Сomorbid conditions in children with down syndrome: problem questions of medical, psychological supervision and rehabilitation (review of literature and own observations)
Keywords:
children, Down syndrome, physical development, developmental anomalies, comorbid pathologyAbstract
The aim. Determination of the main comorbid pathology in children with Down syndrome, the rationale for monitoring- groundings of monitoring and rehabilitation measures.Materials and methods. The paper presents data from literary sources, as well as the results of authors' follow-up of 50 children with Down syndrome aged two months to three and a half years old, who underwent rehabilitation courses at Charity Fund Early Intervention Institute for children with developmental disorders and disabled children.
Results. Children with Down syndrome have a high incidence of developmental abnormalities and pathological conditions affecting functional capabilities of their life supporting systems, which requires certain medical-prophylactic and therapeutic (including surgical, medicamental) measures. The main task of medical support for such a child is diagnosis of these conditions; their correction is carried out according to the same principles as in children without chromosomal abnormalities. Combination of several pathological conditions, which is a characteristic feature of these children, complicates the implementation of rehabilitation measures. No well-defined combinations of pathology and influence of different combinations on the efficacy of rehabilitation have been established; therefore, medical support of children with Down syndrome should be individualized and determined by the needs of a particular child at a certain stage of his/her development.
Conclusion. The presence of comorbid conditions affects the period of childhood and possibilities of medical and psychological rehabilitation in children with Down syndrome. Medical support of these children is of high importance because timely detection of pathology with its correction determines the scope and efficacy of individual rehabilitation programs.
The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee (LEC) of all participating institution. The informed consent of the patient was obtained for conducting the studies.
References
Babayan VV, Vinogradov AF, Zubareva GM, Kornyusho EM, Bordina GE, Khalyapina YaM. (2013). The health status of children with Down's syndrome. Ros Vestn Perinatol Pediat. 1:
Barashnev YuI. (red.) Sindrom Dauna. Mediko-geneticheskiy i sotsial'no-psikhologicheskiy portret. Moscow: TriadaKh: 280.
Bel'mer SV, Revnova MO. (red.) (2013). Celiakiya u detej. Medpraktika-Moscow: 413.
Grigor'yev KI, Vykhristyuk OF, Donin IM. (2016). Sindrom Dauna i tseliakiya. Sindrom Dauna XXI vek. 16(1): 3–12.
Grigorуev KI, Vykhristyuk OF, Donin IM, Zavadenko AN. (2017). Down Syndrome: Comorbidity and Program Objectives in the Work of Pediatrician with such Children. Difficult patient. 1–2: 64–70.
Kashіna-Yarmak VL. (2013). Somatic health status of infants with Down syndrome. Zdorov'ye rebenka. 8: 48—51.
Kukuruza G, Kirilova O, Kashіna-Yarmak V, Tsilyurik S, Kovtun O, Zaychenko G. (2014). Mediko-psikhologіchniy suprovіd dіtey rann'ogo vіku z sindromom Dauna: metod rek. Kiїv: 30.
Lauteslager PEM. (2003). Dvigatel'noe razvitie detej rannego vozrasta s sindromom Dauna. Problemy i resheniya. Per. s angl. ON Ertanovoj pri uchastii EV Klochkovoj. Moscow: Monolit: 344.
Medvedeva TP. (2007). Razvitie poznavatel'noy deyatel'nosti detey s sndromom Dauna. Posobie dlya roditeley. Moscow: Monolit: 80.
Neizhko LY, Odinokova GYu, Erokhina AV, Velichko EV, Berisha А. (2018). Evaluation of Neurosonographic Abnormalities in Infants with Down Syndrome. Difficult patient. 8–9;16: 45–8. https://doi.org/10.24411/2074-1995-2018-10008
Odinokova GYu. (2016). Obshchenie materi i rebenka rannego vozrasta s sindromom Dauna. monografiya. Moscow: Poligraf servis: 210.
Pole EV. (2009). Sindrom Dauna. Fakty: posobie dlya roditeley. Moscow: Blagotvoritel'nyy fond Daunsayd Ap: 36.
