108 results on '"Ziagaki A"'
Search Results
2. A retrospective study of morbidity and mortality of chronic acid sphingomyelinase deficiency in Germany
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Eugen Mengel, Nicole Muschol, Natalie Weinhold, Athanasia Ziagaki, Julia Neugebauer, Benno Antoni, Laura Langer, Maja Gasparic, Sophie Guillonneau, Marie Fournier, Fernando Laredo, and Ruth Pulikottil-Jacob
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Acid sphingomyelinase deficiency ,Morbidity ,Mortality ,Overall survival ,Standardised mortality ratio ,Medicine - Abstract
Abstract Background Acid sphingomyelinase deficiency (ASMD) is a rare, progressive, potentially fatal lysosomal storage disease that exhibits a broad spectrum of clinical phenotypes. There is a need to expand the knowledge of disease mortality and morbidity in Germany because of limited information on survival analysis in patients with chronic ASMD (type B or type A/B). Methods This observational, multicentre, retrospective cohort study was conducted using medical records of patients with the first symptom onset/diagnosis of ASMD type B or type A/B between 1st January 1990 and 31st July 2021 from four German medical centres. Eligible medical records were abstracted to collect data on demographic characteristics, medical history, hospitalisation, mortality, and causes of death from disease onset to the last follow-up/death. Survival outcomes were estimated using the Kaplan–Meier analysis. Standardised mortality ratio (SMR) was also explored. Results This study included 33 chart records of patients with ASMD type B (n = 24) and type A/B (n = 9), with a median (interquartile range [IQR]) age of 8.0 [3.0–20.0] years and 1.0 [1.0–2.0] years, respectively, at diagnosis. The commonly reported manifestations were related to spleen (100.0%), liver (93.9%), and respiratory (77.4%) abnormalities. Nine deaths were reported at a median [IQR] age of 17.0 [5.0–25.0] years, with 66.7% of overall patients deceased at less than 18 years of age; the median [IQR] age at death for patients with ASMD type B (n = 4) and type A/B (n = 5) was 31.0 [11.0–55.0] and 9.0 [4.0–18.0] years, respectively. All deaths were ASMD-related and primarily caused by liver or respiratory failures or severe progressive neurodegeneration (two patients with ASMD type A/B). The median (95% confidence interval [CI]) overall survival age since birth was 45.4 (17.5–65.0) years. Additionally, an SMR [95% CI] analysis (21.6 [9.8–38.0]) showed that age-specific deaths in the ASMD population were 21.6 times more frequent than that in the general German population. Conclusions This study highlights considerable morbidity and mortality associated with ASMD type B and type A/B in Germany. It further emphasises the importance of effective therapy for chronic ASMD to reduce disease complications.
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- 2024
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3. Klassische Galaktosämie
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Ziagaki, Athanasia
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- 2024
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4. Mepolizumab as an effective treatment in a case of hypophysitis in eosinophilic granulomatosis with polyangiitis
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Jessy Chen, Tobias Alexander, Thula Walter-Rittel, Athanasia Ziagaki, and Volker Siffrin
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Neurology. Diseases of the nervous system ,RC346-429 - Abstract
Granulomatosis or eosinophilic granulomatosis with polyangiitis (GPA/EGPA) can affect multiple organs resulting in heterogeneous symptoms and phenotypes. Pituitary gland dysfunction rarely occurs in GPA (1–3%) and even less in EGPA (two case reports). Here, we report a case of a 51-year-old female patient with a four-year history of EGPA who presented with new polydipsia and polyuria. Laboratory testing and magnetic resonance imaging (MRI) confirmed pituitary gland dysfunction caused by a hypophysitis. Therapeutic adjustment with a switch from dupilumab to mepolizumab resulted in a decrease in clinical symptoms, inflammation in MRI, and normalization of C-reactive protein in serum. This case underlines hypophysitis as a rare organ involvement also in EGPA. Moreover, this case demonstrates the responsiveness of neuroinflammatory manifestations to the recently approved anti-interleukin-5 monoclonal antibody mepolizumab as a new potential treatment option.
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- 2023
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5. Eine Ursache, viele Symptome: Die klassische Homocystinurie
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Ziagaki, Athanasia
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- 2023
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6. The neurological and neuropsychiatric spectrum of adults with late-treated phenylketonuria
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Mainka, Tina, Fischer, Jan-Frederik, Huebl, Julius, Jung, Alexandra, Lier, Dinah, Mosejova, Alexandra, Skorvanek, Matej, de Koning, Tom J., Kühn, Andrea A., Freisinger, Peter, Ziagaki, Athanasia, and Ganos, Christos
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- 2021
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7. Cardiac Magnetic Resonance Reveals Incipient Cardiomyopathy Traits in Adult Patients With Phenylketonuria
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Radu Tanacli, Jan‐Hendrik Hassel, Rolf Gebker, Alexander Berger, Michael Gräfe, Christopher Schneeweis, Patrick Doeblin, Eckart Fleck, Christian Stehning, Frank Tacke, Burkert Pieske, Joachim Spranger, Ursula Plöckinger, Athanasia Ziagaki, and Sebastian Kelle
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cardiac magnetic resonance ,cardiomyopathy ,dyslipidemia ,phenylketonuria ,T1 native ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background Phenylketonuria is the most common inborn error of amino acid metabolism, where oxidative stress and collateral metabolic abnormalities are likely to cause cardiac structural and functional modifications. We aim herein to characterize the cardiac phenotype of adult subjects with phenylketonuria using advanced cardiac imaging. Methods and Results Thirty‐nine adult patients with phenylketonuria (age, 30.5±8.7 years; 10‐year mean phenylalanine concentration, 924±330 µmol/L) and 39 age‐ and sex‐matched healthy controls were investigated. Participants underwent a comprehensive cardiac magnetic resonance and echocardiography examination. Ten‐year mean plasma levels of phenylalanine and tyrosine were used to quantify disease activity and adherence to treatment. Patients with phenylketonuria had thinner left ventricular walls (septal end‐diastolic thickness, 7.0±17 versus 8.8±1.7 mm [P1200 µmol/L (909±48 ms). Both mean phenylalanine (P=0.013) and tyrosine (P=0.035) levels were independently correlated with T1; and in a multiple regression model, higher phenylalanine levels and higher left ventricular mass associate with lower T1. Conclusions Cardiac phenotype of adult patients with phenylketonuria reveals some traits of an early‐stage cardiomyopathy. Regular cardiology follow‐up, tighter therapeutic control, and prophylaxis of cardiovascular risk factors, in particular dyslipidemia, are recommended.
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- 2021
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8. Alkaptonurie: Klinische Symptome erst im Erwachsenenalter
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Ziagaki, Athanasia
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- 2022
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9. The German National Action League for people with rare diseases: translating the three tiers center system into active co-operation, a one center experience
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U. Plöckinger and A. Ziagaki
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Rare diseases ,National action plan ,Co-operation ,Medicine - Abstract
Abstract Introduction In 2009 the European Commission called for National action plans (NAP) to improve the care for persons with rare diseases. Germany set up a NAP in 2013 suggesting a three-tiered structure of co-operating centers (CC), centers of excellence (CE) and reference centers (CR). Since then CEs and CRs were organized in the framework of university hospitals. However, realization of CCs taking into account the requirements of the NAP has been slow. We therefore set-up a 12-months program to initiate co-operation and to support the development of structured CCs. Methods Our center invited 3000 physicians from Berlin and/or Brandenburg to participate. They were chosen either due to already referring patients with rare metabolic diseases to the center, residing in a neighborhood with diverse ethnic background, known to have a high prevalence for specific metabolic diseases, or working as a medical sub-specialist (gastroenterology, hematology, rheumatology) with a high probability to diagnose a rare metabolic disease. The center offered co-operation contracts, administrative and structured medical support, privileged access to the center for physicians and their patients, as well as a program of continuous medical education (CME) over a period of 12 months. Results Between 0.1 to 0.5% (mean 0.2%) of the invited physicians participated in CME meetings. None of them was interested in setting up a co-operating center. The physicians were interested in broadening their knowledge about rare diseases, but less so in direct care for these patients and not at all in fulfilling the requirements of the NAP. Conclusions The requirements of the NAP for CC are thought of as unrealistic due to their demands on structural re-organization, quality measurements and additional work-load for outpatient-care. Especially so, with respect for the low number of patients profiting from these efforts and the lack of re-imbursement. We suggest a reconsideration of the German NAP.
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- 2019
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10. Management, vaccination status and COVID-19 morbidity of patients with Gaucher disease in Germany during the COVID-19 pandemic
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Claus Niederau, Claudia Regenbogen, Hans-Martin Fruehauf, Martin Merkel, Athanasia Ziagaki, Eugen Mengel, Christoph Baerwald, Nicole Muschol, Christian Staufner, Christina Lampe, Anton Gillessen, Jan Philipp Koehler, and Stephan vom Dahl
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Gastroenterology - Abstract
Background Continuation of standard management of Gaucher disease (GD) has been challenging during the COVID-19 pandemic, resulting in infrequent/missed infusions and follow-up appointments. Little data are available on the consequences of these changes and on the SARS-CoV-2 vaccinations in German GD patients. Methods A survey with 22 questions about GD management during the pandemic was sent to 19 German Gaucher centres. It was answered by 11/19 centres caring for 257 GD patients (almost ¾ of the German GD population); 245 patients had type 1 and 12 had type 3 GD; 240 were ≥ 18 years old. Results Monitoring intervals were prolonged in 8/11 centres from a median of 9 to 12 months. Enzyme replacement therapy (ERT) was changed to home ERT in 4 patients and substituted by oral substrate reduction therapy (SRT) in 6 patients. From March 2020 to October 2021, no serious complications of GD were documented. Only 4 SARS-CoV-2 infections were reported (1.6%). Two infections were asymptomatic and two mild; all occurred in adult type 1, non-splenectomized patients on ERT. Vaccination rate in adult GD was 79.5% (95.3% mRNA vaccines). Serious vaccination complications were not reported. Conclusions The COVID-19 pandemic has lowered the threshold for switching from practice- or hospital-based ERT to home therapy or to SRT. No major GD complication was documented during the pandemic. Infection rate with SARS-CoV-2 in GD may rather be lower than expected, and its severity is mild. Vaccination rates are high in GD patients and vaccination was well tolerated.
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- 2023
11. 2-deoxy-2-[18]fluoro-D-glucose PET/CT (18FDG PET/CT) may not be a viable biomarker in Pompe disease
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U. Plöckinger, V. Prasad, A. Ziagaki, N. Tiling, and A. Poellinger
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Pompe disease ,2-deoxy-2-[18]fluoro-D-glucose PET/CT ,Biomarker ,MRI ,Medicine ,Genetics ,QH426-470 - Abstract
Abstract Background Pompe disease (PD) is an autosomal recessive, lysosomal storage disease due to a mutation of the acid α-glucosidase (GAA) gene. In adult patients, PD is characterized by slowly progressive limb-girdle and trunk myopathy and restrictive respiratory insufficiency. Enzyme replacement therapy (ERT) is available, improving or stabilizing muscle-function in some and slowing deterioration in other patients. Unfortunately, there is no biomarker available to indicate therapeutic efficacy and/or disease activity. Whole body MRI depicts all skeletal muscles demonstrating foci of atrophic muscles, i.e., late and irreversible pathological changes. Any method indicating the localizations of increased muscle glycogen storage, muscle inflammation and/or degradation could possibly help identifying newly afflicted tissue and may be of prognostic value. We therefore investigated 2-deoxy-2-[18]fluoro-D-glucose (FDG) PET, a biomarker for glucose-metabolism, as a tool to evaluate disease activity and prognosis in PD. Methods In a pilot study, we investigated four patients by FDG dynamic PET/CT while on ERT. One patient had FDG-PET/CT twice, before and after 12 months on ERT. Dynamic FDG-PET/CT quantifies the metabolic rate of glucose utilisation in mg/ml/min. MRI was performed in parallel with pelvic and thigh muscles semi-quantitatively scored for atrophy and disease-activity. Results None of the muscles analysed showed a focally increased FDG-uptake. Thus, quantification of muscle glucose metabolism could not be calculated. However, increased FDG-uptake, i.e., increased glucose utilisation, was observed in the respiratory muscles of one patient with severe, restrictive respiratory failure. In contrast, specific MRI sequences showed oedematous as well as atrophic muscle areas in PD. Conclusions Our pilot study demonstrates that FDG-uptake does not correlate with glycogen storage in vivo. In contrast, MRI is an excellent tool to demonstrate the extent of muscle involvement. Specific MRI sequences may even demonstrate early changes possibly allowing prognostic predictions or localization of early stages of PD.
