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Navigating the Emotional and Practical Challenges of Newborn Screening for Late-Onset Pompe Disease: Insights From
Myriam Boueri1, Allison Paltzer2, Erin Huggins1
1Division of Medical Genetics, Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina.
Insights
Newborn screening for Pompe disease (PD) identifies late-onset cases, but parents need better support and healthcare professional education. Improved communication and resources can ease the transition for families after diagnosis.
Area of Science:
- Genetics and rare diseases
- Lysosomal storage disorders
- Newborn screening programs
Background:
- Pompe disease (PD) is an autosomal recessive lysosomal disorder causing progressive muscle weakness.
- Newborn screening (NBS) improves outcomes for infantile PD but also detects late-onset PD (LOPD) cases.
- LOPD diagnosis via NBS creates a "patient-in-waiting" status for children, causing family uncertainty.
Purpose of the Study:
- To explore parental experiences after LOPD diagnosis through NBS.
- To identify gaps in support systems for families with LOPD.
- To inform improvements in care delivery for LOPD patients and families.
Main Methods:
- Survey of 42 parents of children diagnosed with LOPD via NBS.
- Analysis of diagnostic experiences, care access, anxiety, and healthcare professional (HCP) roles.
- Descriptive statistics, thematic analysis, and Kruskal-Wallis tests were employed.
Main Results:
- Parents desired clear guidance and condition-specific information post-NBS.
- Many reported insufficient support and limited HCP knowledge regarding LOPD.
- Approximately 70.7% experienced reduced anxiety post-diagnosis, though uncertainty remained.
Conclusions:
- Timely communication with knowledgeable HCPs and multidisciplinary support can mitigate psychosocial burden.
- Enhanced resources for HCPs and improved communication are crucial for compassionate care.
- Addressing parental needs is vital for families navigating LOPD diagnosis through NBS.
Abstract:
Pompe disease (PD), an autosomal recessive lysosomal disorder, results in glycogen accumulation in muscle cells, leading to progressive muscle weakness and respiratory insufficiency. Newborn screening (NBS) has improved outcomes for infantile-onset PD by enabling early diagnosis and intervention with enzyme replacement therapy. NBS also identifies late-onset PD (LOPD) cases, wherein children have a wide clinical spectrum and may remain asymptomatic for years, placing families in uncertainty as "patients-in-waiting." This study explores parental experiences following an LOPD diagnosis through NBS to identify gaps in support systems and improve care delivery. Parents of 42 children diagnosed with LOPD through NBS completed a survey regarding their diagnostic experiences, care access, anxiety, and health care professionals' (HCPs') roles. Survey responses were analyzed using descriptive statistics, thematic analysis, and Kruskal-Wallis tests. Parents valued clear guidance and condition-specific information when receiving NBS results. However, many reported insufficient support and HCP's limited LOPD knowledge. About 70.7% experienced reduced anxiety following the LOPD diagnosis, attributed to increased knowledge, supportive health care teams, and their child's stable health, although uncertainty persisted. Among those who saw an HCP, 71.9% reported positive impacts, including improved understanding and mental health support, although 19% thought counseling or information provided lacked clarity or actionable resources. Timely communication with knowledgeable HCPs and multidisciplinary support can potentially reduce the psychosocial burden on families receiving positive NBS results. Efforts should prioritize creating more resources for HCPs and improving communication to ensure consistent compassionate care.
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