Semenova NA, Chubarova AI. (2012). Physical development of infants with Down syndrome upbringing in family. Current Pediatrics. 11(4): 128–132. https://doi.org/10.15690/vsp.v11i4.371
Sindrom Dauna. Adaptovana klіnіchna nastanova, zasnovana na dokazah. (2015). Novosti mediciny i farmacii. Nevrologiya. Nejrohirurgiya. Psihiatriya (tematicheskij nomer). 556: 37–75.
Skalleran SDzh. (red.) (2012). Rebenok s sindromom Dauna. Novoe rukovodstvo dlya roditelej. Moscow: Blagotvoritel'nyj fond Daunsajd Ap: 424.
Stavtseva SN, Nikolaeva EA, Sukhorukov VS. (2014). Oxidative stress and mitochondrial dysfunction in the pathogenesis of Down's disease. Ros Vestn Perinatol Pediat. 3: 39–42.
Stolyarova EI, Shamro EV. (2018). Formirovanie dvigatel'nyh i kommunikativnyh navykov detej rannego vozrasta s sindromom Dauna. Sankt-Peterburg: LEMA: 101.
Uryadnitskaya NA. (2012). Sindrom Dauna: osobennosti neyroanatomii. Sindrom Dauna ХХI vek. 1: 10–3.
Tsvetkov VO, Novolodskaya NA, Suraveshkina NV, Suleymanova LV. (2010). Federated method of approaching to socialization of families with kids with Down's syndrome. Сhild and adolescent rehabilitation. 2: 16–21.
Baumer N, Davidson EJ. (2014). Supporting a happy, healthy adolescence for young people with Down syndrome and other intellectual disabilities: recommendations for clinicians. Current opinion in pediatrics. 26;4: 428–34. https://doi.org/10.1097/MOP.0000000000000122; PMid:25010137
Bull MJ. (2011). Health supervision for children with Down syndrome. Pediatrics. 128(2): 393–406. https://doi.org/10.1542/peds.2011-1605; PMid:21788214.
Camhi SS, Sangal K, Kenyon V, Lima R, Fasano A, Leonard MM. (2019). Pediatric Nonceliac Gluten Sensitivity: A Gluten;related Disorder Treatment Center Experience. J Pediatr Gastroenterol Nutr. 69(2): 200–5. https://doi.org/10.1097/MPG.0000000000002335; PMid:30908383
Cebeci AN, Guven A, Yildiz M. (2013). Profile of hypothyroidism in Down's syndrome. J Clin Res Pediatr Endocrinol. 5: 116—120. https://doi.org/10.4274/Jcrpe.884; PMid:23748065 PMCid:PMC3701917
Channell М, Hahn LJ, Rosser Т, Hamilton D et al. (2019). Characteristics Associated with Autism Spectrum Disorder Risk in Individuals with Down Syndrome. Journal of Autism and Developmental Disorders. 49: 3543–56. https://doi.org/10.1007/s10803-019-04074-1; PMid:31124029
Claret C, Goday A, Benaiges D, Chillaron JJ et al. (2013). Subclinical hypothyroidism in the first years of life in patients with Down syndrome. Pediatr Res. 73: 674—8. https://doi.org/10.1038/pr.2013.26; PMid:23403803
Foley C, Killeen OG. (2019). Musculoskeletal anomalies in children with Down syndrome: an observational study. Arch Dis Child. 104: 482—7. https://doi.org/10.1136/archdischild-2018-315751; PMid:30472668 PMCid:PMC6557226
Hawli Y, Nasrallah M, El;Hajj FG. (2009). Endocrine and musculoskeletal abnormalities in patients with Down syndrome. Nature Reviews Endocrinology. 5(6): 327—334. https://doi.org/10.1038/nrendo.2009.80; PMid:19421241
Iughetti L, Predieri B, Bruzzi P, Predieri F et al. (2014). Ten-year longitudinal study of thyroid function in children with Down's syndrome. Hormone Research in Paediatrics. 2(82): 113—121. https://doi.org/10.1159/000362450; PMid:25011431
Kariyawasam D, Carre A, Luton D, Polak M. (2015). Down syndrome and nonautoimmune hypothyroidisms in neonates and infants. Horm Res Paediatr. 83: 126—131. https://doi.org/10.1159/000370004; PMid:25592247
