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Published on: July 21, 2023
Morquio syndrome: diagnosis in an adult
Catherine Prat1, Olivia Lemaire, Johan Bret
1Rheumatology Department, Purpan Teaching Hospital, Toulouse, France.
Abstract:
Morquio syndrome or mucopolysaccharidosis (MPS) type IV is a rare autosomal recessive disease in which keratan sulfate builds up in cells. There are two variants, A and B, corresponding to deficiencies of two different enzymes. Type A is usually severe, although considerable clinical variability occurs due to the existence of attenuated phenotypes, which may escape diagnosis until adulthood. We illustrate this little known possibility by reporting a case of MPS IV A diagnosed in a 38-year-old woman. We review the clinical and radiological features of this disease, with which pediatricians are more familiar than other physicians. Our case provides an opportunity to emphasize the need for management by a rheumatologist in addition to the standard surgical treatment.
Insights
Morquio syndrome (MPS) type IVA, a rare genetic disorder, can present with mild symptoms leading to late adult diagnosis. This case highlights the importance of recognizing attenuated phenotypes for timely intervention.
Area of Science:
- Genetics
- Biochemistry
- Rare Diseases
Background:
- Morquio syndrome (MPS) type IV is an autosomal recessive lysosomal storage disorder.
- It results from deficiencies in enzymes responsible for keratan sulfate degradation.
- MPS IV has two variants, A and B, with Type A typically being more severe.
Observation:
- A case of MPS IVA was diagnosed in a 38-year-old woman, illustrating an attenuated phenotype.
- This presentation highlights that MPS IVA may escape early diagnosis in childhood.
- Clinical and radiological features of MPS are reviewed, noting pediatricians' greater familiarity.
Findings:
- Attenuated phenotypes of MPS IVA can lead to diagnosis in adulthood.
- Keratan sulfate accumulation underlies the pathology of Morquio syndrome.
- Enzyme deficiencies in Type A MPS IV are distinct from Type B.
Implications:
- Increased awareness of attenuated MPS IVA phenotypes is crucial for adult diagnosis.
- Rheumatologists should be involved in managing MPS IVA patients alongside surgical teams.
- Early and accurate diagnosis improves patient outcomes and management strategies.
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