Frequency and burden of gastrointestinal symptoms in familial dysautonomia
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RESEARCH ARTICLE
Frequency and burden of gastrointestinal symptoms in familial dysautonomia Chethan Ramprasad1 · Lucy Norcliffe‑Kaufmann2 · Jose‑Alberto Palma2 · Joseph Levy3 · Yian Zhang4 · Christy L. Spalink2 · Abraham Khan5 · Scott Smukalla5 · Horacio Kaufmann2,6 · Lea Ann Chen5 Received: 6 January 2020 / Accepted: 21 September 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose Familial dysautonomia (FD) is a rare hereditary sensory and autonomic neuropathy (HSAN-3) that is clinically characterized by impaired pain and temperature perception and abnormal autonomic function. Patients with FD have gastrointestinal dysmotility and report a range of gastrointestinal symptoms that have yet to be systematically evaluated. The aim of this study was to establish the frequency and severity of gastrointestinal symptoms in patients with FD. Methods The validated National Institutes of Health Patient-Reported Outcomes Measurement Information System (PROMIS) survey questionnaire, together with additional FD-specific questions, were distributed to 202 living patients with genetically confirmed FD who had been identified from the New York University FD Patient Registry or, when relevant, to their respective caretaker. As a comparison group, we used a general US adult population for whom PROMIS scores were available (N = 71,812). Results Of the 202 questionnaires distributed, 77 (38%) were returned, of which 53% were completed by the patient. Median age of the respondents was 25 years, and 44% were male. Gastrostomy tube was the sole nutrition route for 25% of the patients, while 53% were reliant on the gastrostomy tube only for liquid intake. The prevalence of gastrointestinal symptoms was significantly higher in each of the eight domains of PROMIS in patients with FD than in the controls. Gastrointestinal symptoms as measured by raw scores on the PROMIS scale were significantly less severe in the FD patient group than in the control population in all domains with the exception of the abdominal pain domain. The surveys completed by caregivers reported the same burden of symptoms as those completed only by patients. Conclusion Gastrointestinal symptoms affect nearly all patients with FD. Gastrointestinal symptoms are more prevalent in adult patients with FD than in the average US adult population but are less severe in the former. Keywords Autonomic · Motility · Neurogastroenterology · Patient reported outcomes
Introduction
Horacio Kaufmann and Lea Ann Chen authors share senior authorship of this manuscript. * Horacio Kaufmann [email protected] 1
Familial dysautonomia (FD), also known as Riley–Day syndrome, is a rare hereditary sensory and autonomic neuropathy (HSAN-3) first described in 1949 in children of Jewish-Ashkenazi ancestry [22]. It is caused by a founder mutation in the 4
Division of Biostatistics, Department of Population Health, New York University School of Medicine, New York City, NY, USA
Department of Medicine, New York University School of Medicin
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