King K, O'Gorman C, Gallagher S. (2014). Thyroid dysfunction in children with Down syndrome: a literature review. Irish Journal of Medical Science. 1(183): 1—6. https://doi.org/10.1007/s11845-013-0994-y; PMid:23934377
Kowalczyk K, Pukajlo K, Malczewska A, Krol;Chwastek A, Barg E. (2013). L-thyroxine therapy and growth processes in children with Down syndrome. Adv Clin Exp Med. 22: 85—92. PMid: 23468266
Marchal JP, Maurice;Stam H, Ikelaar NA, Klouwer FCC et al. ASP. (2014). Effects of Early Thyroxine Treatment on Development and Growth at Age 10.7 Years: Follow-Up of a Randomized Placebo-Controlled Trial in Children With Down's Syndrome. The Journal of Clinical Endocrinology & Metabolism. 99;12: E2722-E2729. https://doi.org/10.1210/jc.2014-2849; PMid:25243574
Mircher С, Sacco S, Bouis С, Gallard J et al. (2019). Thyroid hormone and folinic acid in young children with Down syndrome: the phase 3 ACTHYF trial. Genetics in Medicine. Published: 08 July 2019. https://doi.org/10.1038/s41436-019-0597-8; PMid:31281181
Murphy J, Philip M, Macken S, Meehan J et al. (2008). Thyroid dysfunction in Down's syndrome and screening for hypothyroidism in children and adolescents using capillary TSH measurement. Journal of Pediatric Endocrinology and Metabolism. 21(2): 155—163. https://doi.org/10.1515/JPEM.2008.21.2.155; PMid:18422028
Nenna R, Mosca A, Mennini M, Papa RЕ et al. (2015). Celiac Disease Screening Among a Large Cohort of Overweight/Obese Children. J. Pediatr Gastroenterol Nutr 60(3): 405—7. https://doi.org/10.1097/MPG.0000000000000656; PMid:25714583
Nisihara RM, Kotze LM, Utiyama SR, Oliveira NP, Fiedler PT, Messias-Reason IT. (2005). Celiac disease in children and adolescents with Down syndrome. J Pediatr (Rio J). 81: 373—6. https://doi.org/10.2223/JPED.1381; PMid:16247538
Nowak-Oczkowska A, Szaflarska;Poplawska A, Soroczynska-Wrzyszcz A. (2013). Czy pacjenci z zespolem Downa sa grupa ryzyka wystapienia celiakii? Przeglad Gastroenterologiczny. 8;2: 77—85. https://doi.org/10.5114/pg.2013.34832
Pallardo FV, Lloret A, Lebel M, d'Ischia M, Cogger VC et al. (2010). Mitochondrial dysfunction in some oxidative stress-related genetic diseases: Ataxia-Telangiectasia, Down syndrome, Fanconi anaemia and Werner syndrome. Biogerontology. 11: 401—19. https://doi.org/10.1007/s10522-010-9269-4; PMid:20237955
Skotko BG, Davidson EJ, Weintraub GS. (2013). Contributions of a specialty clinic for children and adolescents with Down syndrome. Am J Med Genet A. 161a(3):430—7. https://doi.org/10.1002/ajmg.a.35795; PMid:23401090
Tenenbaum A, Hanna RN, Averbuch D, Wexler ID, Chavkin M, Merrick J. (2014). Hospitalization of children with Down syndrome. Front. Public Health. 2: 22. https://doi.org/10.3389/fpubh.2014.00022; PMid: 24688981. PMCid: PMC3960574
Tenenbaum A, Kastiel Y, Meiner Z, Kerem E, Abu-Libde A, Wexler ID. (2008). Multidisciplinary care of persons with Down syndrome in Jerusalem. Int J Disabil Hum Dev. 7(3): 355—7. https://doi.org/10.1515/IJDHD.2008.7.3.355
Tenenbaum A, Lebel E, Malkiel S, Kastiel Y, Abulibdeh A, Zangen DH. (2012). Euthyroid submedian free T4 and subclinical hypothyroidism may have a detrimental clinical effect in Down syndrome. Horm Res Paediatr. 78: 113—8. https://doi.org/10.1159/000342075; PMid:22922417
Wexler ID, Abu;Libdeh A, Kastiel Y, Nimrodi A, Kerem E, Tenenbaum A. (2009). Optimizing health care for individuals with Down syndrome in Israel. The Israel Medical Association Journal. 11(11): 655—9.
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