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- Novos biomarcadores nas DLS´s: O que eles nos dizemPublication . Gaspar, Paulo; Rocha, Hugo; Alves, Sandra; Vilarinho, LauraComunicação sobre os novos biomarcadores nas Doenças Lisossomais de Sobrecarga, do diagnóstico ao follow-up.
- Early Diagnosis of Mucopolysaccharidoses in PediatricsPublication . da Silva Gaspar, Paulo Jorge Miranda; Neiva, Raquel; Sousa e Silva, Lisbeth Elena; Diogo, Luisa; Ferreira, A.; Miranda, A.; Ribeiro, S.; Antunes, D.; Garcia, P.; Rodrigues, E.; Campos, T.; Janeiro, P.; Lopes, Altina; Pereira, Cristina; Nogueira, Célia; Sousa, S.; Ferreira, S.; Alves, Sandra; Leão Teles, Elisa; Vilarinho, LauraIntroduction: Mucopolysaccharidoses (MPSs) are a group of Lysosomal Storage Disorders with multisystem involvement, presenting different degrees of severity and evolution. At early disease stages and late onset forms, diagnosis can be postponed for years or even missed. The FIND PROJECT was designed to claim awareness to the redflags of MPSs at pediatric age and to provide a useful tool for physicians to diagnose these pathologies, since most of them are amenable to enzyme replacement therapy.
- Differential Diagnosis of Alpha-Mannosidosis in MPSsPublication . da Silva Gaspar, Paulo Jorge Miranda; Gonçalves, Diana; Neiva, Raquel; Sousa e Silva, Lisbeth Elena; Vilarinho, LauraIntroduction: Mucopolysaccharidosis (MPSs) and oligosaccharidosis, two subgroups of lysosomal storage disorders (LSDs), face diagnostic challenges due to their wide spectrum of clinical presentations and overlapping symptoms. One of the oligosaccharidose is α-mannosidosis, an extremely rare and often undiagnosed disorder. It is characterized by a deficiency in the enzymatic activity of α-mannosidase, which is responsible for cleaving mannose from N-linked oligosaccharides. This study aimed to investigate the activity of α-mannosidase in dried blood spot (DBS) samples that had undergone screening for MPSs.
- Early diagnosis of acid sphingomyelinase deficiency (ASMD) through biomarkers analysisPublication . Neiva, Raquel; da Silva Gaspar, Paulo Jorge Miranda; Sousa e Silva, Lisbeth Elena; Gonçalves, I.; Ferreira, S.; Diogo, Luisa; Vilarinho, LauraIntroduction: Acid sphingomyelinase deficiency (ASMD), historically known as Niemann–Pick disease (NPD) types A, A/B, and B, is a rare, progressive, potentially fatal lysosomal storage disease caused by pathogenic variants in SMPD1 gene. It presents a wide spectrum of symptoms, age of onset, and degree and type of organ effected. The disease manifestations frequently involve hepatosplenomegaly with progressive organ dysfunction, interstitial lung disease, and bleeding. In this work, we will present a patient whose lysosomal biomarkers study allowed the diagnosis of ASMD. Methods: This patient had hepatosplenomegaly, elevated transaminases in which the primary clinical suspicion was an acid lipase deficiency. By the analysis of our multiplex biomarker panel by LC-MS/MS analysis, we were able to do a differential diagnosis. Results/Case report: The lysosphingomyelin (lysoSM) and lysosphingomyelin-509 (lysoSm-509) were approximately 100 a 150x than normal, suggestive of Niemann–Pick disease. The diagnosis of ASMD was confirmed by reduced acid sphingomyelinase enzyme activity measured in peripheral blood leukocytes and the presence of a pathogenic variant in both alleles in the SMPD1 gene. Conclusion: ASMD can be underestimate and the diagnostic odissey arise from an overlap in symptomology with other diseases, including primary hepatic disease, Gaucher disease, Niemann–Pick disease, and lysosomal acid lipase deficiency. The multiplex biomarker panel, with different lysolipids, allows simultaneously diagnosis of different LSDs, in a timely manner, leading to an early intervention, before the appearance of more deleterious symtpoms.
