Preview

Pediatric pharmacology

Advanced search

CLINICAL RECOMMENDATION TO THE DIAGNOSTICS AND TREATMENT OF HYPOPHOSPHATASIA IN CHILDREN

https://doi.org/10.15690/pf.v13i6.1665

Abstract

Hypophosphatasia is a rare genetic disorder caused by deficiency of tissue-specific  alkaline phosphatase as a result of mutations in the ALPL gene. Depending on the form and severity of the disease, pathology may spawn in utero, in childhood or in adult age. Given functions of alkaline phosphatase, patients experience multisystem disorders: primarily changes in bone (osteoporosis, rachitic deformations,  fractures),  lung  disease  (hypoplasia  with respiratory  failure)  and  central  nervous  system  (seizures),  hypercalcemia with development of nephrocalcinosis. Without timely treatment, the disease may be harmful to life in most cases. Patients required observation of a multidisciplinary team of physicians. The only effective treatment is enzyme replacement therapy with asfotase alpha. It is also necessary to carry out symptomatic treatment and rehabilitation of patients with the use of physiotherapy and therapeutic physical training complexes of exercises.

About the Authors

A. A. Baranov
Scientific Center of Children’s Health; Russian Federation N.I. Pirogov Russian National Research Medical University
Russian Federation
Moscow


L. S. Namazova-Baranova
Scientific Center of Children’s Health; Russian Federation N.I. Pirogov Russian National Research Medical University; I.M. Sechenov First Moscow State Medical University
Russian Federation


К. V. Savostianov
Scientific Center of Children’s Health
Russian Federation
Moscow


Т. V. Margieva
Scientific Center of Children’s Health; Russian Federation N.I. Pirogov Russian National Research Medical University
Russian Federation
Moscow


E. A. Vishneva
Scientific Center of Children’s Health
Russian Federation
Moscow


G. Т. Yakhyaeva
Scientific Center of Children’s Health
Russian Federation
Moscow


References

1. Whyte MP. Hypophosphatasia — aetiology, nosology, pathogenesis, diagnosis and treatment. Nat Rev Endocrinol. 2016;12(4): 233–246. doi: 10.1038/nrendo.2016.14.

2. Millan JL, Whyte MP. Alkaline phosphatase and hypophosphatasia. Calcif Tissue Int. 2016;98(4):398–416. doi: 10.1007/s00223-015-0079-1.

3. Mornet E, Yvard A, Taillandier A, et al. A molecular-based estimation of the prevalence of hypophosphatasia in the European population. Ann Hum Genet. 2011;75(3):439–445. doi: 10.1111/j.1469-1809.2011.00642.x.

4. Whyte MP, Leung E, Wilcox W, et al. Hypophosphatasia: a retrospective natural history study of the severe perinatal and infantile forms. Poster presented at the 2014 Pediatric Academic Societies and Asian Society for Pediatric Research Joint Meeting. Vancouver, B.C., Canada, May 5, 2014. Abstract 752416.

5. Whyte MP, Zhang F, Wenkert D, et al. Hypophosphatasia: validation and expansion of the clinical nosology for children from 25 years experience with 173 pediatric patients. Bone. 2015; 75:229–239. doi: 10.1016/j.bone.2015.02.022.

6. Bishop N, Munns CF, Ozono K. Transformative therapy in hypophosphatasia. Arch Dis Child. 2016;101(6):514–515. doi: 10.1136/archdischild-2015-309579.

7. Anderson HC, Harmey D, Camacho NP, et al. Sustained osteomalacia of long bones despite major improvement in other hypophosphatasia-related mineral deficits in tissue nonspecific alkaline phosphatase/nucleotide pyrophosphatase phosphodiesterase 1 double-deficient mice. Am J Pathol. 2005;166(6):1711–1720. doi: 10.1016/S0002-9440(10)62481-9.

8. Braunstein NА. Multiple fractures, pain, and severe disability in a patient with adult-onset hypophosphatasia. Bone Rep. 2016;4: 1–4. doi: 10.1016/j.bonr.2015.10.005.

9. Whyte M. Hypophosphatasia. In: Thakker RV, Whyte MP, Eisman J, Igarashi T, editors. Genetics of bone biology and skeletal disease. London: Academic Press; 2013. p. 337–360.

10. Whyte MP, Greenberg CR, Salman NJ, et al. Enzyme-replacement therapy in life-threatening hypophosphatasia. N Engl J Med. 2012;366(10):904–913. doi: 10.1056/NEJMoa1106173.


Review

For citations:


Baranov A.A., Namazova-Baranova L.S., Savostianov К.V., Margieva Т.V., Vishneva E.A., Yakhyaeva G.Т. CLINICAL RECOMMENDATION TO THE DIAGNOSTICS AND TREATMENT OF HYPOPHOSPHATASIA IN CHILDREN. Pediatric pharmacology. 2016;13(6):539-543. (In Russ.) https://doi.org/10.15690/pf.v13i6.1665

Views: 3686


ISSN 1727-5776 (Print)
ISSN 2500-3089 (Online)