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O Atlas Brasileiro Online de Doenças Raras é um serviço da Rede Nacional de Doenças Raras. Ele foi criado para disseminar informações sobre epidemiologia, quadro clínico, recursos diagnósticos e terapêuticos usados, e custos relacionados a doenças raras de origem genética e não genética no Brasil.
As doenças raras podem ser definidas como aquelas que afetam até 65 pessoas em cada 100 mil, ou seja, 1,3 pessoas para cada 2.000 indivíduos. No Brasil, estima-se que cerca de treze milhões de pessoas possuem alguma doença rara.
Após coletar, armazenar, processar e analisar os dados provenientes do projeto Rede Nacional de Doenças Raras, produzimos e publicamos estudos científicos para revistas e conferências científicas nacionais e internacionais.
Portanto, bem-vindo(a) a nossa lista de publicações. Essas publicações científicas representam um esforço contínuo para o entendimento e a explicação de fenômenos na área das doenças raras.
Esses esforços visam fornecer subsídios úteis e relevantes para a tomada de decisão baseadas em evidências no campo das doenças raras. Corroborando assim para o cumprimento dos objetivos gerais e específicos deste projeto.
Karina Montemor Klegen de Oliveira, Luiza de Oliveira Simões, Ana Mondadori dos Santos, Carlos Eduardo Steiner
Introduction: Williams-Beuren syndrome is a contiguous gene syndrome caused by microdeletion of the locus 7q11.23. It is a clinically recognizable condition whose cardinal features include growth deficiency, variable degrees of neurodevelopmental disorders, congenital cardiac defects, outgoing personality, and typical facies. Case Series Presentation: This retrospective study analyzed 38 consecutive patients in a single center for rare diseases, diagnosed by Preus criteria modified by the Sugayama scoring system, comprising 17 male and 21 female individuals aged 1 month to 55 years. Cases were divided into two groups concerning (a) exclusive clinical diagnosis or (b) clinical diagnosis followed by a laboratory cytogenetic or cytogenomic test; except for hypertension, no significant difference was seen among both groups. The most frequent findings were intellectual deficiency, developmental delay, typical facies, and overfriendliness, all above 80% of the total sample. On the other hand, supravalvar aortic stenosis was found in only 32.4%, while other congenital heart diseases were seen in 56.7% of the sample. Unusual features included one individual with 13 pairs of ribs, another with unilateral microphthalmia, and three with unilateral renal agenesis. Comorbidities comprised 9 cases of hypothyroidism and 1 case each of precocious puberty, segmental vitiligo, type 1 diabetes mellitus, and congenital adrenal hyperplasia. Conclusion: Preus criteria modified by the Sugayama scoring system are still efficient and helpful for clinical diagnosis. This is the second report on microphthalmia and the first study describing the association between vitiligo, type 1 diabetes mellitus, and congenital adrenal hyperplasia in individuals with Williams-Beuren syndrome.
Lorea CF, Oliveira BM, Fighera GZ, Milke JC , Broch MS, Viegas I, Melo BA, Dos Santos ML, Félix TM , RARAS Network Group
INTRODUCTION: Urea cycle disorders (UCDs) represent a group of rare diseases (RDs) characterized by impaired ammonia detoxification, leading to significant challenges in diagnosis and management. The Brazilian Rare Diseases Network (RARAS) aims to conduct an epidemiological surveillance of RD in 40 health centers from all regions of the country. OBJECTIVE: Present the epidemiological profile of UCDs cases in RARAS Network. MATERIALS AND METHODS: Data from patients with suspected and confirmed UCD diagnoses were extracted from RARAS REDCap database, from retrospective (2018-2019) and prospective (2022-2023) approaches. RESULTS: Fourteen individuals were identified with a UCD diagnosis of almost 20 thousand cases registered in the RARAS database. One case had suspected diagnosis (waiting for confirmatory tests), two were diagnosed through neonatal screening and 11 were diagnosed postnatally. The most prevalent disorders were Argininemia (n=4), Ornithine transcarbamylase deficiency (n=3), and Citrullinemia type I (n=3). Diagnoses were either biochemical (69.2%) or molecular (30.8%). Unified Health System (SUS) funded 69.2% of diagnoses. The interval until diagnosis ranged from 36 days to 27 years and 4 months (median of 3 years and 3 months). Also, 78.5% patients reported receiving treatment, of which 64.2% relied on private sources. The most consulted medical specialties were neurology or pediatric neurology (77.7%), followed by gastroenterology and hepatology (44.4%). The most common signs and symptoms, registered through the Human Phenotype Ontology, were hyperammonemia (n=5); jaundice; vomiting; seizure and intellectual disability (n=3). Nine patients (64.3%) registered hospitalizations (mean: 2.22 per patient), mainly due to UCD (ICD-10 E72.2). No death was reported in the studied period. CONCLUSION: Currently, in Brazil, the Neonatal Screening Program does not encompass tests for UCDs; nevertheless, a few states have implemented expanded neonatal screening. The two cases in this study were born in these locations. This study highlights the need to support UCD diagnosis through neonatal screening as early diagnosis is essential to therapeutic interventions and patient outcomes improvements. These results show the importance of public policies with SUS as the main funding source for diagnosis and management of UCDs patients.
Doenças Metabólicas Hereditárias:Sinais de Alerta e Conduta
MARIA TERESINHA DE OLIVEIRA CARDOSO
GUIA PARA DIAGNOSTRICO E TRATAMENTO DE ERROS INATOS DO METABOLISMO NO CAPITULO 7.1 DA SEÇAO 15 DE GENETICA CLÍNICA DE TRATADO DE PEDIATRIA DA SOCIEDADE BRASILEIRA DE PEDIATRIA VOLUME 1 3ª EDIÇAO EDIT.MANOLE
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Ministério da Saúde do Brasil
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