Article published Open Source in: Hormone Research in Paediatrics, DOI, 10.1159/000540692, August 5, 2024
Authors: Rodrigo Montero-Lopez, Mariam R. Farman, Florian Högler, Vrinda Saraff, Wolfgang Högler
What is this article about:
Hypophosphatasia (HPP) is a rare genetic disorder caused by mutations in the ALPL gene, leading to low alkaline phosphatase (ALP) levels and high pyridoxal-5-phosphate (PLP) levels. The disorder presents a wide clinical spectrum, from severe forms causing perinatal lethality to mild, asymptomatic cases, making diagnosis and management challenging. Key issues include the lack of standardized diagnostic criteria, difficulties in genetic testing, and the need for multidisciplinary care. Enzyme replacement therapy (ERT) has shown effectiveness in severe cases but poses challenges in initiation and assessment for milder forms. Ongoing follow-up is essential for monitoring treatment effectiveness and managing potential side effects.
Key Take Aways:
1) HPP is caused by ALPL gene mutations, resulting in distinctive biochemical markers (low ALP, high PLP).
2) Diagnosis is complicated due to a wide range of symptoms and the absence of standardized criteria.
3) Mild forms of HPP often go undiagnosed or mismanaged, requiring better clinical guidelines.
4) ERT is effective for severe HPP but challenging to assess and initiate in milder cases.
5) Continuous monitoring and a multidisciplinary approach are crucial for effective patient care.