Diagnosis Recommendations for Late-onset Pompe Disease

Luís Brito-Avô, José Delgado Alves, João Matos Costa, Ana Valverde, Lélita Santos, Francisco Araújo, Patrício Aguiar, António Marinho, Anabela Oliveira, Daniel Gomes

Abstract


Introduction: Pompe disease is a progressive and debilitating autossomal recessive myopathy due to mutations in lysossomal acid-α-glucosidase. Its late-onset form has a heterogeneous presentation mimicking other neuromuscular diseases, leading to diagnostic challenge.
Objective: To develop consensus based recommendations for the diagnosis of late-onset Pompe Disease.
Material and Methods: Bibliographic review and analysis of an opinion questionnaire applied to a group of specialists with expertise in the diagnosis of several myopathies and lysossomal storage disorders. Discussed in consensus meeting.
Recommendations: Patients with a progressive limb-girdle weakness, fatigue, cramps and muscle pain should be evaluated with CK levels, electromyography, dynamic spirometry and muscle biopsy in inconclusive cases. Suspected cases and those in which muscle biopsy could not allow other diagnosis should be screened for lysossomal acid-α-glucosidase deficiency with DBS (dried blood spot). The diagnosis should be confirmed by determination of lysossomal acid-α-glucosidase activity in a second sample and lysossomal acid-α-glucosidase gene sequencing.
Keywords: Age of Onset; Consensus; Glycogen Storage Disease Type II.

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