- A Multiplex Biomarker panel: A powerful tool for LSDs DiagnosisPublication . Neiva, Raquel; da Silva Gaspar, Paulo Jorge Miranda; Sousa e Silva, Lisbeth Elena; Gonçalves, Isabel; Ferreira, Sara; Diogo, Luisa; Vilarinho, LauraIntrodução / Descrição do Caso: Lysosomal Storage Disorders (DLSs) are a set of rare, chronic and multisystemic pathologies with a variable mode of presentation and severity. Acid sphingomyelinase deficiency (ASMD), historically known as Niemann–Pick disease (NPD) types A, A/B, and B, is a rare, progressive, potentially fatal lysosomal storage disease caused by pathogenic variants in SMPD1 gene. The disease manifestations frequently involve hepatosplenomegaly with progressive organ dysfunction, interstitial lung disease, and bleeding. The cellular damage caused by sphingomyelin accumulation can be irreversible and can lead to life-threatening complications with reduced life expectancy. ASMD can be underestimate and the diagnostic odyssey arise from an overlap in symptomology with other diseases, including primary hepatic disease, Gaucher disease, NPC, and lysosomal acid lipase deficiency.
- Find Project: Results of 8 YearsPublication . da Silva Gaspar, Paulo Jorge Miranda; Neiva, Raquel; Sousa e Silva, Lisbeth Elena; Guimarães, Fábio; Diogo, Luisa; Ferreia, Ana Cristina; Miranda, Ana; Antunes, Diana; Louro, Pedro; Ribeiro, Sara; Garcia, Paula; Rodrigues, Esmeralda; Campos, Teresa; Janeiro, Patrícia; Sousa, Sérgio; Ferreira, Sara; Silva, Carmen; Lopes, Altina; Pereira, Cristina; Nogueira, Célia; Alves, Sandra; Leão Teles, Elisa; Vilarinho, LauraIntrodução e Objectivos: Mucopolysaccharidoses (MPSs) are a group of Lysosomal Storage Disorders with multisystem involvement, presenting different degrees of severity and evolution. At early disease stages and late onset forms, diagnosis can be postponed for years or even missed. The FIND PROJECT was designed to claim awareness to the red flags of MPSs at pediatric age and to provide an useful tool for physicians to diagnose these pathologies, since most of them are amenable to enzyme replacement therapy.
- A new method for the identification of mucopolysaccharidosis and oligosaccharidosisPublication . da Silva Gaspar, Paulo Jorge Miranda; Neiva, Raquel; Sousa e Silva, Lisbeth Elena; Vilarinho, LauraIntrodução e Objectivos: Lysosomal storage disorders are a group of rare diseases that affect approximately 1 in 4,000 live births in Portugal (Pinto et al , 2004). They are characterized by multisystemic involvement and a wide range of phenotypical presentations, often overlapping with other diseases. As a result, many patients experience a lengthy process of seeking a correct diagnosis, known as the "diagnostic odyssey". To address this challenge, a new tandem mass spectrometry method has been developed for the urinary identification of both oligosaccharides and mucopolysaccharides(MPS).
- Rastreio neonatal da drepanocitose: prevalência ao nascimento de 1: 2 381 RNPublication . Rodrigues, Diogo; Marcão, Ana; Lopes, Maria de Lurdes soares; Guimarães, Fábio; Vilarinho, LauraIntrodução e Objetivos: A drepanocitose é uma das patologias monogénicas mais comuns e graves a nível mundial, sendo atualmente considerada um problema de saúde pública na Europa. Trata-se de uma doença hereditária, com transmissão autossómica recessiva, na qual os doentes apresentam uma variante estrutural anormal de hemoglobina – HbS. Com este trabalho pretendemos apresentar a prevalência ao nascimento da drepanocitose em Portugal. Metodologia: Foram rastreados para a drepanocitose 324 077 Recém-Nascidos (RN), em duas fases distintas: Fase I (05/2021 - 01/2022) 24 130 RN exclusivamente dos distritos de Lisboa e Setúbal; Fase II (02/2022 - 07/2025) 299 947 RN de todo o Português. O perfil de hemoglobinas foi estudado pelo método da eletroforese capilar, a partir de amostras de sangue seco colhidas em cartão de Guthrie, entre o 3.º e o 6.º dia de vida do RN. Resultados: No total foram identificados 152 casos de drepanocitose dos quais 135 eram homozigóticos (HbSS) e 17 heterozigóticos compostos (HbSC). Todos os doentes foram reportados a um Centro de Tratamento (CT) para confirmação e avaliação clínica. A prevalência ao nascimento de drepanocitose no nosso país é de 1:2 381 RN. Além do casos de drepanocitose, foram também identificados e reportados para CT mais 15 casos de outras hemoglobinopatias: 3 β-talassémia major, 8 HbEE, 3 HbCC e 1 HbDD. Conclusões: Estes resultados evidenciam a crescente prevalência da drepanocitose em Portugal, alinhando-se com o panorama europeu, e que parece dever-se aos fluxos migratórios mais recentes. A inclusão do rastreio neonatal da drepanocitose no painel de doenças do Programa Nacional de Rastreio Neonatal, em 2023, comprova a importância desta patologia no nosso país.