Frequency of Pompe’s Disease and Neuromuscular Etiologies in Patients With Restrictive Respiratory Failure Associated With Signs of Muscle Weakness

Overview

A breach of respiratory function may be one of the elements more or less early or predominant clinical picture of neuromuscular diseases. It is considered that the obstructive syndromes represent 64% and restrictive or mixed syndromes 36% of chronic respiratory insufficiency, approximately 7% due to a neuromuscular disease. The frequency and type of impairment are dependent on the underlying pathology. The neuromuscular restrictive respiratory failure (IRR) remains partially unknown pulmonologists, especially because the signs of muscle weakness are sometimes difficult to detect. However, respiratory diseases are a major concern in neuromuscular diseases because they can have an impact both on sleep (not sleep, …) on the daily activities (breathlessness on exertion, dyspnea) and thereby alter the quality of life of patients. Moreover, they represent a significant morbidity and mortality factor. Chest tightness may in some cases reveal the disease and thus constitute the chief complaint of a patient with a neuromuscular disease. In late-onset Pompe disease, lung disease is the predominant clinical symptoms in about 30% of patients. An algorithm was developed to guide practitioners and help them in their diagnostic approach to the cause of the IRR (diagnostic algorithm ATS / ERS 2005). However, this algorithm does not allow precise identification of the neuromuscular causes. At the patient level, this can have an impact by extending the time before placing a diagnosis. In Pompe disease, the average time to diagnosis reached 7.9 years. However, there are for this disease a simple and rapid diagnostic test. Therefore, a greater awareness of practitioners with regard to the particular Pompe disease and neuromuscular diseases in general may be beneficial to patients. This study aims to: i) awareness pulmonologists to the possibility of neuromuscular an IRR. ii) characterize the frequency of neuromuscular origin of IRR in a broad population of patients with concomitant signs muscle weakness. iii) reduce the time to diagnosis by directing patients to neuromuscular reference center early.

Full Title of Study: “Frequency of Pompe’s Disease and Neuromuscular Etiologies in Patients With Restrictive Respiratory Failure Associated With Signs of Muscle Weakness”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: N/A
    • Intervention Model: Single Group Assignment
    • Primary Purpose: Diagnostic
    • Masking: None (Open Label)
  • Study Primary Completion Date: December 11, 2019

Interventions

  • Other: Blood sample
    • A blood sample for CPK dosage and pompe disease test

Arms, Groups and Cohorts

  • Other: Restrictive Respiratory Failure
    • A CPK dosage, muscular questionnaires and a Pompe Disease test are practiced on patient with Restrictive Respiratory Failure without etiology

Clinical Trial Outcome Measures

Primary Measures

  • Number of new cases of Pompe disease diagnosed by a positive DBS
    • Time Frame: At the inclusion
    • Number of new cases of Pompe disease diagnosed by a positive DBS in patients with unexplained restriction pulmonaires.ries volumes, the patient is adressed to a specialist to dertermine etilogy of the muscular disease.

Secondary Measures

  • Number of new cases and etiologies of neuromuscular diseases diagnosed in patients with unexplained restriction of lung volumes
    • Time Frame: at 6 month
    • If a patient have an high CPK rate or a blotter test positive for Pompe disease or a suspicion of muscular disease with the muscular questionnaires, the patient is addressed to a specialist to determine etiology of the muscular disease.
  • Frequency and description of neurological symptoms associated with neuromuscular diseases to respiratory revelation
    • Time Frame: at 6 month
    • If a patient have an high CPK rate or a suspicion of muscular disease with the muscular questionnaires, the patient is addressed to a specialist to determine etiology of the muscular disease.

Participating in This Clinical Trial

Inclusion Criteria

  • Presence of a CV <80% of predicted and / or <LIN – Presence spirometry a report Tiffeneau (FEV / CV) equal to or higher than normal – Signature of informed consent – Men and women age ≥ 18 years – Production of a medical examination – Affiliated to social security Exclusion Criteria:

  • restrictive breath traumatic – restrictive respiratory failure associated with parenchymal disorder, whether localized or diffuse – known neuromuscular disease associated with a restrictive lung disease – Patient under guardianship, curatorship, protected by law – Inability to cooperate – Morbid obesity with a BMI ≥40

Gender Eligibility: All

Minimum Age: 18 Years

Maximum Age: N/A

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • Centre Hospitalier Universitaire de Nice
  • Provider of Information About this Clinical Study
    • Sponsor
  • Overall Official(s)
    • Sabrina Sacconi, Principal Investigator, Centre Hospitalier Universitaire de Nice

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