ΡΡ ΠΠ°Π²Π°ΡΠ°ΠΊΠΈ, ΡΠ°Π·ΡΠ°Π±ΠΎΡΠ°Π½Π½ΡΡ
ΠΏΡΠΎΡΠ΅ΡΡΠΈΠΎΠ½Π°Π»ΡΠ½ΠΎΠΉ Π°ΡΡΠΎΡΠΈΠ°ΡΠΈΠ΅ΠΉ Π΄Π΅ΡΡΠΊΠΈΡ
ΡΠΏΠ΅ΡΠΈΠ°Π»ΠΈΡΡΠΎΠ² β Π‘ΠΎΡΠ·ΠΎΠΌ ΠΏΠ΅Π΄ΠΈΠ°ΡΡΠΎΠ² Π ΠΎΡΡΠΈΠΈ. ΠΠ·Π»ΠΎΠΆΠ΅Π½Ρ ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΡΠ΅ Π΄Π°Π½Π½ΡΠ΅ ΠΎ ΡΠ°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½Π½ΠΎΡΡΠΈ ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΠΈ, ΠΏΡΠΈΠ²Π΅Π΄Π΅Π½Ρ Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠ½ΡΠ΅ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΏΡΠΈΠ·Π½Π°ΠΊΠΈ Π±ΠΎΠ»Π΅Π·Π½ΠΈ, ΠΏΠΎΠ·Π²ΠΎΠ»ΡΡΡΠΈΠ΅ ΠΌΠ°ΠΊΡΠΈΠΌΠ°Π»ΡΠ½ΠΎ ΡΠ²ΠΎΠ΅Π²ΡΠ΅ΠΌΠ΅Π½Π½ΠΎ ΡΡΡΠ°Π½ΠΎΠ²ΠΈΡΡ Π΄ΠΈΠ°Π³Π½ΠΎΠ· ΠΈ Π½Π΅Π·Π°ΠΌΠ΅Π΄Π»ΠΈΡΠ΅Π»ΡΠ½ΠΎ Π½Π°Π·Π½Π°ΡΠΈΡΡ ΡΠΏΠ΅ΡΠΈΡΠΈΡΠ΅ΡΠΊΠΎΠ΅ Π»Π΅ΡΠ΅Π½ΠΈΠ΅. Π’Π΅ΡΠ°ΠΏΠ΅Π²ΡΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΌΠ΅ΡΠΎΠΏΡΠΈΡΡΠΈΡ, ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½Π½ΡΠ΅ Π² Π½Π΅ΠΎΠ±Ρ
ΠΎΠ΄ΠΈΠΌΠΎΠΌ ΠΎΠ±ΡΠ΅ΠΌΠ΅, ΠΎΠΏΡΠ΅Π΄Π΅Π»ΡΡΡ Π΄Π°Π»ΡΠ½Π΅ΠΉΡΠΈΠΉ ΠΏΡΠΎΠ³Π½ΠΎΠ·. ΠΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½Π½ΡΠΉ Π² ΡΡΠ°ΡΡΠ΅ ΠΊΠΎΠΌΠΏΠ»Π΅ΠΊΡΠ½ΡΠΉ ΠΏΠΎΠ΄Ρ
ΠΎΠ΄ ΠΊ Π²Π΅Π΄Π΅Π½ΠΈΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Π΄Π΅ΡΡΠΊΠΎΠ³ΠΎ Π²ΠΎΠ·ΡΠ°ΡΡΠ° Ρ Π΄Π°Π½Π½ΠΎΠΉ Π½ΠΎΠ·ΠΎΠ»ΠΎΠ³ΠΈΠ΅ΠΉ ΠΏΠΎΠ·Π²ΠΎΠ»ΠΈΡ ΠΎΠ±Π΅ΡΠΏΠ΅ΡΠΈΡΡ Π²ΡΡΠΎΠΊΠΈΠΉ ΡΡΠΎΠ²Π΅Π½Ρ ΠΊΠ°ΡΠ΅ΡΡΠ²Π° ΠΎΠΊΠ°Π·ΡΠ²Π°Π΅ΠΌΠΎΠΉ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΎΠΉ ΠΏΠΎΠΌΠΎΡΠΈ Π΄Π΅ΡΡΠΌ Ρ ΡΠΈΠ½Π΄ΡΠΎΠΌΠΎΠΌ ΠΠ°Π²Π°ΡΠ°ΠΊΠΈ
EFFICACY AND SAFETY OF ENZYME REPLACEMENT THERAPY IN CHILDREN WITH MUCOPOLYSACCHARIDOSIS TYPE I, II, AND VI: A SINGLE-CENTER COHORT STUDY
Background. There are limited data on the efficacy of long-term enzyme replacement therapy (ERT) in children with mucopolysaccharidosis (MPS).Objective. Our aim was to study the efficacy and safety of long-term ERT in children with MPS type I, II, and VI.Methods. We analyzed the results of ERT with laronidase, idursulfase, and galsulfase in children with MPS type I, II, and VI admitted to the federal research center from January 2007 to November 2016. The response rate was assessed by the level of normalized urinary excretion of glycosaminoglycans (GAGs) (the ratio of GAGs concentration to urine creatinine) recalculated in percent (%) exceedance of the upper limit of normal for the corresponding age. Data on the administered therapy and its results, including adverse events, is extracted from the medical records of in-patients.Results. The results of treatment (intravenous infusions, intervals between administrations from 4 to 10 days) were studied in 33 children (5 of them were girls) with MPS type I (n = 4; laronidase at a dose of 0.58 mg/kg), II (n = 26; idursulfase at a dose of 0.5 mg/kg), and VI (n = 3; galsulfase at a dose of 1 mg/kg). A decrease in the normalized urinary excretion of GAGs from 376% (172; 791) to 54% (0; 146) exceedance of the upper limit of normal for the age (p < 0.001) was noted in the course of ERT lasting (median) 27 (14; 41) months. A decrease in the normalized GAGs excretion below the upper limit of normal for the age was established in 12/33 (36%) patients. ERT-associated adverse events were identified in 12 patients; one case required a two-fold therapy interruption. The development of nephrotic syndrome in the course of ERT in patients with severe MPS II was first described.Conclusion. Long-term ERT in children with MPS type I, II, and VI is characterized by acceptable efficacy and safety. Key words: children, mucopolysaccharidosis, enzyme replacement therapy, laronidase, idursulfase, galsulfase, glycosaminoglycans