Pompe's Disease Clinical Trial
Official title:
Pompe Prevalence Study in Patients With Muscle Weakness Without Diagnosis
An international consensual group recommends confirming the diagnosis of the Pompe disease
after a dried blood spot (DBS) with a dosage of the enzymatic activity in other tissue. This
strategy is currently used in the usual practice.
The aim is evaluate the prevalence of the Pompe disease among patients with progressive limb
girdle muscular weakness and/or axial deficiency, and/or respiratory insufficiency. The
diagnosis will be confirmed using DBS.
In Pompe disease, deficiency of the enzyme acid alpha-glucosidase (GAA) results in
accumulation of glycogen within the lyososomes of numerous tissues and cell types especially
in muscular cells.
Pompe disease is pan ethnic (but with increased prevalence in the afro-American and Chinese
population). Pompe disease is rare with an estimated incidence of 1 in 40,000 births. In
France so far, a hundred patients have been diagnosed. The difference of results between the
epidemiologic studies published and the number of French patients diagnosed is caused by an
under-diagnostic of this pathology, very rare and unknown.
The late onset type of the disease (from childhood to adult) is revealed by progressive
muscle weakness generally beginning in proximal muscles of the legs. Respiratory muscle
weakness is often the cause of death among patients having respiratory insufficiency.
Recognizing Pompe disease can be challenging, as signs and symptoms may be shared with other
disorders (limb girdle muscular dystrophy, dystrophinopathy or inflammatory myopathy).
Muscle biopsies are often used to measure GAA activity and for histology in patients with
muscle weakness. But glycogen accumulation in the muscles of patients varies with biopsy
site, so the diagnosis of Pompe disease can be missed by using only a muscle biopsy.
Fibroblasts can also serve as a source of material for research but cell culture facilities
are not easy for clinicians and it takes several weeks to obtain confluent cultures. Then,
assays that use blood to diagnose Pompe disease were developed. Therefore, a group of
international clinicians and biologists met together in London in December 2006 and
established an agreement concerning the various methods of this enzyme dosage. Recently, a
test on a DBS (dried blood spot) has been developed. This test is not invasive, easy to
collect and transport, requires small sample volume and provides rapid results. This
international consensual group recommends confirming the diagnosis of the Pompe disease
after a DBS with a dosage of the enzymatic activity in other tissue. This strategy is
currently used in the usual practice.
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Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Diagnostic
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