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- 2018
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12. Recommendations for diagnosing and managing individuals with glutaric aciduria type 1:third revision
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Boy, Nikolas, Mühlhausen, Chris, Maier, Esther M., Ballhausen, Diana, Baumgartner, Matthias R., Beblo, Skadi, Burgard, Peter, Chapman, Kimberly A., Dobbelaere, Dries, Heringer-Seifert, Jana, Fleissner, Sandra, Grohmann-Held, Karina, Hahn, Gabriele, Harting, Inga, Hoffmann, Georg F., Jochum, Frank, Karall, Daniela, Konstantopoulous, Vassiliki, Krawinkel, Michael B., Lindner, Martin, Märtner, E. M.Charlotte, Nuoffer, Jean Marc, Okun, Jürgen G., Plecko, Barbara, Posset, Roland, Sahm, Katja, Scholl-Bürgi, Sabine, Thimm, Eva, Walter, Magdalena, Williams, Monique, Dahl, Stephan vom, Ziagaki, Athanasia, Zschocke, Johannes, Kölker, Stefan, Boy, Nikolas, Mühlhausen, Chris, Maier, Esther M., Ballhausen, Diana, Baumgartner, Matthias R., Beblo, Skadi, Burgard, Peter, Chapman, Kimberly A., Dobbelaere, Dries, Heringer-Seifert, Jana, Fleissner, Sandra, Grohmann-Held, Karina, Hahn, Gabriele, Harting, Inga, Hoffmann, Georg F., Jochum, Frank, Karall, Daniela, Konstantopoulous, Vassiliki, Krawinkel, Michael B., Lindner, Martin, Märtner, E. M.Charlotte, Nuoffer, Jean Marc, Okun, Jürgen G., Plecko, Barbara, Posset, Roland, Sahm, Katja, Scholl-Bürgi, Sabine, Thimm, Eva, Walter, Magdalena, Williams, Monique, Dahl, Stephan vom, Ziagaki, Athanasia, Zschocke, Johannes, and Kölker, Stefan
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Glutaric aciduria type 1 is a rare inherited neurometabolic disorder of lysine metabolism caused by pathogenic gene variations in GCDH (cytogenic location: 19p13.13), resulting in deficiency of mitochondrial glutaryl-CoA dehydrogenase (GCDH) and, consequently, accumulation of glutaric acid, 3-hydroxyglutaric acid, glutaconic acid, and glutarylcarnitine detectable by gas chromatography/mass spectrometry (organic acids) and tandem mass spectrometry (acylcarnitines). Depending on residual GCDH activity, biochemical high and low excreting phenotypes have been defined. Most untreated individuals present with acute onset of striatal damage before age three (to six) years, precipitated by infectious diseases, fever or surgery, resulting in irreversible, mostly dystonic movement disorder with limited life expectancy. In some patients, striatal damage develops insidiously. In recent years, the clinical phenotype has been extended by the finding of extrastriatal abnormalities and cognitive dysfunction, preferably in the high excreter group, as well as chronic kidney failure. Newborn screening is the prerequisite for pre-symptomatic start of metabolic treatment with low lysine diet, carnitine supplementation and intensified emergency treatment during catabolic episodes, which, in combination, have substantially improved neurologic outcome. In contrast, start of treatment after onset of symptoms cannot reverse existing motor dysfunction caused by striatal damage. Dietary treatment can be relaxed after the vulnerable period for striatal damage, i.e. age 6 years. However, impact of dietary relaxation on long-term outcome is still unclear. This third revision of evidence-based recommendations aims to re-evaluate previous recommendations 1-3 and to implement new research findings on the evolving phenotypic diversity as well as the impact of non-interventional variables and treatment quality on clinical outcomes. This article is protected by copyright. All rights reser
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- 2023
13. The German National Action League for people with rare diseases: translating the three tiers center system into active co-operation, a one center experience
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Plöckinger, U. and Ziagaki, A.
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- 2019
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14. Management, vaccination status and COVID-19 morbidity of patients with Gaucher disease in Germany during the COVID-19 pandemic
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Niederau, Claus, additional, Regenbogen, Claudia, additional, Fruehauf, Hans-Martin, additional, Merkel, Martin, additional, Ziagaki, Athanasia, additional, Mengel, Eugen, additional, Baerwald, Christoph, additional, Muschol, Nicole, additional, Staufner, Christian, additional, Lampe, Christina, additional, Gillessen, Anton, additional, Koehler, Jan Philipp, additional, and vom Dahl, Stephan, additional
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- 2023
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15. Mepolizumab as an effective treatment in a case of hypophysitis in eosinophilic granulomatosis with polyangiitis
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Chen, Jessy, primary, Alexander, Tobias, additional, Walter-Rittel, Thula, additional, Ziagaki, Athanasia, additional, and Siffrin, Volker, additional
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- 2023
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16. Recommendations for diagnosing and managing individuals with glutaric aciduria type 1: Third revision
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Boy, Nikolas, primary, Mühlhausen, Chris, additional, Maier, Esther M., additional, Ballhausen, Diana, additional, Baumgartner, Matthias R., additional, Beblo, Skadi, additional, Burgard, Peter, additional, Chapman, Kimberly A., additional, Dobbelaere, Dries, additional, Heringer‐Seifert, Jana, additional, Fleissner, Sandra, additional, Grohmann‐Held, Karina, additional, Hahn, Gabriele, additional, Harting, Inga, additional, Hoffmann, Georg F., additional, Jochum, Frank, additional, Karall, Daniela, additional, Konstantopoulous, Vassiliki, additional, Krawinkel, Michael B., additional, Lindner, Martin, additional, Märtner, E. M. Charlotte, additional, Nuoffer, Jean‐Marc, additional, Okun, Jürgen G., additional, Plecko, Barbara, additional, Posset, Roland, additional, Sahm, Katja, additional, Scholl‐Bürgi, Sabine, additional, Thimm, Eva, additional, Walter, Magdalena, additional, Williams, Monique, additional, vom Dahl, Stephan, additional, Ziagaki, Athanasia, additional, Zschocke, Johannes, additional, and Kölker, Stefan, additional
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- 2022
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17. Mepolizumab as an effective treatment in a case of hypophysitis in eosinophilic granulomatosis with polyangiitis
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Chen, J., Alexander, T., Walter-Rittel, T., Ziagaki, A., and Siffrin, V.
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Function and Dysfunction of the Nervous System - Abstract
Granulomatosis or eosinophilic granulomatosis with polyangiitis (GPA/EGPA) can affect multiple organs resulting in heterogeneous symptoms and phenotypes. Pituitary gland dysfunction rarely occurs in GPA (1–3%) and even less in EGPA (two case reports). Here, we report a case of a 51-year-old female patient with a four-year history of EGPA who presented with new polydipsia and polyuria. Laboratory testing and magnetic resonance imaging (MRI) confirmed pituitary gland dysfunction caused by a hypophysitis. Therapeutic adjustment with a switch from dupilumab to mepolizumab resulted in a decrease in clinical symptoms, inflammation in MRI, and normalization of C-reactive protein in serum. This case underlines hypophysitis as a rare organ involvement also in EGPA. Moreover, this case demonstrates the responsiveness of neuroinflammatory manifestations to the recently approved anti-interleukin-5 monoclonal antibody mepolizumab as a new potential treatment option.
- Published
- 2023
18. Personality Traits and Physical Complaints in Patients With Acromegaly: A Cross Sectional Multi-Center Study With Analysis of Influencing Factors
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Anca Zimmermann, Rüdiger Zwerenz, Michael Droste, Christof Schöfl, Christian J. Strasburger, Ursula Plöckinger, Athanasia Ziagaki, Jürgen Honegger, Anne Dixius, Bledar Millaku, Gerrit Toenges, Manfred E. Beutel, and Matthias M. Weber
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neuropsychological profile ,physical complaints ,acromegaly ,disease activity ,pituitary insufficiency ,Diseases of the endocrine glands. Clinical endocrinology ,RC648-665 - Abstract
Objective: Acromegalic patients display a distinct neuropsychological profile and suffer from chronic physical complaints. We aimed to investigate in more detail these aspects in acromegalic patients, dependent on influencing factors like disease activity, age, sex, chronic medication, surgery, pituitary radiation, pituitary insufficiency and comorbidities.Design: Cross sectional, multicentric.Methods: 129 patients (M/W 65/64, 58.3 ± 12.7 years, 53/76 with active/controlled disease). Acromegalic patients completed the following inventories: NEO-FFI, IIP-D, and the Giessen Complaints List (GBB-24), after written informed consent. Age, sex, IGF-1 concentrations, comorbidities, treatment modalities and pituitary insufficiency were documented.Results: Acromegalic patients or specific patient-subgroups were more agreeable, neurotic, exploitable/permissive, introverted/socially avoidant, non-assertive/insecure, nurturant and less open to experience, cold/denying, domineering, compared to normal values from the healthy population (controls). Multivariable analysis demonstrated that these overall results were due to the specific patient subgroups as patients on chronic medication, with arthrosis and pituitary insufficiency. Disease activity was only associated with the trait nurturant. Higher scores for introversion were associated with arthrosis. Lower domineering was independent of any disease- or treatment related variable or comorbidity. The GBB inventory showed overall higher scores in patients, with higher scores for exhaustion and general complaints being associated with pituitary insufficiency, coronary heart disease and history of malignancy in the multivariable analysis. Joint complaints were independent of any disease- or treatment- related variable.Conclusions: We define new aspects of a distinct neuropsychological profile in patients with acromegaly, which are largely independent of disease activity. Chronic physical complaints are more pronounced in patients than in controls, with exhaustion and general complaints showing no association with disease activity.
