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Modern Approaches to the Management of Children with Hypophosphatasia

https://doi.org/10.15690/pf.v20i4.2601

Abstract

Hypophosphatasia is rare genetic disease caused by tissue-nonspecific alkaline phosphatase deficiency due to the mutation in the ALPL gene. Disease can manifest in utero, in childhood or in adults depending on its form and severity. This article presents modern data on the epidemiology, etiology, and clinical signs of hypophosphatasia in children, covers in details differential diagnostic search, and gives guidelines for its evidence-based treatment. Without timely treatment the prognosis of the disease is unfavorable in most cases. Such patients require follow-up by multidisciplinary team of physicians. The only effective method of treatment is enzyme replacement therapy with asfotase alfa. Symptomatic therapy is also crucial as well as physiotherapeutic procedures and therapeutic exercise programs (at rehabilitation stage).

About the Authors

Aleksander A. Baranov
Research Institute of Pediatrics and Children's Health in Petrovsky National Research Centre of Surgery; Sechenov First Moscow State Medical University
Russian Federation

Moscow


Disclosure of interest:

None



Tatiana T. Batysheva
Scientific and Practical Center for Pediatric Psychoneurology of Moscow Health Department; Russian People's Friendship University
Russian Federation

Moscow


Disclosure of interest:

None



Olga V. Bykova
Scientific and Practical Center for Pediatric Psychoneurology of Moscow Health Department; Russian People's Friendship University
Russian Federation

Moscow


Disclosure of interest:

None



Nato D. Vashakmadze
Research Institute of Pediatrics and Children's Health in Petrovsky National Research Centre of Surgery; Pirogov Russian National Research Medical University
Russian Federation

Moscow


Disclosure of interest:

None



Elena V. Vislobokova
Moscow State University of Medicine and Dentistry named after A.I. Evdokimov
Russian Federation

Moscow


Disclosure of interest:

None



Alisa V. Vitebskaya
Sechenov First Moscow State Medical University
Russian Federation

Moscow


Disclosure of interest:

None



Elena A. Vishneva
Research Institute of Pediatrics and Children's Health in Petrovsky National Research Centre of Surgery; Pirogov Russian National Research Medical University
Russian Federation

Moscow


Disclosure of interest:

None



Victoria Yu. Voynova
Pirogov Russian National Research Medical University; Veltischev Research and Clinical Institute for Pediatrics
Russian Federation

Moscow


Disclosure of interest:

None



Natalia V. Zhurkova
Research Institute of Pediatrics and Children's Health in Petrovsky National Research Centre of Surgery
Russian Federation

Moscow


Disclosure of interest:

None



Ekaterina Yu. Zakharova
Research Centre for Medical Genetics
Russian Federation

Moscow


Disclosure of interest:

None



Larisa P. Kisel'nikova
Moscow State University of Medicine and Dentistry named after A.I. Evdokimov
Russian Federation

Moscow


Disclosure of interest:

None



Mikhail M. Kostik
Saint-Petersburg State Pediatric Medical University; Almazov National Medical Research Centre
Russian Federation

Saint-Petersburg


Disclosure of interest:

None



Sergey I. Kutsev
Research Centre for Medical Genetics
Russian Federation

Moscow


Disclosure of interest:

None



Tea V. Margieva
Sechenov First Moscow State Medical University; Research and Clinical Institute for Children
Russian Federation

Moscow


Disclosure of interest:

None



Leyla S. Namazova-Baranova
Research Institute of Pediatrics and Children's Health in Petrovsky National Research Centre of Surgery; Pirogov Russian National Research Medical University
Russian Federation

Moscow


Disclosure of interest:

None



Svetlana V. Mikhaylova
Moscow State University of Medicine and Dentistry named after A.I. Evdokimov; Russian Children's Clinical Hospital
Russian Federation

Moscow


Disclosure of interest:

None



Sergey V. Moiseev
Sechenov First Moscow State Medical University
Russian Federation

Moscow


Disclosure of interest:

None



Tatyana S. Nagornaya
Research Centre for Medical Genetics
Russian Federation

Moscow


Disclosure of interest:

None



Liliia R. Selimzyanova
Research Institute of Pediatrics and Children's Health in Petrovsky National Research Centre of Surgery; Sechenov First Moscow State Medical University; Pirogov Russian National Research Medical University
Russian Federation

Moscow


Disclosure of interest:

None



Alla N. Semyachkina
Veltischev Research and Clinical Institute for Pediatrics and Pediatric Surgery
Russian Federation

Moscow


Disclosure of interest:

None



Olga Ya. Smirnova
Research Institute of Pediatrics and Children's Health in Petrovsky National Research Centre of Surgery
Russian Federation

Moscow


Disclosure of interest:

None



Marina V. Fedoseenko
Research Institute of Pediatrics and Children's Health in Petrovsky National Research Centre of Surgery; Pirogov Russian National Research Medical University
Russian Federation

Moscow


Disclosure of interest:

None



Svetlana V. Pishchal'nikova
All-Russian Society of Orphan Diseases
Russian Federation

Moscow


Disclosure of interest:

None



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Review

For citations:


Baranov A.A., Batysheva T.T., Bykova O.V., Vashakmadze N.D., Vislobokova E.V., Vitebskaya A.V., Vishneva E.A., Voynova V.Yu., Zhurkova N.V., Zakharova E.Yu., Kisel'nikova L.P., Kostik M.M., Kutsev S.I., Margieva T.V., Namazova-Baranova L.S., Mikhaylova S.V., Moiseev S.V., Nagornaya T.S., Selimzyanova L.R., Semyachkina A.N., Smirnova O.Ya., Fedoseenko M.V., Pishchal'nikova S.V. Modern Approaches to the Management of Children with Hypophosphatasia. Pediatric pharmacology. 2023;20(4):318-336. (In Russ.) https://doi.org/10.15690/pf.v20i4.2601

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