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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.
Oliveira BM, Baiochi JF, Milke JC, Lorea CF, Viegas I, Bernardi FA, Alves D, Schwartz IVD, Félix TM, RARAS Network Group
BACKGROUND: Inborn errors of metabolism (IEM) present significant challenges in diagnosis and management. The Brazilian Rare Diseases Network (BRDN) is a consortium of 40 healthcare centers from all five regions of Brazil established in 2020, designed to perform an epidemiological survey on rare diseases (RD). This study aims to present comprehensive data on patients with IEM assisted in the centers of BRDN, including their clinical profiles, diagnosis, and treatments applied. METHODS: We conducted a comprehensive review of all cases with confirmed or suspected IEM in BRDN. Selection criteria were established using the Rare IEM classification from Orphadata (v. Dec 4, 2023, https: //www.orphadata.com/classifications/), incorporating ICD-10, OMIM, and Orpha diagnostic codes. A retrospective (2018-2019) and prospective (2022-2024) data collection was conducted using a RedCap standard form. RESULTS: Of 19,307 total records at BRDN, 2,667 (13.8%) IEM cases were registered (retrospective phase: 1,798/12,285; prospective phase: 870/7022). Most participants (32.4%) lived in the Southeast region of Brazil. The mean age at inclusion was 18.0 years (±15.5), and 1,402 (52.6%) were female. Diagnosis of IEM was confirmed in 88.3% and suspected in 11.7%. For RD coding, Orpha was mostly (71.4%) used. The most frequent diagnoses were Phenylketonuria (PKU, n=762), Mucopolysaccharidosis (MPS) type 2 (n=102), Fabry disease (n=95), MPS type 6 (n=89) and Gaucher disease (n=86). Biochemical diagnosis was performed in 66.6% of cases, molecular diagnosis was conducted in 25.7%, and the remaining cases were categorized as Others. Only 26.2% were diagnosed through newborn screening. The most recorded Human Phenotype Ontology were: Reduced phenylalanine hydroxylase level, Seizure, and Hyperphenylalaninemia. Positive family history was registered in 27.1% and 16.5% reported consanguinity. In the retrospective phase, specific treatment for IEM was reported in 71.6% of cases. Within the overall cohort, 41.2% received diet therapy. Previous hospitalizations were documented in 88.3%. The mortality rate was 1.8% during the retrospective phase. CONCLUSIONS: This study shows the first Brazilian nationwide data on IEM, demonstrating the importance of networking between specialized RD centers. PKU is included in the Brazilian Newborn Screening Program, leading to higher diagnostic prevalence. This data may contribute to improving the assistance of IEM in Brazil.
Criança com Defeito Congênito
maria teresinha de oliveira cardoso, MARA SANTOS CORDOBA
CAPITULO 1 DA SEÇÃO 15 DE GENETICA CLINICA DO TRATADO DE PEDIATRIA/SOCIEDADE BRASILEIRA DE PEDIATTRIA ,; VOL 1, 3ª EDIÇÃO .EDITORA MANOLE,2014 caracterizando os principais defeitos congenitos ;uma orientação para o exame fisico dismorfologico nda criança
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.
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