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- 2018
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19. Eine Ursache, viele Symptome: Die klassische Homocystinurie
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Athanasia Ziagaki
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General Medicine - Published
- 2023
20. The neurological and neuropsychiatric spectrum of adults with late-treated phenylketonuria
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Dinah Lier, Matej Skorvanek, Julius Huebl, Jan Frederik Fischer, Christos Ganos, Tina Mainka, Athanasia Ziagaki, Andrea A. Kühn, Tom J. de Koning, Peter Freisinger, Alexandra Jung, Alexandra Mosejova, and Movement Disorder (MD)
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Male ,0301 basic medicine ,congenital, hereditary, and neonatal diseases and abnormalities ,Pediatrics ,medicine.medical_specialty ,Delayed Diagnosis ,Movement disorders ,Tics ,Neuropsychiatry ,Time-to-Treatment ,03 medical and health sciences ,0302 clinical medicine ,DEFICITS ,Intellectual Disability ,Phenylketonurias ,Intellectual disability ,Prevalence ,TICS ,medicine ,Humans ,Phenylketonuria ,BRAIN ,Depression (differential diagnoses) ,business.industry ,Mental Disorders ,TOURETTE-SYNDROME ,DEMENTIA ,Parkinsonism ,Middle Aged ,Metabolic disorder ,medicine.disease ,MANIFESTATIONS ,030104 developmental biology ,Neurology ,Inborn error of metabolism ,Autism spectrum disorder ,Female ,ONSET PHENYLKETONURIA ,Neurology (clinical) ,Geriatrics and Gerontology ,medicine.symptom ,business ,030217 neurology & neurosurgery - Abstract
Introduction Phenylketonuria (PKU) is a rare, treatable inborn error of metabolism with frequent neurological and neuropsychiatric complications, especially in undiagnosed or insufficiently treated individuals. Given the wide range of clinical presentations and the importance of treatment implications, we here delineate the neurological and neuropsychiatric symptom spectrum in a large cohort of previously unreported adults with late-treated PKU. Methods We consecutively evaluated late-treated PKU cases and pooled clinical and paraclinical data, including video-material, from three centers with expertise in complex movement disorders, inborn errors of metabolism and pediatrics. Results 26 individuals were included (10 females, median age 52 years). Developmental delay and intellectual disability were omnipresent with severe impairment of expressive communication noted in 50% of cases. Movement disorders were prevalent (77%), including tremor (38%, mostly postural), stereotypies (38%), and tics (19%). One case had neurodegenerative levodopa-responsive parkinsonism. Mild ataxia was noted in 54% of cases and 31% had a history of seizures. Neuropsychiatric characteristics included obsessive-compulsive (35%) and self-injurious behaviors (31%), anxiety (27%), depression (19%) and features compatible with those observed in individuals with autism spectrum disorder (19%). Neuroimaging revealed mild white matter changes. Adherence to dietary treatment was inconsistent in the majority of cases, particularly throughout adolescence. Conclusion A history of movement disorders, particularly tremor, stereotypies and tics, in the presence of developmental delay, intellectual disability and neuropsychiatric features, such as obsessive-compulsive and self-injurious behaviors in adults should prompt the diagnostic consideration of PKU. Initiation and adherence to (dietary) treatment can ameliorate the severity of these symptoms.
- Published
- 2021
21. Impact of pregnancy planning and preconceptual dietary training on metabolic control and offspring's outcome in phenylketonuria
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Grohmann‐Held, Karina, primary, Burgard, Peter, additional, Baerwald, Christoph G. O., additional, Beblo, Skadi, additional, vom Dahl, Stephan, additional, Das, Anibh, additional, Dokoupil, Katharina, additional, Fleissner, Sandra, additional, Freisinger, Peter, additional, Heddrich‐Ellerbrok, Margret, additional, Jung, Alexandra, additional, Korpel, Vanessa, additional, Krämer, Johannes, additional, Lier, Dinah, additional, Maier, Esther M., additional, Meyer, Uta, additional, Mühlhausen, Chris, additional, Newger, Martha, additional, Och, Ulrike, additional, Plöckinger, Ursula, additional, Rosenbaum‐Fabian, Stefanie, additional, Rutsch, Frank, additional, Santer, René, additional, Schick, Petra, additional, Schwarz, Martin, additional, Spiekerkötter, Ute, additional, Strittmatter, Ursula, additional, Thiele, Alena G., additional, Ziagaki, Athanasia, additional, Mütze, Ulrike, additional, Gleich, Florian, additional, Garbade, Sven F., additional, and Kölker, Stefan, additional
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- 2022
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22. Riboflavin 1 Transporter Deficiency: Novel SLC52A1 Variants and Expansion of the Phenotypic Spectrum.
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Grünert, Sarah C., Ziagaki, Athanasia, Heinen, André, Schumann, Anke, Tucci, Sara, Spiekerkoetter, Ute, and Schmidts, Miriam
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DRIED blood spot testing , *NEWBORN infants , *VITAMIN B2 , *GENETIC variation - Abstract
Riboflavin transporter 1 (RFVT1) deficiency is an ultrarare metabolic disorder due to autosomal dominant pathogenic variants in SLC52A1. The RFVT1 protein is mainly expressed in the placenta and intestine. To our knowledge, only five cases of RFVT1 deficiency from three families have been reported so far. While newborns and infants with SLC52A1 variants mainly showed a multiple acyl-CoA dehydrogenase deficiency-like presentation, individuals identified in adulthood were usually clinically asymptomatic. We report two patients with novel heterozygous SLC52A1 variants. Patient 1 presented at the age of 62 with mild hyperammonemia following gastroenteritis. An acylcarnitine analysis in dried blood spots was abnormal with a multiple acyl-CoA dehydrogenase deficiency-like pattern, and genetic analysis confirmed a heterozygous SLC52A1 variant, c.68C > A, p. Ser23Tyr. Patient 2 presented with recurrent seizures and hypsarrhythmia at the age of 7 months. Metabolic investigations yielded unremarkable results. However, whole exome sequencing revealed a heterozygous start loss variant, c.3G > A, p. Met1Ile in SLC52A1. These two cases expand the clinical spectrum of riboflavin transporter 1 deficiency and demonstrate that symptomatic presentation in adulthood is possible. [ABSTRACT FROM AUTHOR]
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- 2023
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23. 2-deoxy-2-[18]fluoro-D-glucose PET/CT (18FDG PET/CT) may not be a viable biomarker in Pompe disease
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Plöckinger, U., Prasad, V., Ziagaki, A., Tiling, N., and Poellinger, A.
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- 2018
- Full Text
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24. Impact of pregnancy planning and preconceptual dietary training on metabolic control and offspring's outcome in phenylketonuria
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Karina Grohmann‐Held, Peter Burgard, Christoph G. O. Baerwald, Skadi Beblo, Stephan vom Dahl, Anibh Das, Katharina Dokoupil, Sandra Fleissner, Peter Freisinger, Margret Heddrich‐Ellerbrok, Alexandra Jung, Vanessa Korpel, Johannes Krämer, Dinah Lier, Esther M. Maier, Uta Meyer, Chris Mühlhausen, Martha Newger, Ulrike Och, Ursula Plöckinger, Stefanie Rosenbaum‐Fabian, Frank Rutsch, René Santer, Petra Schick, Martin Schwarz, Ute Spiekerkötter, Ursula Strittmatter, Alena G. Thiele, Athanasia Ziagaki, Ulrike Mütze, Florian Gleich, Sven F. Garbade, and Stefan Kölker
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Phenylketonuria, Maternal ,Phenylalanine ,Pregnancy Outcome ,Child Behavior ,Syndrome ,Diet ,Pregnancy ,Phenylketonurias ,Genetics ,Humans ,Female ,Child ,Genetics (clinical) ,Retrospective Studies - Abstract
To prevent maternal phenylketonuria (PKU) syndrome low phenylalanine concentrations (target range, 120-360 μmol/L) during pregnancy are recommended for women with PKU. We evaluated the feasibility and effectiveness of current recommendations and identified factors influencing maternal metabolic control and children's outcome. Retrospective study of first successfully completed pregnancies of 85 women with PKU from 12 German centers using historical data and interviews with the women. Children's outcome was evaluated by standardized IQ tests and parental rating of child behavior. Seventy-four percent (63/85) of women started treatment before conception, 64% (54/85) reached the phenylalanine target range before conception. Pregnancy planning resulted in earlier achievement of the phenylalanine target (18 weeks before conception planned vs. 11 weeks of gestation unplanned, p 0.001) and lower plasma phenylalanine concentrations during pregnancy, particularly in the first trimester (0-7 weeks of gestation: 247 μmol/L planned vs. 467 μmol/L unplanned, p 0.0001; 8-12 weeks of gestation: 235 μmol/L planned vs. 414 μmol/L unplanned, p 0.001). Preconceptual dietary training increased the success rate of achieving the phenylalanine target before conception compared to women without training (19 weeks before conception vs. 9 weeks of gestation, p 0.001). The majority (93%) of children had normal IQ (mean 103, median age 7.3 years); however, IQ decreased with increasing phenylalanine concentration during pregnancy. Good metabolic control during pregnancy is the prerequisite to prevent maternal PKU syndrome in the offspring. This can be achieved by timely provision of detailed information, preconceptual dietary training, and careful planning of pregnancy.
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- 2022
25. A generic emergency protocol for patients with inborn errors of metabolism causing fasting intolerance: A retrospective, single-center study and the generation of www.emergencyprotocol.net
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Rossi A., Hoogeveen I. J., Lubout C. M. A., de Boer F., Fokkert-Wilts M. J., Rodenburg I. L., van Dam E., Grunert S. C., Martinelli D., Scarpa M., Dekker H., te Boekhorst S. T., van Spronsen F. J., Derks T. G. J., de Baere L., Bellettato C., Bosch A. M., Sallago J. B., Botto L. D., Brunner-Krainz M., Caroe C., Casswall T., Contreras Pulido E. L., Couce M. L., Dessein A. -F., Donati M. A., Eyskens F., Moura De Souza C. F., Fraile P. Q., Fuchs S. A., Gasperini S., Haas D., Hernandez E. M., Hochuli M., Hugon A., Karall D., Koeberl D., Labrune P., Lajic S., van Lingen C., Maiorana A., Mention K., Moenig I., Mohnike K., Montanari C., Nassogne M. -C., Parini R., Rahman S., Reyes M., Schwantje M., Skouma A., Strisciuglio P., Thiel M., Weinstein D., Ziagaki A., Amsterdam Gastroenterology Endocrinology Metabolism, Center for Liver, Digestive and Metabolic Diseases (CLDM), Rossi, A., Hoogeveen, I. J., Lubout, C. M. A., de Boer, F., Fokkert-Wilts, M. J., Rodenburg, I. L., van Dam, E., Grunert, S. C., Martinelli, D., Scarpa, M., Dekker, H., te Boekhorst, S. T., van Spronsen, F. J., Derks, T. G. J., de Baere, L., Bellettato, C., Bosch, A. M., Sallago, J. B., Botto, L. D., Brunner-Krainz, M., Caroe, C., Casswall, T., Contreras Pulido, E. L., Couce, M. L., Dessein, A. -F., Donati, M. A., Eyskens, F., Moura De Souza, C. F., Fraile, P. Q., Fuchs, S. A., Gasperini, S., Haas, D., Hernandez, E. M., Hochuli, M., Hugon, A., Karall, D., Koeberl, D., Labrune, P., Lajic, S., van Lingen, C., Maiorana, A., Mention, K., Moenig, I., Mohnike, K., Montanari, C., Nassogne, M. -C., Parini, R., Rahman, S., Reyes, M., Schwantje, M., Skouma, A., Strisciuglio, P., Thiel, M., Weinstein, D., and Ziagaki, A.
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Adult ,Male ,medicine.medical_specialty ,Telemedicine ,Adolescent ,fatty acid oxidation disorders ,glycogen storage diseases ,eHealth ,emergency treatment ,hypoglycemia ,telemedicine ,Lipid Metabolism, Inborn Error ,Context (language use) ,Hypoglycemia ,Glycogen Storage Disease Type I ,Single Center ,Lipid Metabolism, Inborn Errors ,Young Adult ,glycogen storage disease ,Retrospective Studie ,Genetics ,Medicine ,Humans ,Adverse effect ,Child ,Genetics (clinical) ,Retrospective Studies ,Coma ,business.industry ,Fatty Acids ,Infant, Newborn ,Infant ,Original Articles ,Fasting ,Middle Aged ,medicine.disease ,fatty acid oxidation disorder ,Child, Preschool ,Emergency medicine ,Observational study ,Original Article ,Female ,medicine.symptom ,business ,Oxidation-Reduction ,Fatty Acid ,Human - Abstract
INTRODUCTION: Patients with inborn errors of metabolism causing fasting intolerance can experience acute metabolic decompensations. Long-term data on outcomes using emergency letters are lacking.METHODS: This is a retrospective, observational, single-center study of the use of emergency letters based on a generic emergency protocol in patients with hepatic glycogen storage diseases (GSD) or fatty acid oxidation disorders (FAOD). Data on hospital admissions, initial laboratory results and serious adverse events were collected. Subsequently, the website www.emergencyprotocol.net was generated in the context of the CONNECT MetabERN eHealth project following multiple meetings, protocol revisions and translations.RESULTS: Representing 470 emergency protocol years, 127 hospital admissions were documented in 54/128(42%) patients who made use of emergency letters generated based on the generic emergency protocol. Hypoglycemia (here defined as glucose concentration 5 years. Convulsions, coma or death were not documented. By providing basic information, emergency letters for individual patients with hepatic GSD or the main FAOD can be generated at www.emergencyprotocol.net, in 9 different languages.DISCUSSION: Generic emergency protocols are safe and easy for home management by the caregivers and the first hour in-hospital management to prevent metabolic emergencies in patients with hepatic GSD and medium-chain Acyl CoA dehydrogenase deficiency. The website www.emergencyprotocol.net is designed to support families and healthcare providers to generate personalized emergency letters for patients with hepatic GSD and the main FAOD. This article is protected by copyright. All rights reserved.
