Prevalence, Neonatal Characteristics, and First-Year Mortality of Down Syndrome: A National Study

Weijerman, Michel E.; Furth, A. Marceline van; Noordegraaf, A. Vonk; Wouwe, J.P. van; Broers, Chantal J.M.; Gemke, Reinoud J. B. J.

doi:10.1016/j.jpeds.2007.09.045

Cited by 208 publications

(208 citation statements)

References 17 publications

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“…The 0.38% prevalence of Down's syndrome in our population of diabetic patients was much higher than the Down's syndrome prevalence in other general populations. For instance, a study from the Netherlands reported a prevalence of Down's syndrome of 16 per 10,000 live births [8]. The Dutch study also reported increased neonatal and infant mortality in patients with Down's syndrome, which would suggest an even lower prevalence in older children.…”

Section: Discussionmentioning

confidence: 99%

Down’s syndrome in diabetic patients aged <20 years: an analysis of metabolic status, glycaemic control and autoimmunity in comparison with type 1 diabetes

et al. 2010

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Aims/hypothesis Intellectual impairment in individuals with Down's syndrome and diabetes mellitus potentially limits the quality of diabetic control. In addition, these patients are at risk of having immunological abnormalities. The present study compared metabolic status and concomitant diseases in young (<20 years old) Down's syndrome patients with diabetes vs young type 1 diabetic patients. Methods The Diabetes-Patienten-Verlaufsdaten is a longitudinal follow-up database, which collects data from 298 German and Austrian diabetes centres. Data available on diabetic patients aged <20 years were analysed statistically.

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Section: Discussionmentioning

confidence: 99%

Down’s syndrome in diabetic patients aged <20 years: an analysis of metabolic status, glycaemic control and autoimmunity in comparison with type 1 diabetes

et al. 2010

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“…1 Children with DS have an increased risk of developing both acute myeloid leukemia, as well as acute lymphoblastic leukemia (ALL). 2 DS-ALL patients differ in presenting characteristics from ALL patients without DS (non-DS-ALL).…”

Section: Introductionmentioning

confidence: 99%

Methotrexate-induced side effects are not due to differences in pharmacokinetics in children with Down syndrome and acute lymphoblastic leukemia

Buitenkamp¹,

Mathôt²,

Haas³

et al. 2010

Haematologica

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BackgroundChildren with Down syndrome have an increased risk of developing acute lymphoblastic leukemia and a poor tolerance of methotrexate. This latter problem is assumed to be caused by a higher cellular sensitivity of tissues in children with Down syndrome. However, whether differences in pharmacokinetics play a role is unknown. Design and MethodsWe compared methotrexate-induced toxicity and pharmacokinetics in a retrospective casecontrol study between patients with acute lymphoblastic leukemia who did or did not have Down syndrome. Population pharmacokinetic models were fitted to data from all individuals simultaneously, using non-linear mixed effect modeling. ResultsOverall, 468 courses of methotrexate (1-5 g/m 2 ) were given to 44 acute lymphoblastic leukemia patients with Down syndrome and to 87 acute lymphoblastic leukemia patients without Down syndrome. Grade 3-4 gastrointestinal toxicity was significantly more frequent in the children with Down syndrome than in those without (25.5% versus 3.9%; P=0.001). The occurrence of grade 3-4 gastrointestinal toxicity was not related to plasma methotrexate area under the curve. Methotrexate clearance was 5% lower in the acute lymphoblastic leukemia patients with Down syndrome (P=0.001); however, this small difference is probably clinically not relevant, because no significant differences in methotrexate plasma levels were detected at 24 and 48 hours. ConclusionsWe did not find evidence of differences in the pharmacokinetics of methotrexate between patients with and without Down syndrome which could explain the higher frequency of gastrointestinal toxicity and the greater need for methotrexate dose reductions in patients with Down syndrome. Hence, these problems are most likely explained by differential pharmacodynamic effects in the tissues between children with and without Down syndrome. Although the number of patients was limited to draw conclusions, we feel that it may be safe in children with Down syndrome to start with intermediate dosages of methotrexate (1-3 g/m 2 ) and monitor the patients carefully.Key words: metrotrexate pharmacokinetics, Down syndrome, acute lymphoblastic leukemia, methotrexate.Citation: Buitenkamp TD, Mathôt RAA, de Haas V, Pieters R, and Zwaan CM. Methotrexateinduced side effects are not due to differences in pharmacokinetics in children with Down's syndrome and acute lymphoblastic leukemia. Haematologica 2010;95:01106-1113. doi:10.3324/haematol.2009

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“…3,6 Approximately half of infants with Down syndrome are diagnosed with congenital heart defects, compared with a baseline risk of ∼1%. 7,8 Related complications, such as pulmonary hypertension and heart failure may affect health and survival, 9 but a change in attitudes toward treatment of infants with Down syndrome, corrective heart surgery included, has improved prognosis. 10,11 For example, the infant mortality rate among infants with Down syndrome in Sweden has decreased from 41% during 1969 to 1973 to 4% during 1999 to 2003.…”

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confidence: 99%

Trends in Congenital Heart Defects in Infants With Down Syndrome

Bergström¹,

Carr²,

Petersson³

et al. 2016

Pediatrics

128

124

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Prevalence, Neonatal Characteristics, and First-Year Mortality of Down Syndrome: A National Study

Cited by 208 publications

References 17 publications

Down’s syndrome in diabetic patients aged <20 years: an analysis of metabolic status, glycaemic control and autoimmunity in comparison with type 1 diabetes

Down’s syndrome in diabetic patients aged <20 years: an analysis of metabolic status, glycaemic control and autoimmunity in comparison with type 1 diabetes

Methotrexate-induced side effects are not due to differences in pharmacokinetics in children with Down syndrome and acute lymphoblastic leukemia

Trends in Congenital Heart Defects in Infants With Down Syndrome

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