Dysautonomia Clinical Trial
Official title:
Dysautonomic Signs Among MECP2boys
Dysautonomic signs are well known among girls with a Rett Syndrom. Rett syndrom is caused by a MECP2 mutation in 95% of cases. We want to search dysautonomic signs among boys with a MECP2 mutations because they are less studied than the girls and they have more varied phenotypes.
First, we will launch a national call for participation in all the genetics departments in
France to research boys with a missense or a non-sens mutation in the MECP2 gene. Our
inclusion criteria is : less than 16 years old or dead before 16 years old patients of
masculin sex with a missense or non-sens mutation in the MECP2 gene. Exclusion criteria is :
patient under judicial protection or participation refusal by one of the legal guardian.
Inclusion will take place in August 2020.
We had conceived an excel spreadsheet (2007 version) to collect all the datas needed with
general data such as age, genetic mutation with the HGVS nomenclature using the
NM_001110792.2, familial and personal history, mensurations, dysmorphic signs. To search
dysautonomic signs, we used a system approach. We will look for neurological signs : abnormal
movements, sleep disturbance, cardiologic signs :abnormal bradycardia or tachycardia,
hypotension, rythms anomalies, respiratory signs : respiratory irregularities, apnea,
hyperpnea , digestive signs : gastrooesophagal reflux, constipation, diarrhea, vomiting or
subocclusif episodes, thermoregulation signs : abnormal hypo or hyperthermia, excessive
sweating. Each time a dysautonomic sign will be reported in a letter of a patient, we will
demand this sign to be objectived by a complementary exam, or by a precise device during an
hospitalisation : electoencephalogram (EEG), polysomnography (PSG), Electrocardiogram (ECG),
holter-ECG, digestive fibroscopies, scoped surveillance.
If we have a positive response, we will contact the main caregiver of the patient who can be
a neurologist or a geneticist and will provid him a spreadsheet and an explanatory sheet. We
will ask of him a systematic review of all the letters of the patient including letters of
hospitalisation, of the specialists, complementary exams. A non-opposition letter will be
sent to him in a way he can send it to the legal guardians of the children : a non-opposition
of 15 days will be requested. Then, the filled spreadsheet will be sent back to the center of
inclusion in Brest through a securised mailbox. Data will be kept on a secure database with a
password.
Our primary endpoint is the presence of at least one dysautonomic sign. We intend to include
between 10 and 20 patients in this multicentric study. To analyse our results, we will use a
descriptive approach.
This protocole was validated by the Ethic Comitee of Brest in june 18, 2020
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