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- 2021
26. Long‐Term Colestyramine Treatment Prevents Cholestatic Attacks in Refractory Benign Recurrent Intrahepatic Cholestasis Type 1 Disease
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E Koukoulioti, Susanne N. Weber, Frank Lammert, Thomas Berg, and Athanasia Ziagaki
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Male ,0301 basic medicine ,medicine.medical_specialty ,medicine.drug_class ,Cholestyramine Resin ,Benign Recurrent Intrahepatic Cholestasis ,Drug Resistance ,Administration, Oral ,Cholestasis, Intrahepatic ,Disease ,Gene mutation ,Gastroenterology ,Intestinal absorption ,03 medical and health sciences ,0302 clinical medicine ,Refractory ,Recurrence ,Internal medicine ,Secondary Prevention ,medicine ,Humans ,Secretion ,Hepatology ,Bile acid ,business.industry ,Patient Acuity ,Middle Aged ,Treatment Outcome ,030104 developmental biology ,030211 gastroenterology & hepatology ,Farnesoid X receptor ,business - Abstract
Benign recurrent intrahepatic cholestasis (BRIC) is an autosomal recessive cholestatic disease characterized by intermittent cholestatic episodes of variable severity and duration. BRIC type 1 has been linked to gene mutations encoded in the hepatocanalicular transporter ATP8B1.1 It has been suggested that ATP8B1 affects the regulation of the farnesoid X receptor, and thus ATP8B1 deficiency could lead to an imbalance between intestinal absorption of bile acids and hepatic secretion, causing bile acid accumulation.2 The latter aggravates hepatocellular dysfunction leading to a vicious cycle.
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- 2021
27. Obesity and pituitary gland volume – a correlation study using three-dimensional magnetic resonance imaging
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Dominik Geisel, Athanasia Ziagaki, Timo Alexander Auer, Anas Jadan, Thomas Bobbert, Edzard Wiener, Uli Fehrenbach, and Katharina Maria Kreutz
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Adult ,Male ,Pituitary gland ,Pathology ,medicine.medical_specialty ,Adolescent ,Contrast Media ,030209 endocrinology & metabolism ,Neurological Disorders ,Body Mass Index ,03 medical and health sciences ,Imaging, Three-Dimensional ,Sex Factors ,0302 clinical medicine ,Organometallic Compounds ,Humans ,Medicine ,Endocrine system ,Radiology, Nuclear Medicine and imaging ,Obesity ,030212 general & internal medicine ,Aged ,Retrospective Studies ,medicine.diagnostic_test ,business.industry ,Age Factors ,Magnetic resonance imaging ,Organ Size ,General Medicine ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,medicine.anatomical_structure ,Pituitary Gland ,Female ,Neurology (clinical) ,business ,Body mass index ,Volume (compression) - Abstract
Purpose Obesity has become a major health problem and is associated with endocrine disorders and a disturbed hypothalamic-pituitary axis. The purpose of this study was to correlate pituitary gland volume determined by routine magnetic resonance imaging with patient characteristics, in particular body mass index and obesity. Material and methods A total of 144 ‘healthy’ patients with normal findings in cerebral magnetic resonance imaging were retrospectively included. Pituitary gland volume was measured in postcontrast three-dimensional T1-weighted sequences. A polygonal three-dimensional region of interest covering the whole pituitary gland was assessed manually. Physical characteristics (gender, age, body height and body mass index) were correlated with pituitary gland volume. Multiple subgroup and regression analyses were performed. Results Pituitary gland volumes were significantly larger in females than in males ( p0.05). Regression analysis showed that increased pituitary gland volume is associated with higher body mass index independent from gender, age and body height. Conclusion Pituitary gland volume is increased in obese individuals and a high body mass index can be seen as an independent predictor of increased pituitary gland volume. Therefore, gland enlargement might be an imaging indicator of dysfunction in the hypothalamus-pituitary axis. Besides gender and age, body mass index should be considered by radiologists when diagnosing abnormal changes in pituitary gland volume.
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- 2020
28. Recommendations for diagnosing and managing individuals with glutaric aciduria type 1: third revision
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Nikolas Boy, Chris Mühlhausen, Esther M. Maier, Diana Ballhausen, Matthias R. Baumgartner, Skadi Beblo, Peter Burgard, Kimberly A. Chapman, Dries Dobbelaere, Jana Heringer‐Seifert, Sandra Fleissner, Karina Grohmann‐Held, Gabriele Hahn, Inga Harting, Georg F. Hoffmann, Frank Jochum, Daniela Karall, Vassiliki Konstantopoulous, Michael B. Krawinkel, Martin Lindner, E. M. Charlotte Märtner, Jean‐Marc Nuoffer, Jürgen G. Okun, Barbara Plecko, Roland Posset, Katja Sahm, Sabine Scholl‐Bürgi, Eva Thimm, Magdalena Walter, Monique Williams, Stephan vom Dahl, Athanasia Ziagaki, Johannes Zschocke, Stefan Kölker, and Pediatrics
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SDG 3 - Good Health and Well-being ,Genetics ,610 Medicine & health ,Genetics (clinical) - Abstract
Glutaric aciduria type 1 is a rare inherited neurometabolic disorder of lysine metabolism caused by pathogenic gene variations in GCDH (cytogenic location: 19p13.13), resulting in deficiency of mitochondrial glutaryl-CoA dehydrogenase (GCDH) and, consequently, accumulation of glutaric acid, 3-hydroxyglutaric acid, glutaconic acid and glutarylcarnitine detectable by gas chromatography/mass spectrometry (organic acids) and tandem mass spectrometry (acylcarnitines). Depending on residual GCDH activity, biochemical high and low excreting phenotypes have been defined. Most untreated individuals present with acute onset of striatal damage before age 3 (to 6) years, precipitated by infectious diseases, fever or surgery, resulting in irreversible, mostly dystonic movement disorder with limited life expectancy. In some patients, striatal damage develops insidiously. In recent years, the clinical phenotype has been extended by the finding of extrastriatal abnormalities and cognitive dysfunction, preferably in the high excreter group, as well as chronic kidney failure. Newborn screening is the prerequisite for pre-symptomatic start of metabolic treatment with low lysine diet, carnitine supplementation and intensified emergency treatment during catabolic episodes, which, in combination, have substantially improved neurologic outcome. In contrast, start of treatment after onset of symptoms cannot reverse existing motor dysfunction caused by striatal damage. Dietary treatment can be relaxed after the vulnerable period for striatal damage, that is, age 6 years. However, impact of dietary relaxation on long-term outcomes is still unclear. This third revision of evidence-based recommendations aims to re-evaluate previous recommendations (Boy et al., J Inherit Metab Dis, 2017;40(1):75-101; Kolker et al., J Inherit Metab Dis 2011;34(3):677-694; Kolker et al., J Inherit Metab Dis, 2007;30(1):5-22) and to implement new research findings on the evolving phenotypic diversity as well as the impact of non-interventional variables and treatment quality on clinical outcomes.
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- 2022
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29. Methodology for Generating Datasets with Characteristic Diagnostic Parameters of Rare Diseases Using the Example of Pompe Disease, Gaucher Disease and Smith-Lemli-Opitz Syndrome
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Ann-Christin Liebers-Kyungay, Klaus Mohnike, Corine van Lingen, Anita Bressan, Katja Palm, and Athanasia Ziagaki
- Abstract
BackgroundFinding a diagnosis for rare diseases is a challenge for patients and those treating them. Establishing a uniform methodology for specifying the symptoms of a patient seems useful. This, as well as a database with clinical parameters reported in patients already diagnosed with the corresponding disease or that have led to the diagnosis, would facilitate the global data exchange between specialists and subsequently diagnosis. The aim of this work is to develop standardized data sets with the most frequent symptoms exemplarily for the three rare diseases late-onset Pompe disease, Gaucher disease Type I and Smith-Lemli-Opitz syndrome (SLOS).Methods and resultsA systematic literature review of characteristic symptoms and diagnostic criteria was performed for each of the three disorders. These parameters were converted into vocabulary standardized by The Human Phenotype Ontology (HPO), so-called HPO terms. Subsequently, a retrospective analysis of the patient files of 23 late-onset Pompe disease patients, 21 Gaucher disease Type I patients and 25 SLOS patients was carried out together with the University Children's Hospital Magdeburg and the Center of excellence for Rare Metabolic Diseases at the Charité Berlin. Features present in ≥ 40 % of the cohort and collected simultaneously in a certain minimum number of patients were filtered out. The analysis resulted in data sets with 20 diagnostic parameters for late-onset Pompe disease, 16 features for Gaucher disease Type I and 17 parameters for SLOS. After the statistical evaluation, the results were discussed comparatively with similar studies exemplarily for SLOS.ConclusionThe developed datasets for the three diseases provide a good basis for expansion with further patient examples and for extending the methodology to other diseases with the aim of improving the diagnostic pathway and thus the health care of patients with rare diseases.
