Critical clinical situations in adult patients with Mucopolysaccharidoses (MPS) | Orphanet Journal of Rare Diseases | Full Text

Critical clinical situations in adult patients with Mucopolysaccharidoses (MPS) | Orphanet Journal of Rare Diseases | Full Text

Critical clinical situations in adult patients with Mucopolysaccharidoses (MPS)

• Karolina M. Stepien, 
• Anait K. Gevorkyan, 
• Christian J. Hendriksz, 
• Tinatin V. Lobzhanidze, 
• Jordi Pérez-López, 
• Govind Tol, 
• Mireia del Toro Riera, 
• Nato D. Vashakmadze & 
• Christina Lampe 

Orphanet Journal of Rare Diseases volume 15, Article number: 114 (2020) Cite this article

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Abstract

Background

Mucopolysaccharidoses (MPS) are rare, inherited disorders associated with enzyme deficiencies that result in glycosaminoglycan (GAG) accumulation in multiple organ systems. Management of MPS is evolving as patients increasingly survive to adulthood and undergo multiple surgeries throughout their lives. As surgeries in these patients are considered to be high risk, this can result in a range of critical clinical situations in adult patients.

Results

We discuss strategies to prepare for and manage critical clinical situations in adult patients with MPS, including supporting the multidisciplinary team, preoperative and airway assessments, surgical preparations, and postoperative care. We also present eight critical clinical cases (age range: 21–38 years) from four leading inherited metabolic disease centres in Europe to highlight challenges and practical solutions to optimise the care of adult patients with MPS. Critical clinical situations included surgical procedures, pregnancy and a thrombus in a port-a-cath.

Conclusions

Individualised strategies to manage critical clinical situations need to be developed for each patient to compensate for the heterogeneous symptoms that may be present and the potential complications that may occur. These strategies should include input from the wider MDT, and be coordinated by metabolic specialists with expertise in the management of MPS disorders and surgery in adult patients with MPS.