Delayed Diagnosis in Duchenne Muscular Dystrophy: Data from the Muscular Dystrophy Surveillance, Tracking, and Research Network (MD STARnet) - 09/08/11
, Deborah J. Fox, MPH b, Shree Pandya, PT, MS a, Christina P. Westfield, RN, BSN b, Soman Puzhankara, MS c, Paul A. Romitti, PhD c, Katherine D. Mathews, MD d, Timothy M. Miller, MD e, Dennis J. Matthews, MD f, Lisa A. Miller, MD, MSPH g, Christopher Cunniff, MD e, Charlotte M. Druschel, MD, MPH b, Richard T. Moxley, MD a
Reprint requests: Dr Emma Ciafaloni, University of Rochester, 601 Elmwood Avenue, PO Box 673, Rochester, NY 14642.Abstract |
Objective |
To identify key factors for the delay in diagnosis of Duchenne muscular dystrophy (DMD) without known family history.
Study design |
The cohort comes from the Muscular Dystrophy Surveillance, Tracking, and Research Network (MD STARnet), a multistate, multiple-source, population-based surveillance system that identifies and gathers information on all cases of Duchenne and Becker muscular dystrophy born since 1982. We analyzed medical records of 453 Duchenne and Becker muscular dystrophy boys to document the time course and steps taken to reach a definitive diagnosis.
Results |
Among 156 boys without known family history of DMD prior to birth, first signs or symptoms were noted at a mean age of 2.5 years. Concerns resulted in primary care provider evaluation of the child at a mean age of 3.6 years. Mean age at time of initial creatine kinase was 4.7 years. Mean age at definitive diagnosis of DMD was 4.9 years.
Conclusions |
There is a delay of about 2.5 years between onset of DMD symptoms and the time of definitive diagnosis, unchanged over the previous 2 decades. This delay results in lost opportunities for timely genetic counseling and initiation of corticosteroid treatment. We recommend checking creatine kinase early in the evaluation of boys with unexplained developmental delay.
Le texte complet de cet article est disponible en PDF.Mots-clés : CK, DBMD, DMD, MD STARnet, SS
Plan
| Supported by the Centers for Disease Control and Prevention Cooperative Agreement (5U01DD000187). The authors declare no conflicts of interest. |
Vol 155 - N° 3
P. 380-385 - septembre 2009 Retour au numéro
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