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- 2021
30. Undiagnosed Phenylketonuria Can Exist Everywhere: Results From an International Survey
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van Wegberg, Annemiek M.J., primary, Trefz, Friedrich, additional, Gizewska, Maria, additional, Ahmed, Sibtain, additional, Chabraoui, Layachi, additional, Zaki, Maha S., additional, Maillot, François, additional, van Spronsen, Francjan J., additional, Ahring, K., additional, Al Mutairi, F., additional, Arnoux, J.B., additional, Ballhausen, D., additional, Baruteau, J., additional, Bernstein, L., additional, Bijarnia-Mahay, S., additional, Boemer, F., additional, Bordugo, A., additional, Brodosi, L., additional, Brooks, S., additional, Chew, H.B., additional, Chyz, K., additional, Coker, M., additional, Collingwood, C., additional, Cornejo, V., additional, Couce, M.L., additional, Cozens, A., additional, Dahri, S., additional, Das, A.M., additional, de Laet, C., additional, de las Heras Montero, J., additional, de Vreugd, A., additional, Debray, F.G., additional, Dercksen, M., additional, Descartes, M., additional, Diogo, L., additional, Drogari, E., additional, Eiroa, H., additional, Eminoglu, F.T., additional, Enns, G.M., additional, Eyskens, F., additional, Feillet, F., additional, Ford, S., additional, Franzson, L., additional, Freisinger, P., additional, Garcia, P., additional, Grafakou, O., additional, Gramer, G., additional, Gray, S., additional, Groselj, U., additional, Grünert, S.C., additional, Haas, D., additional, Handoom, B., additional, Harte, T.B., additional, Hendriksz, C., additional, Heredia, R.S., additional, Hertecant, J., additional, Hoi-Yee Wu, T., additional, Inwood, A., additional, Jamuar, S.S., additional, Jesina, P., additional, Jonsson, J.J., additional, Jovanovic, A., additional, Kern, I., additional, Kilavuz, S., additional, Knerr, I., additional, Kor, D., additional, Korycinska-Chaaban, D., additional, Kreile, M., additional, Kumru, B., additional, Lanpher, B., additional, Lapatto, R., additional, Lavigne, C., additional, Leao-Teles, E., additional, Leuzzi, V., additional, Longo, N., additional, Lopez-Uriarte, A., additional, Lubout, C.M.A., additional, MacDonald, A., additional, Megdad, E.M., additional, Mitchell, J., additional, Mochel, F., additional, Moreno-Lozano, P.J., additional, Morris, A., additional, Moura de Souza, C.F., additional, Munoz, T., additional, Nevalainen, P.I., additional, Oscarson, M., additional, Õunap, K., additional, Paci, S., additional, Pastores, G.M., additional, Pearl, P.L., additional, Piazzon, F.B., additional, Pitt, J., additional, Poon, G., additional, Porta, F., additional, Presner, N., additional, Rabaty, A.A., additional, Reinson, K., additional, Reismann, P., additional, Rink, T., additional, Rocha, J.C., additional, Rodrigues, E., additional, Saini, A.G., additional, Sanchez-Valle, A., additional, Sander, J., additional, Sarkhail, P., additional, Schwartz, I.V.D., additional, Sharma, R., additional, Sheng, B., additional, Siriwardena, K., additional, Sirrs, S., additional, Sjarif, D.R., additional, Sondheimer, N., additional, Sparkes, R., additional, Specola, N., additional, Stepien, K.M., additional, Szatmari, I., additional, Tchan, M., additional, Tkemaladze, T., additional, Tran, C., additional, Valle, M.G., additional, Vela-Amieva, M., additional, Verdaguer, M.L., additional, Vergano, S.A., additional, Vermeersch, P., additional, Vulturar, R., additional, Wagenmakers, M.A.E.M., additional, Weinhold, N., additional, Williams, A.B., additional, Wilson, W.G., additional, Zafeiriou, D., additional, Zhang, H., additional, Ziagaki, A., additional, and Zolkowska, J., additional
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- 2021
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31. Methodology for Generating Datasets with Characteristic Diagnostic Parameters of Rare Diseases Using the Example of Pompe Disease, Gaucher Disease and Smith-Lemli-Opitz Syndrome
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Liebers-Kyungay, Ann-Christin, primary, Mohnike, Klaus, additional, Lingen, Corine van, additional, Bressan, Anita, additional, Palm, Katja, additional, and Ziagaki, Athanasia, additional
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- 2021
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32. Cardiac Magnetic Resonance Reveals Incipient Cardiomyopathy Traits in Adult Patients With Phenylketonuria
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Ursula Plöckinger, Athanasia Ziagaki, Sebastian Kelle, Eckart Fleck, Jan-Hendrik Hassel, Patrick Doeblin, Frank Tacke, Rolf Gebker, Joachim Spranger, Michael Gräfe, Radu Tanacli, Burkert Pieske, Alexander Berger, Christian Stehning, and Christopher Schneeweis
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Adult ,medicine.medical_specialty ,Magnetic Resonance Spectroscopy ,Phenylalanine ,Cardiomyopathy ,phenylketonuria ,medicine.disease_cause ,cardiac magnetic resonance ,Imaging ,Young Adult ,Internal medicine ,Phenylketonurias ,medicine ,Humans ,Diseases of the circulatory (Cardiovascular) system ,Amino acid metabolism ,T1 native ,Original Research ,Heart Failure ,Metabolic Syndrome ,Adult patients ,business.industry ,dyslipidemia ,medicine.disease ,Phenotype ,RC666-701 ,Cardiology ,Tyrosine ,Cardiology and Cardiovascular Medicine ,business ,Cardiac magnetic resonance ,Cardiomyopathies ,cardiomyopathy ,Dyslipidemia ,Oxidative stress - Abstract
Background Phenylketonuria is the most common inborn error of amino acid metabolism, where oxidative stress and collateral metabolic abnormalities are likely to cause cardiac structural and functional modifications. We aim herein to characterize the cardiac phenotype of adult subjects with phenylketonuria using advanced cardiac imaging. Methods and Results Thirty‐nine adult patients with phenylketonuria (age, 30.5±8.7 years; 10‐year mean phenylalanine concentration, 924±330 µmol/L) and 39 age‐ and sex‐matched healthy controls were investigated. Participants underwent a comprehensive cardiac magnetic resonance and echocardiography examination. Ten‐year mean plasma levels of phenylalanine and tyrosine were used to quantify disease activity and adherence to treatment. Patients with phenylketonuria had thinner left ventricular walls (septal end‐diastolic thickness, 7.0±17 versus 8.8±1.7 mm [ P P =0.004]), more dilated left ventricular cavity (end‐diastolic volume, 87±14 versus 80±14 mL/m 2 [ P =0.0178]; end‐systolic volume, 36±9 versus 29±8 mL/m 2 [ P P P =0.027]), and lower left ventricular mass (38.2±7.9 versus 47.8±11.0 g/m 2 [ P P 1200 µmol/L (909±48 ms). Both mean phenylalanine ( P =0.013) and tyrosine ( P =0.035) levels were independently correlated with T1; and in a multiple regression model, higher phenylalanine levels and higher left ventricular mass associate with lower T1. Conclusions Cardiac phenotype of adult patients with phenylketonuria reveals some traits of an early‐stage cardiomyopathy. Regular cardiology follow‐up, tighter therapeutic control, and prophylaxis of cardiovascular risk factors, in particular dyslipidemia, are recommended.
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- 2021
33. The Wide Phenotypic Spectrum of L-2 Hydroxyglutaric Aciduria in Adults
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Athanasia Ziagaki, Andrea A. Kühn, Tina Mainka, Christos Ganos, Tom J. de Koning, and Movement Disorder (MD)
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Genetics ,Neurology ,business.industry ,Wide phenotypic spectrum ,Medicine ,L-2-hydroxyglutaric aciduria ,Neurology (clinical) ,Letters: Published Articles ,business - Published
- 2020
34. Cardiac Magnetic Resonance Reveals Incipient Cardiomyopathy Traits in Adult Patients With Phenylketonuria
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Tanacli, Radu, primary, Hassel, Jan‐Hendrik, additional, Gebker, Rolf, additional, Berger, Alexander, additional, Gräfe, Michael, additional, Schneeweis, Christopher, additional, Doeblin, Patrick, additional, Fleck, Eckart, additional, Stehning, Christian, additional, Tacke, Frank, additional, Pieske, Burkert, additional, Spranger, Joachim, additional, Plöckinger, Ursula, additional, Ziagaki, Athanasia, additional, and Kelle, Sebastian, additional
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- 2021
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35. Long-term growth hormone (GH) replacement of adult GH deficiency (GHD) benefits the heart
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Wilhelm Haverkamp, A Ziagaki, Ursula Plöckinger, and Daniela Blaschke
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Adult ,Male ,medicine.medical_specialty ,Time Factors ,Hormone Replacement Therapy ,medicine.drug_class ,Endocrinology, Diabetes and Metabolism ,030209 endocrinology & metabolism ,Drug Administration Schedule ,03 medical and health sciences ,Basal (phylogenetics) ,0302 clinical medicine ,Endocrinology ,Internal medicine ,Natriuretic Peptide, Brain ,medicine ,Natriuretic peptide ,Humans ,Interventricular septum ,Insulin-Like Growth Factor I ,Heart Failure ,Ejection fraction ,Human Growth Hormone ,business.industry ,Heart ,General Medicine ,Middle Aged ,medicine.disease ,Peptide Fragments ,Treatment Outcome ,medicine.anatomical_structure ,Echocardiography ,Growth Hormone ,030220 oncology & carcinogenesis ,Heart failure ,Cardiology ,Female ,Gh replacement ,business ,GH Deficiency ,Follow-Up Studies ,Hormone - Abstract
Objective Growth hormone (GH) deficiency is related to increased cardiovascular mortality. We studied clinical status, concentration of amino-terminal-pro B-type natriuretic-peptide (NT-proBNP) and echocardiographic parameters during long-term GH replacement (GH-R). Methods Fifty-one patients (29 females), 45.9 ± 11.3 years (mean ± s.d.), median follow-up 36.2 months, echocardiography and laboratory determinations initially and at 12-months intervals. Results At the last follow-up (last observation carried forward) (LFU (LOCF)) insulin-like growth-factor-1 standard deviation score (IGF-1 SDS) was ±1 in 92% of the patients. The median NT-proBNP declined significantly and stabilized (−40.5%) at LFU (LOCF) due to patients with a basal NT-proBNP >125 ng/L (indicative of heart failure). The basal NT-proBNP and the final IGF-1 SDS were significant predictors of the NT-proBNP at LFU (LOCF). Initially left ventricular enddiastolic diameter (LVEDD), left ventricular posterior wall diameter (LVPWD) and ejection fraction (EF) were normal, while interventricular septum diameter (IVSD) and left ventricular mass index (LVMi) were slightly increased. LVPWD and IVSD had significantly declined by year three. The LVMi was moderately to severely abnormal in 37.3 and 52.0% of patients initially and at LFU (LOCF). At LFU (LOCF) LVMi and IGF-1 were significantly correlated in the 14 male patients of this subgroup. Conclusion Long-term GH-R of GHD positively affected ISVD and LVPWD. In a subgroup of patients with severe GHD, LVMi increased concomitantly to the decline in NT-proBNP and this was positively correlated to the final IGF-1 concentration. Whether this observation indicates a positive development in a structurally altered heart muscle (reversal of adverse remodelling) or poses a future risk for heart failure needs further follow-up.
