对有全面发育迟缓或智力障碍的儿童进行全面评估。

IF 3.2 Q1 PEDIATRICS Clinical and Experimental Pediatrics Pub Date : 2024-09-01 Epub Date: 2024-05-29 DOI:10.3345/cep.2023.01697
Abdullah Nasser Aldosari, T Saeed Aldosari
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引用次数: 0

摘要

全面发育迟缓(GDD)和智力障碍(ID)是相对常见的神经发育疾病,对患儿、其家庭和社会都有重大影响。GDD/ID 的病因多种多样,既有遗传因素,也有后天因素。虽然大多数 GDD/ID 病例的确切病因仍不清楚,但估计有一半的病例可归因于遗传因素。因此,详细的病史和全面的体格检查仍是指导诊断调查 GDD/ID 潜在病因的关键。基因检测技术的进步取代了染色体微阵列核型分析和荧光原位杂交等传统方法,目前已成为特发性 GDD/ID 儿童的主要基因检测方法。此外,对脆性 X 和雷特综合征的评估也应成为初步诊断评估的组成部分。近年来,全外显子组测序和全基因组测序已成为评估 GDD/ID 儿童的重要诊断工具,并大大提高了诊断率。基因治疗已成为一种前景广阔的途径,并有望成为解决各种遗传发育和癫痫疾病的基石。由一支精通多学科的团队进行早期干预,可显著改善 GDD/ID 的预后和治疗效果,尤其是当父母或看护人积极参与干预过程时。本综述讨论了风险因素和常见的潜在病因,探讨了遗传评估的最新证据和建议,并为 GDD/ID 儿童提供了管理策略。
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Comprehensive evaluation of the child with global developmental delays or intellectual disability.

Global developmental delay (GDD) and intellectual disability (ID) are relatively common neurodevelopmental disorders that significantly impact affected children, their families, and society. The etiology of GDD/ID is notably diverse, encompassing both genetic and acquired factors. Although the precise cause of most GDD/ID cases remains unclear, an estimated half of all cases can be attributed to genetic factors. Thus, a detailed medical history and comprehensive physical examination remain pivotal for guiding diagnostic investigations into the underlying causes of GDD/ID. Advancements in genetic testing have supplanted traditional methods such as karyotyping and fluorescence in situ hybridization with chromosomal micro arrays, which are now the primary genetic tests for children with idiopathic GDD/ID. Moreover, the evaluation of Fragile X and Rett syndrome should be an integral component of initial diagnostic assessments. In recent years, whole-exome sequencing and whole-genome sequ-encing have emerged as important diagnostic tools for evaluating children with GDD/ID and have substantially enhanced the diagnostic yield rates. Gene therapy has emerged as a promising avenue and is poised to become a cornerstone in addressing various genetic developmental and epilepsy disorders. Early intervention facilitated by a proficient multidisciplinary team can markedly enhance the prognosis and outcomes of GDD/ID, particularly when parents or caregivers are actively engaged in the interventional process. This review discusses risk factors and common underlying causes, explores recent evidence and recommendations for genetic evaluation, and offers management strategies for children with GDD/ID.

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来源期刊
CiteScore
8.00
自引率
2.40%
发文量
88
审稿时长
60 weeks
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