A Multidisciplinary Consensus for Clinical Care and Research Needs for Sturge-Weber Syndrome

作者:De la Torre Alejandro J; Luat Aimee F; Juhasz Csaba; Ho Mai Lan; Argersinger Davis P; Cavuoto Kara M; Enriquez Algeciras Mabel; Tikkanen Stephanie; North Paula; Burkhart Craig N; Chugani Harry T; Ball Karen L; Pinto Anna Lecticia; Loeb Jeffrey A*
来源:Pediatric Neurology, 2018, 84: 11-20.
DOI:10.1016/j.pediatrneurol.2018.04.005

摘要

Background: Sturge-Weber syndrome is a neurocutaneous disorder associated with port-wine birthmark, leptomeningeal capillary malformations, and glaucoma. It is associated with an unpredictable clinical course. Because of its rarity and complexity, many physicians are unaware of the disease and its complications. A major focus moving ahead will be to turn knowledge gaps and unmet needs into new research directions.
Methods: On October 1-3, 2017, the Sturge-Weber Foundation assembled clinicians from the Clinical Care Network with patients from the Patient Engagement Network of the Sturge-Weber Foundation to identify our current state of knowledge, knowledge gaps, and unmet needs.
Results: One clear unmet need is a need for consensus guidelines on care and surveillance. It was strongly recommended that patients be followed by multidisciplinary clinical teams with life-long follow-up for children and adults to monitor disease progression in the skin, eye, and brain. Standardized neuroimaging modalities at specified time points are needed together with a stronger clinicopathologic understanding. Uniform tissue banking and clinical data acquisition strategies are needed with cross-center, longitudinal studies that will set the stage for new clinical trials. A better understanding of the pathogenic roles of cerebral calcifications and stroke-like symptoms is a clear unmet need with potentially devastating consequences.
Conclusions: Biomarkers capable of predicting disease progression will be needed to advance new therapeutic strategies. Importantly, how to deal with the emotional and psychological effects of Sturge-Weber syndrome and its impact on quality of life is a clear unmet need.