Hereditary tyrosinemia type I: A new clinical classification with difference in prognosis on dietary treatment
✍ Scribed by Francjan J. Van Spronsen; Yolande Thomasse; G. Peter A. Smit; James V. Leonard; Peter T. Clayton; Vaclav Fidler; Ruud Berger; Hugo S. A. Heymans
- Book ID
- 102850946
- Publisher
- John Wiley and Sons
- Year
- 1994
- Tongue
- English
- Weight
- 505 KB
- Volume
- 20
- Category
- Article
- ISSN
- 0270-9139
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✦ Synopsis
Hereditary tyrosinemia type 1 (McKusick 27670) is a heterogeneous disease with poor prognosis, yet there are few reports of the long-term prognosis. It is therefore difficult to decide on the treatment for individual patients. We have conducted an international survey of patients with tyrosinemia type I and examined the probability of survival on dietary treatment and the causes of death in 108 patients with tyrosinemia type I. The survival after the onset of symptoms varied with the age at onset; the earlier the symptoms developed the poorer the outlook. Liver failure and recurrent bleeding (67%), hepatocellular carcinoma (17%) and the porphyria-like syndrome with respiratory failure (10%) were the most common causes of death. The 1- and 2-yr survival probability after the onset of symptoms in patients in whom symptoms developed before 2 mo, between 2 and 6 mo and after 6 mo were 38%/29%, 74%/74% and 96%/96%, respectively. On the basis of these survival rates, a new classificationwhich is important with respect to choices in treatmentis proposed: very early (onset of symptoms < 2 mo), early (2 to 6 mo) andlate presentingform ( > 6 mo).