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- 2019
36. Long‐Term Colestyramine Treatment Prevents Cholestatic Attacks in Refractory Benign Recurrent Intrahepatic Cholestasis Type 1 Disease
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Koukoulioti, Eleni, primary, Ziagaki, Athanasia, additional, Weber, Susanne N., additional, Lammert, Frank, additional, and Berg, Thomas, additional
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- 2021
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37. Undiagnosed Phenylketonuria Can Exist Everywhere: Results From an International Survey
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Annemiek M.J. van Wegberg, Friedrich Trefz, Maria Gizewska, Sibtain Ahmed, Layachi Chabraoui, Maha S. Zaki, François Maillot, Francjan J. van Spronsen, K. Ahring, F. Al Mutairi, J.B. Arnoux, D. Ballhausen, J. Baruteau, L. Bernstein, S. Bijarnia-Mahay, F. Boemer, A. Bordugo, L. Brodosi, S. Brooks, H.B. Chew, K. Chyz, M. Coker, C. Collingwood, V. Cornejo, M.L. Couce, A. Cozens, S. Dahri, A.M. Das, C. de Laet, J. de las Heras Montero, A. de Vreugd, F.G. Debray, M. Dercksen, M. Descartes, L. Diogo, E. Drogari, H. Eiroa, F.T. Eminoglu, G.M. Enns, F. Eyskens, F. Feillet, S. Ford, L. Franzson, P. Freisinger, P. Garcia, O. Grafakou, G. Gramer, S. Gray, U. Groselj, S.C. Grünert, D. Haas, B. Handoom, T.B. Harte, C. Hendriksz, R.S. Heredia, J. Hertecant, T. Hoi-Yee Wu, A. Inwood, S.S. Jamuar, P. Jesina, J.J. Jonsson, A. Jovanovic, I. Kern, S. Kilavuz, I. Knerr, D. Kor, D. Korycinska-Chaaban, M. Kreile, B. Kumru, B. Lanpher, R. Lapatto, C. Lavigne, E. Leao-Teles, V. Leuzzi, N. Longo, A. Lopez-Uriarte, C.M.A. Lubout, A. MacDonald, E.M. Megdad, J. Mitchell, F. Mochel, P.J. Moreno-Lozano, A. Morris, C.F. Moura de Souza, T. Munoz, P.I. Nevalainen, M. Oscarson, K. Õunap, S. Paci, G.M. Pastores, P.L. Pearl, F.B. Piazzon, J. Pitt, G. Poon, F. Porta, N. Presner, A.A. Rabaty, K. Reinson, P. Reismann, T. Rink, J.C. Rocha, E. Rodrigues, A.G. Saini, A. Sanchez-Valle, J. Sander, P. Sarkhail, I.V.D. Schwartz, R. Sharma, B. Sheng, K. Siriwardena, S. Sirrs, D.R. Sjarif, N. Sondheimer, R. Sparkes, N. Specola, K.M. Stepien, I. Szatmari, M. Tchan, T. Tkemaladze, C. Tran, M.G. Valle, M. Vela-Amieva, M.L. Verdaguer, S.A. Vergano, P. Vermeersch, R. Vulturar, M.A.E.M. Wagenmakers, N. Weinhold, A.B. Williams, W.G. Wilson, D. Zafeiriou, H. Zhang, A. Ziagaki, J. Zolkowska, and Center for Liver, Digestive and Metabolic Diseases (CLDM)
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Adult ,Male ,medicine.medical_specialty ,congenital, hereditary, and neonatal diseases and abnormalities ,Delayed Diagnosis ,Adolescent ,Refugee ,media_common.quotation_subject ,Immigration ,phenylketonuria ,lnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4] ,late diagnosis ,Emigrants and Immigrants ,CHILDREN ,immigrant ,Global Health ,Health Services Accessibility ,Young Adult ,NBS ,Neonatal Screening ,Phenylketonurias ,MANAGEMENT ,Medicine ,Humans ,LATE-DIAGNOSED PHENYLKETONURIA ,refugee ,Child ,media_common ,Newborn screening ,business.industry ,Health Policy ,International survey ,Infant, Newborn ,Infant ,nutritional and metabolic diseases ,food and beverages ,ADULTS ,Late diagnosis ,Family medicine ,Child, Preschool ,Health Care Surveys ,PKU ,Pediatrics, Perinatology and Child Health ,embryonic structures ,Female ,business - Abstract
Many countries do not have a newborn screening (NBS) program, and immigrants from such countries are at risk for late diagnosis of phenylketonuria (PKU). In this international survey, 52 of 259 patients (20%) with late diagnosed PKU were immigrants, and 145 of the 259 (55%) were born before NBS or in a location without NBS. ispartof: JOURNAL OF PEDIATRICS vol:239 pages:231-+ ispartof: location:United States status: published
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- 2021
38. Comparison of Pheochromocytoma-Specific Morbidity and Mortality Among Adults With Bilateral Pheochromocytomas Undergoing Total Adrenalectomy vs Cortical-Sparing Adrenalectomy
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Neumann, H.P.H., Tsoy, U., Bancos, I., Amodru, V., Walz, M.K., Tirosh, A., Kaur, R.J., McKenzie, T., Qi, X.P., Bandgar, T., Petrov, R., Yukina, M.Y., Roslyakova, A., Horst-Schrivers, A.N.A. van der, Berends, A.M.A., Hoff, A.O., Castroneves, L.A., Ferrara, A.M., Rizzati, S., Mian, C., Dvorakova, S., Hasse-Lazar, K., Kvachenyuk, A., Peczkowska, M., Loli, P., Erenler, F., Krauss, T., Almeida, M.Q., Liu, L.F., Zhu, F.Z., Recasens, M., Wohllk, N., Corssmit, E.P.M., Shafigullina, Z., Calissendorff, J., Grozinsky-Glasberg, S., Kunavisarut, T., Schalin-Jantti, C., Castinetti, F., Vlcek, P., Beltsevich, D., Egorov, V.I., Schiavi, F., Links, T.P., Lechan, R.M., Bausch, B., Young, W.F., Eng, C., Jaiswal, S.K., Zschiedrich, S., Fragoso, M.C.B.V., Pereira, M.A.A., Li, M.H., Costa, J.B., Juhlin, C.C., Gross, D., Violante, A.H.D., Kocjan, T., Ngeow, J., Yoel, U., Fraenkel, M., Simsir, I.Y., Ugurlu, M.U., Ziagaki, A., Diaz, L.R., Kudlai, I.S., Gimm, O., Scherbaum, C.R., Abebe-Campino, G., Barbon, G., Taschin, E., Malinoc, A., Khudiakova, N.V., Ivanov, N.V., Pfeifer, M., Zovato, S., Ploeckinger, U., Makay, O., Grineva, E., Jarzab, B., Januszewicz, A., Shah, N., Seufert, J., Opocher, G., Larsson, C., Int Bilateral-Pheochromocytoma-Reg, Ege Üniversitesi, HUS Abdominal Center, Endokrinologian yksikkö, Damage and Repair in Cancer Development and Cancer Treatment (DARE), Guided Treatment in Optimal Selected Cancer Patients (GUTS), Neumann, Hartmut P. H., Tsoy, Uliana, Bancos, Irina, Amodru, Vincent, Walz, Martin K., Tirosh, Amit, Kaur, Ravinder Jeet, McKenzie, Travis, Qi, Xiaoping, Bandgar, Tushar, Petrov, Roman, Yukina, Marina Y., Roslyakova, Anna, van der Horst-Schrivers, Anouk N. A., Berends, Annika M. A., Hoff, Ana O., Castroneves, Luciana Audi, Ferrara, Alfonso Massimiliano, Rizzati, Silvia, Mian, Caterina, Dvorakova, Sarka, Hasse-Lazar, Kornelia, Kvachenyuk, Andrey, Peczkowska, Mariola, Loli, Paola, Erenler, Feyza, Krauss, Tobias, Almeida, Madson Q., Liu, Longfei, Zhu, Feizhou, Recasens, Monica, Wohllk, Nelson, Corssmit, Eleonora P. M., Shafigullina, Zulfiya, Calissendorff, Jan, Grozinsky-Glasberg, Simona, Kunavisarut, Tada, Schalin-Jantti, Camilla, Castinetti, Frederic, Vlcek, Petr, Beltsevich, Dmitry, Egorov, Viacheslav, I, Schiavi, Francesca, Links, Thera P., Lechan, Ronald M., Bausch, Birke, Young, William F., Jr., Eng, Charis, Jaiswal, Sanjeet Kumar, Zschiedrich, Stefan, Fragoso, Maria C. B., V, Pereira, Maria A. A., Li, Minghao, Biarnes Costa, Josefina, Juhlin, Carl Christofer, Gross, David, Violante, Alice H. D., Kocjan, Tomaz, Ngeow, Joanne, Yoel, Uri, Fraenkel, Merav, Simsir, Ilgin Yildirim, Ugurlu, M. Umit, Ziagaki, Athanasia, Robles Diaz, Luis, Kudlai, Inna Stepanovna, Gimm, Oliver, Scherbaum, Christina Rebecca, Abebe-Campino, Gadi, Barbon, Giovanni, Taschin, Elisa, Malinoc, Angelica, Khudiakova, Natalia Valeryevna, Ivanov, Nikita, V, Pfeifer, Marija, Zovato, Stefania, Ploeckinger, Ursula, Makay, Ozer, Grineva, Elena, Jarzab, Barbara, Januszewicz, Andrzej, Shah, Nalini, Seufert, Jochen, Opocher, Giuseppe, Larsson, Catharina, and Lee Kong Chian School of Medicine (LKCMedicine)
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Male ,endocrine system diseases ,SURGERY ,medicine.medical_treatment ,Adrenal Gland Neoplasms ,030230 surgery ,Primary Adrenal Insufficiency ,0302 clinical medicine ,Interquartile range ,Paraganglioma ,Registries ,Original Investigation ,OUTCOMES ,integumentary system ,Adrenal crisis ,Adrenalectomy ,General Medicine ,GERMLINE MUTATIONS ,3. Good health ,Online Only ,Diabetes and Endocrinology ,PARAGANGLIOMA ,CONFER ,030220 oncology & carcinogenesis ,Female ,medicine.symptom ,hormones, hormone substitutes, and hormone antagonists ,Adult ,medicine.medical_specialty ,endocrine system ,GENETICS ,Urology ,Pheochromocytoma ,Bilateral Pheochromocytomas ,03 medical and health sciences ,Young Adult ,medicine ,Adrenal insufficiency ,MANAGEMENT ,Humans ,Medicine [Science] ,RECURRENCE ,Retrospective Studies ,business.industry ,Research ,Retrospective cohort study ,medicine.disease ,PREDISPOSITION ,3121 General medicine, internal medicine and other clinical medicine ,Morbidity ,Neoplasm Recurrence, Local ,business ,Organ Sparing Treatments - Abstract
Key Points Question Is cortical-sparing adrenalectomy associated with increased pheochromocytoma-specific morbidity and mortality for patients with bilateral pheochromocytomas compared with total adrenalectomy? Findings In this cohort study of 625 patients with bilateral pheochromocytomas, most had hereditary syndromes, but 36% initially presented with unilateral pheochromocytoma. Bilateral total adrenalectomy resulted in a high rate of adverse effects from glucocorticoid replacement therapy, whereas cortical-sparing surgery was not associated with a worse outcome. Meaning These findings suggest that cortical-sparing surgery may be the preferred approach for patients at risk for, or diagnosed with, bilateral pheochromocytomas, especially those harboring a germline mutation in one of the known predisposition genes., This cohort study compares outcomes associated with cortical-sparing adrenalectomy vs total adrenalectomy for patients with bilateral pheochromocytomas., Importance Large studies investigating long-term outcomes of patients with bilateral pheochromocytomas treated with either total or cortical-sparing adrenalectomies are needed to inform clinical management. Objective To determine the association of total vs cortical-sparing adrenalectomy with pheochromocytoma-specific mortality, the burden of primary adrenal insufficiency after bilateral adrenalectomy, and the risk of pheochromocytoma recurrence. Design, Setting, and Participants This cohort study used data from a multicenter consortium-based registry for 625 patients treated for bilateral pheochromocytomas between 1950 and 2018. Data were analyzed from September 1, 2018, to June 1, 2019. Exposures Total or cortical-sparing adrenalectomy. Main Outcomes and Measures Primary adrenal insufficiency, recurrent pheochromocytoma, and mortality. Results Of 625 patients (300 [48%] female) with a median (interquartile range [IQR]) age of 30 (22-40) years at diagnosis, 401 (64%) were diagnosed with synchronous bilateral pheochromocytomas and 224 (36%) were diagnosed with metachronous pheochromocytomas (median [IQR] interval to second adrenalectomy, 6 [1-13] years). In 505 of 526 tested patients (96%), germline mutations were detected in the genes RET (282 patients [54%]), VHL (184 patients [35%]), and other genes (39 patients [7%]). Of 849 adrenalectomies performed in 625 patients, 324 (52%) were planned as cortical sparing and were successful in 248 of 324 patients (76.5%). Primary adrenal insufficiency occurred in all patients treated with total adrenalectomy but only in 23.5% of patients treated with attempted cortical-sparing adrenalectomy. A third of patients with adrenal insufficiency developed complications, such as adrenal crisis or iatrogenic Cushing syndrome. Of 377 patients who became steroid dependent, 67 (18%) developed at least 1 adrenal crisis and 50 (13%) developed iatrogenic Cushing syndrome during median (IQR) follow-up of 8 (3-25) years. Two patients developed recurrent pheochromocytoma in the adrenal bed despite total adrenalectomy. In contrast, 33 patients (13%) treated with successful cortical-sparing adrenalectomy developed another pheochromocytoma within the remnant adrenal after a median (IQR) of 8 (4-13) years, all of which were successfully treated with another surgery. Cortical-sparing surgery was not associated with survival. Overall survival was associated with comorbidities unrelated to pheochromocytoma: of 63 patients who died, only 3 (5%) died of metastatic pheochromocytoma. Conclusions and Relevance Patients undergoing cortical-sparing adrenalectomy did not demonstrate decreased survival, despite development of recurrent pheochromocytoma in 13%. Cortical-sparing adrenalectomy should be considered in all patients with hereditary pheochromocytoma.
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- 2019
39. Cardiac Magnetic Resonance Reveals Incipient Cardiomyopathy Traits in Adult Patients with Phenylketonuria
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Bernhard Schnackenburg, Frank Tacke, Burkert Pieske, Ursula Plöckinger, Jan-Hendrik Hassel, Athanasia Ziagaki, Eckart Fleck, Michael Gräfe, Radu Tanacli, Alexander Berger, Rolf Gebker, Sebastian Kelle, and Christopher Schneeweis
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medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Neuropsychology ,Diastole ,Cardiomyopathy ,Disease ,medicine.disease ,Cardiac magnetic resonance imaging ,Internal medicine ,medicine ,Cardiology ,Stage (cooking) ,business ,Dyslipidemia ,Cardiac imaging - Abstract
Background: Phenylketonuria (PKU) is the most common inborn error of amino-acid metabolism, which, when untreated results to severe neuropsychological complications. . New born screenings programs and immediate beginning of phenylalanine-restricted diet, greatly ameliorate the prognosis. However, previous studies have shown that PKU patients have elevated levels of oxidative stress and collateral metabolic abnormalities such as dyslipidemia, predisposing to cardiovascular disease. The purpose of this study was to characterize the cardiac phenotype of adult subjects with PKU using advanced cardiac imaging. Methods: Thirty-nine adult patients with PKU (age 30.5±8.7 year old, median 10 year phenylalanine concentration (Phe) 924±330 µmol/L) and thirty-nine age- and gender- matched healthy controls were investigated. Participants underwent a comprehensive cardiac magnetic resonance imaging (CMR) and echocardiography examination to determine systolic and diastolic left (LV) and right (RV) ventricular function, LV mass, ventricular fibrosis, left atrial function and aortic distensibility. CMR parametric mapping was used to characterize structural tissue modification. All available quarterly plasma levels of Phe and tyrosine (Tyr) levels were averaged for 10 years prior to the CMR scan to evaluate therapeutic efficacy and compliance. Results: PKU patients had thinner LV walls (Septal end-diastolic (ED) thickness 7.0±17 vs 8.8±1.7 mm, p 1200µmol/L (909±48 ms). Both mean Phe (p=0.013) and Tyr (p=0.035) concentration levels were independently predictive for lower T1 values in a regression model. Conclusion: Taken together our findings indicate an early stage LV dysfunction in patients with PKU which associates lower T1 native levels probably reflecting an infiltration with lipids of the myocardium. These results suggest the importance of regular cardiac follow-up in clinical monitoring of the adult subjects with PKU. Funding Statement: Sebastian Kelle is supported by a grant from Philips Healthcare and received funding from the DZHK (German Centre for Cardiovascular Research) and by the BMBF (German Ministry of Education and Research). Declaration of Interests: None of the other authors reports a relationship with industry and other relevant entities – financial or otherwise – that might pose a conflict of interest in connection with the submitted article. The following authors report financial activities outside the submitted work: Radu Tanacli reports no conflict of interest. Burkert Pieske reports having received consultancy and lecture honoraria from Bayer Daiichi Sankyo, MSD, Novartis, Sanofi-Aventis, Stealth Peptides and Vifor Pharma; and editor honoraria from the Journal of the American College of Cardiology. Radu Tanacli and the other co-authors report no conflict of interest. Ethics Approval Statement: The study was approved by the Ethics Committee of the Charite University of Medicine in Berlin, complied with the Declaration of Helsinki and was registered at the German Register for Clinical Studies (DRKS00001120).
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- 2020
40. The Wide Phenotypic Spectrum of L‐2 Hydroxyglutaric Aciduria in Adults
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Mainka, Tina, primary, Ziagaki, Athanasia, additional, Koning, Tom J., additional, Kühn, Andrea A., additional, and Ganos, Christos, additional
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- 2020
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41. Obesity and pituitary gland volume – a correlation study using three-dimensional magnetic resonance imaging
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Fehrenbach, Uli, primary, Jadan, Anas, additional, Auer, Timo A, additional, Kreutz, Katharina, additional, Geisel, Dominik, additional, Ziagaki, Athanasia, additional, Bobbert, Thomas, additional, and Wiener, Edzard, additional
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- 2020
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42. Cardiac Magnetic Resonance Reveals Incipient Cardiomyopathy Traits in Adult Patients with Phenylketonuria
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Tanacli, Radu, primary, Hassel, Jan-Hendrik, additional, Schnackenburg, Bernhard, additional, Gebker, Rolf, additional, Berger, Alexander, additional, Gräfe, Michael, additional, Schneeweis, Christopher, additional, Fleck, Eckart, additional, Tacke, Frank, additional, Pieske, Burkert, additional, Plöckinger, Ursula, additional, Ziagaki, Athanasia, additional, and Kelle, Sebastian, additional
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- 2020
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43. An integrative correlation of myopathology, phenotype and genotype in late onset Pompe disease
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Markus Bergmann, Markus Deschauer, Martin Kulessa, Andreas Hahn, Matthias Boentert, Ursula Plöckinger, Christian Mawrin, Stefan Vielhaber, Cornelia Kornblum, Athanasia Ziagaki, Iris Weyer-Menkhoff, Benedikt Schoser, Lara Viergutz, Werner Stenzel, Kristl G. Claeys, Ilka Schneider, Joachim Weis, Dagmar Nolte, Peter Young, and Anne Schänzer
- Subjects
0301 basic medicine ,Adult ,Male ,Pathology ,medicine.medical_specialty ,Histology ,Adolescent ,Genotype ,Late onset ,Pathology and Forensic Medicine ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Fibrosis ,Physiology (medical) ,Biopsy ,medicine ,Lysosomal storage disease ,Humans ,ddc:610 ,Muscle, Skeletal ,Genetic Association Studies ,Aged ,medicine.diagnostic_test ,business.industry ,Glycogen Storage Disease Type II ,Autophagy ,Skeletal muscle ,Enzyme replacement therapy ,Middle Aged ,medicine.disease ,030104 developmental biology ,medicine.anatomical_structure ,Phenotype ,Neurology ,Female ,Neurology (clinical) ,business ,030217 neurology & neurosurgery - Abstract
Neuropathology & applied neurobiology 46(4), 359-374 (2019). doi:10.1111/nan.12580, Published by Wiley-Blackwell, Oxford [u.a.]
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- 2019
44. An integrative correlation of myopathology, phenotype and genotype in late onset Pompe disease
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Kulessa, Martin, Weyer‐Menkhoff, Iris, Viergutz, Lara, Kornblum, Cornelia, Claeys, Kristl G., Schneider, Ilka, Plöckinger, Ursula, Young, Peter, Boentert, Matthias, Vielhaber, Stefan, Mawrin, Christian, Bergmann, Markus, Weis, Joachim, Ziagaki, Athanasia, Stenzel, Werner, Deschauer, Marcus, Nolte, Dagmar, Hahn, Andreas, Schoser, Benedikt, Schänzer, Anne, Kulessa, Martin, Weyer‐Menkhoff, Iris, Viergutz, Lara, Kornblum, Cornelia, Claeys, Kristl G., Schneider, Ilka, Plöckinger, Ursula, Young, Peter, Boentert, Matthias, Vielhaber, Stefan, Mawrin, Christian, Bergmann, Markus, Weis, Joachim, Ziagaki, Athanasia, Stenzel, Werner, Deschauer, Marcus, Nolte, Dagmar, Hahn, Andreas, Schoser, Benedikt, and Schänzer, Anne
- Abstract
Aims: Pompe disease is caused by pathogenic mutations in the alpha 1,4‐glucosidase (GAA) gene and in patients with late onset Pome disease (LOPD), genotype–phenotype correlations are unpredictable. Skeletal muscle pathology includes glycogen accumulation and altered autophagy of various degrees. A correlation of the muscle morphology with clinical features and the genetic background in GAA may contribute to the understanding of the phenotypic variability. Methods: Muscle biopsies taken before enzyme replacement therapy were analysed from 53 patients with LOPD. On resin sections, glycogen accumulation, fibrosis, autophagic vacuoles and the degree of muscle damage (morphology‐score) were analysed and the results were compared with clinical findings. Additional autophagy markers microtubule‐associated protein 1A/1B‐light chain 3, p62 and Bcl2‐associated athanogene 3 were analysed on cryosections from 22 LOPD biopsies. Results: The myopathology showed a high variability with, in most patients, a moderate glycogen accumulation and a low morphology‐score. High morphology‐scores were associated with increased fibrosis and autophagy highlighting the role of autophagy in severe stages of skeletal muscle damage. The morphology‐score did not correlate with the patient's age at biopsy, disease duration, nor with the residual GAA enzyme activity or creatine‐kinase levels. In 37 patients with LOPD, genetic analysis identified the most frequent mutation, c.‐32‐13T>G, in 95%, most commonly in combination with c.525delT (19%). No significant correlation was found between the different GAA genotypes and muscle morphology type. Conclusions: Muscle morphology in LOPD patients shows a high variability with, in most cases, moderate pathology. Increased pathology is associated with more fibrosis and autophagy.
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- 2019
45. Prevention Medicine in Bilateral Phaeochromocytoma
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Annika M A Berends, Ana O. Hoff, Mariola Pęczkowska, Roman Petrov, Nelson Wohllk, Tomaz Kocjan, Vincent Amodru, David J. Gross, Camilla Schalin-Jäntti, Barbara Jarzab, Xiao-Ping Qi, Marina Y. Yukina, Charis Eng, Francesca Schiavi, Simona Grozinsky-Glasberg, Özer Makay, Irina Bancos, Ursula Ploeckinger, Sanjeet Kumar Jaiswal, Jochen Seufert, Ronald M. Lechan, Ravinder Kaur Jeet, Madson Q. Almeida, Stefania Zovato, Angelica Malinoc, Marija Pfeifer, Josefina Biarnes Costa, Athanasia Ziagaki, Anouk N A van der Horst-Schrivers, Feizhou Zhu, Andrey Kvachenyuk, Elena Grineva, Oliver Gimm, Ilgin Yildirim Simsir, Sarka Dvorakova, Uri Yoel, Maria Candida Barisson Villares Fragoso, Giuseppe Opocher, Inna Stepanovna Kudlai, Longfei Liu, Luis Robles Diaz, Catharina Larsson, Viacheslav I. Egorov, Frederic Castinetti, Zulfiya Shafigullina, Andrzej Januszewicz, Maria Adelaide Albergaria Pereira, Stefan Zschiedrich, Silvia Rizzati, Umit Ugurlu, Alfonso Massimiliano Ferrara, Luciana A. Castroneves, Nikita V. Ivanov, Paola Loli, Mònica Recasens, Dmitry Beltsevich, Kornelia Hasse-Lazar, Minghao Li, Eleonora P M Corssmit, Tushar Bandgar, Tada Kunavisarut, Nalini S. Shah, Thera P. Links, Joanne Ngeow, C. Christofer Juhlin, Giovanni Barbon, Jan Callissendorff, Christina Rebecca Scherbaum, Hartmut P. H. Neumann, Anna Roslyakova, Alice Helena Dutra Violante, Feyza Erenler, Tobias Krauss, Petr Vlcek, Caterina Mian, Uliana Tsoy, Martin K. Walz, William F. Young, Elisa Taschin, Natalia Valeryevna Khudiakova, Merav Fraenkel, and Birke Bausch
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medicine.medical_specialty ,050208 finance ,Surgical approach ,Standard of care ,medicine.diagnostic_test ,business.industry ,General surgery ,05 social sciences ,Age at diagnosis ,Institutional review board ,3. Good health ,Iatrogenic Cushing Syndrome ,Informed consent ,0502 economics and business ,medicine ,Overall survival ,050207 economics ,business ,Genetic testing - Abstract
Background: Adrenalectomy is standard of care for phaeochromocytomas, but for bilateral phaeochromocytoma, the recommendations are inconsistent. However, large studies systematically investigating long-term outcomes for total adrenalectomies compared to those for patients with adrenal-sparing operations are lacking. Methods: A multi-center consortium-based registry was established to study clinical, genetic and surgical data in 623 patients with bilateral phaeochromocytomas. Findings: Of 623 patients, median age at diagnosis was 30 (range 3-79) years and 48% were female. Synchronous bilateral phaeochromocytomas were diagnosed in 396 patients and metachronousphaeochromocytomas in 227 (36%); interval to second operations were up to 40 (median 6) years. In 96% of tested patients germline mutations were detected in the genes RET (56%), VHL (34%), and others (10%). Of 849 operations, 385 (45%) surgeries in 326 patients were planned as adrenal-sparing which was successful in 251. 372 patients became steroid-dependent. Follow-up was up to 53 (median 11) years. Adrenal crises developed in 67 patients (18%) during follow-up, and 49 (13%) had manifestations of iatrogenic Cushing syndrome. Of the steroid-independent patients, 34 (14%) had developed another phaeochromocytoma within the remnant adrenal after up to 27, median 8 years, all treated with removal of the new phaeochromocytoma. Overall survival was mainly influenced by non-phaeochromocytoma comorbidities, whereas only 1% died of metastatic phaeochromocytoma. Cortical-sparing operations did not affect survival. Interpretation: Cortical-sparing operations avert lifelong steroid-dependency without affecting survival. Preoperative genetic testing is recommended even in unilateral phaeochromocytoma presentations to identify patients at heritable risk, to guide surgical approach, and inform for gene-specific extra-adrenal morbidities. Funding Statement: Supported in part by the grant AZV 16-32665A to Sarka Dvorakova and Petr Vlcek, and the Blank Foundation to Charis Eng. Declaration of Interests: None of the authors have relevant conflicts of interest. Ethics Approval Statement: The institutional review boards for human subjects’ protection or ethical committees of all participating centers approved this study. Patients provided written informed consent according to the protocols of respective institutional review boards. In The Netherlands data were collected anonymously, and no further Institutional Review Board approval is required.
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- 2018
46. Prevention Medicine in Bilateral Phaeochromocytoma
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Uliana Tsoy, Vincent Amodru, Martin K. Walz, Irina Bancos, Ravinder Kaur Jeet, Xiaoping Qi, Tushar Bandgar, Sanjeet Kumar Jaiswal, Roman Petrov, Anna Roslyakova, Marina Y. Yukina, Anouk N. A. van der Horst-Schrivers, Annika M.A. Berends, Ana O. Hoff, Luciana Audi Castroneves, Alfonso Massimiliano Ferrara, Silvia Rizzati, Caterina Mian, Sarka Dvorakova, Kornelia Hasse-Lazar, Andrey Kvachenyuk, Mariola Peczkowska, Paola Loli, Feyza Erenler, Stefan Zschiedrich, Tobias Krauss, Madson Q. Almeida, Maria C. B. V. Fragoso, Maria A. A. Pereira, Longfei Liu, Minghao Li, Feizhou Zhu, Mònica Recasens, Josefina Biarnes Costa, Nelson Wohllk, Eleonora Corssmit, Zulfiya Shafigullina, Jan Callissendorff, Carl Christofer Juhlin, Simona Grozinsky-Glasberg, David Gross, Tada Kunavisarut, Alice H. D. Violante, Tomaz Kocjan, Joanne Ngeow, Uri Yoel, Merav Fraenkel, Ilgin Yildirim Simsir, Umit Ugurlu, Athanasia Ziagaki, Camilla Schalin-Jundefinedntti, Luis Robles Dundefinedaz, Inna Stepanovna Kudlai, Oliver Gimm, Christina Rebecca Scherbaum, Giovanni Barbon, Elisa Taschin, Angelica Malinoc, Natalia Valeryevna Khudiakova, Nikita V. Ivanov, Frederic Castinetti, Marija Pfeifer, Dmitry Beltsevich, Viacheslav I. Egorov, Stefania Zovato, Ursula Ploeckinger, undefinedzer Makay, Elena Grineva, Francesca Schiavi, Barbara Jarzab, Andrzej Januszewicz, Giuseppe Opocher, Nalini Shah, Jochen Seufert, Thera P. Links, Catharina Larsson, Ronald M. Lechan, Birke Bausch, William F. Young, Charis Eng, and Hartmut P. H. Neumann
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- 2018
47. 2-deoxy-2-[18]fluoro-D-glucose PET/CT (18FDG PET/CT) may not be a viable biomarker in Pompe disease
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Nikolaus Tiling, Ursula Plöckinger, Athanasia Ziagaki, A Poellinger, and Vikas Prasad
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0301 basic medicine ,Male ,Pathology ,Contrast Media ,lcsh:Medicine ,chemistry.chemical_compound ,0302 clinical medicine ,Positron Emission Tomography Computed Tomography ,Drug Discovery ,Glycogen storage disease type II ,Lysosomal storage disease ,610 Medicine & health ,medicine.diagnostic_test ,Glycogen ,Glycogen Storage Disease Type II ,Pompe disease ,2-deoxy-2-[18]fluoro-D-glucose PET/CT ,Enzyme replacement therapy ,Middle Aged ,Magnetic Resonance Imaging ,Molecular Medicine ,Biomarker (medicine) ,medicine.symptom ,Research Article ,MRI ,Adult ,medicine.medical_specialty ,lcsh:QH426-470 ,03 medical and health sciences ,Atrophy ,Fluorodeoxyglucose F18 ,Genetics ,medicine ,Humans ,Enzyme Replacement Therapy ,Myopathy ,Muscle, Skeletal ,Molecular Biology ,business.industry ,lcsh:R ,Magnetic resonance imaging ,Biomarker ,medicine.disease ,lcsh:Genetics ,030104 developmental biology ,Glucose ,chemistry ,business ,030217 neurology & neurosurgery ,Biomarkers - Abstract
Background Pompe disease (PD) is an autosomal recessive, lysosomal storage disease due to a mutation of the acid α-glucosidase (GAA) gene. In adult patients, PD is characterized by slowly progressive limb-girdle and trunk myopathy and restrictive respiratory insufficiency. Enzyme replacement therapy (ERT) is available, improving or stabilizing muscle-function in some and slowing deterioration in other patients. Unfortunately, there is no biomarker available to indicate therapeutic efficacy and/or disease activity. Whole body MRI depicts all skeletal muscles demonstrating foci of atrophic muscles, i.e., late and irreversible pathological changes. Any method indicating the localizations of increased muscle glycogen storage, muscle inflammation and/or degradation could possibly help identifying newly afflicted tissue and may be of prognostic value. We therefore investigated 2-deoxy-2-[18]fluoro-D-glucose (FDG) PET, a biomarker for glucose-metabolism, as a tool to evaluate disease activity and prognosis in PD. Methods In a pilot study, we investigated four patients by FDG dynamic PET/CT while on ERT. One patient had FDG-PET/CT twice, before and after 12 months on ERT. Dynamic FDG-PET/CT quantifies the metabolic rate of glucose utilisation in mg/ml/min. MRI was performed in parallel with pelvic and thigh muscles semi-quantitatively scored for atrophy and disease-activity. Results None of the muscles analysed showed a focally increased FDG-uptake. Thus, quantification of muscle glucose metabolism could not be calculated. However, increased FDG-uptake, i.e., increased glucose utilisation, was observed in the respiratory muscles of one patient with severe, restrictive respiratory failure. In contrast, specific MRI sequences showed oedematous as well as atrophic muscle areas in PD. Conclusions Our pilot study demonstrates that FDG-uptake does not correlate with glycogen storage in vivo. In contrast, MRI is an excellent tool to demonstrate the extent of muscle involvement. Specific MRI sequences may even demonstrate early changes possibly allowing prognostic predictions or localization of early stages of PD.
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- 2018
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48. An integrative correlation of myopathology, phenotype and genotype in late onset Pompe disease
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Kulessa, M., primary, Weyer‐Menkhoff, I., additional, Viergutz, L., additional, Kornblum, C., additional, Claeys, K. G., additional, Schneider, I., additional, Plöckinger, U., additional, Young, P., additional, Boentert, M., additional, Vielhaber, S., additional, Mawrin, C., additional, Bergmann, M., additional, Weis, J., additional, Ziagaki, A., additional, Stenzel, W., additional, Deschauer, M., additional, Nolte, D., additional, Hahn, A., additional, Schoser, B., additional, and Schänzer, A., additional
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- 2019
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49. Long-term growth hormone (GH) replacement of adult GH deficiency (GHD) benefits the heart
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Ziagaki, A, primary, Blaschke, D, additional, Haverkamp, W, additional, and Plöckinger, U, additional
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- 2019
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50. An integrative correlation of myopathology, phenotype and genotype in late onset Pompe disease.
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Kulessa, M., Weyer‐Menkhoff, I., Viergutz, L., Kornblum, C., Claeys, K. G., Schneider, I., Plöckinger, U., Young, P., Boentert, M., Vielhaber, S., Mawrin, C., Bergmann, M., Weis, J., Ziagaki, A., Stenzel, W., Deschauer, M., Nolte, D., Hahn, A., Schoser, B., and Schänzer, A.
- Subjects
GLYCOGEN storage disease type II ,AUTOPHAGY ,SKELETAL muscle ,GENOTYPES ,MICROTUBULE-associated proteins - Abstract
Aims: Pompe disease is caused by pathogenic mutations in the alpha 1,4‐glucosidase (GAA) gene and in patients with late onset Pome disease (LOPD), genotype–phenotype correlations are unpredictable. Skeletal muscle pathology includes glycogen accumulation and altered autophagy of various degrees. A correlation of the muscle morphology with clinical features and the genetic background in GAA may contribute to the understanding of the phenotypic variability. Methods: Muscle biopsies taken before enzyme replacement therapy were analysed from 53 patients with LOPD. On resin sections, glycogen accumulation, fibrosis, autophagic vacuoles and the degree of muscle damage (morphology‐score) were analysed and the results were compared with clinical findings. Additional autophagy markers microtubule‐associated protein 1A/1B‐light chain 3, p62 and Bcl2‐associated athanogene 3 were analysed on cryosections from 22 LOPD biopsies. Results: The myopathology showed a high variability with, in most patients, a moderate glycogen accumulation and a low morphology‐score. High morphology‐scores were associated with increased fibrosis and autophagy highlighting the role of autophagy in severe stages of skeletal muscle damage. The morphology‐score did not correlate with the patient's age at biopsy, disease duration, nor with the residual GAA enzyme activity or creatine‐kinase levels. In 37 patients with LOPD, genetic analysis identified the most frequent mutation, c.‐32‐13T>G, in 95%, most commonly in combination with c.525delT (19%). No significant correlation was found between the different GAA genotypes and muscle morphology type. Conclusions: Muscle morphology in LOPD patients shows a high variability with, in most cases, moderate pathology. Increased pathology is associated with more fibrosis and autophagy. [ABSTRACT FROM AUTHOR]
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- 2020
- Full Text
- View/download PDF
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