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![]() As with many other medical conditions, a doctor might not initially suspect that a patient has MPS I. This is because some of the early signs and symptoms associated with MPS I affect the body in many ways, and may appear in many organ systems. Also, many of the early signs and symptoms are similar to those of other, more common childhood illnesses. For this reason, patients may see several specialists before a diagnosis of MPS I is made. As well, physicians must often rule out other causes first before beginning to consider a disease as rare as MPS I. There are two methods your physician can use to diagnose MPS I. One of the first steps is a urine test, which can look for abnormally high levels of glycosaminoglycans (GAG). Results are compared to known reference ranges for various ages, to samples from people who do not have MPS I, and to samples from a person who does have MPS I. Most, but not all, people with MPS I have GAG levels in their urine that are higher than people without MPS I. However, a urine test is only the first step in diagnosing MPS I: a physician will only know for sure by completing an enzyme test using a blood or skin sample. Blood and Skin Cell Tests
A doctor can confirm an MPS I diagnosis by measuring enzyme activity levels in the blood or skin cells. In healthy individuals, the tests show white blood cells, serum and skin cells that contain normal enzyme activity. In individuals with MPS I, the enzyme activity is much lower. Who should be tested?
Physicians may consider testing for MPS I when associated signs and symptoms are present and are unexplained by other causes. Testing may also be considered for family members of individuals with MPS I. Early diagnosis is vital. The earlier that MPS I is diagnosed, the sooner effective treatment and care may be used to help a person with MPS I, and hopefully prevent irreversible damage caused by the disease. Family Screening
Because MPS I is an inherited disorder, family screening is important. One diagnosis of MPS I may uncover other affected siblings within a family. With early diagnosis, the disease may be better managed. A genetic counselor may be a valuable resource to help you understand how MPS I is inherited in families, and may also provide guidance to families for diagnostic, medical, and support services. For a list of diagnostic centers, see the Diagnostic Centers section of this website. |
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ALDURAZYME® (laronidase) is indicated for patients with Hurler and Hurler-Scheie forms of Mucopolysaccharidosis I (MPS I) and for patients with the Scheie form who have moderate to severe symptoms. The risks and benefits of treating mildly affected patients with the Scheie form have not been established.
ALDURAZYME has been shown to improve pulmonary function and walking capacity. ALDURAZYME has not been evaluated for effects on the central nervous system manifestations of the disorder.
Important Safety Information
WARNING
Risk of anaphylaxis. Life-threatening anaphylactic reactions have been observed in some patients during ALDURAZYME infusions. Therefore, appropriate medical support should be readily available when ALDURAZYME is administered. Patients with compromised respiratory function or acute respiratory disease may be at risk of serious acute exacerbation of their respiratory compromise due to infusion reactions, and require additional monitoring.
Life-threatening anaphylactic reactions have been observed in some patients during or up to 3 hours after ALDURAZYME infusions. Reactions have included: respiratory failure, respiratory distress, stridor, tachypnea, bronchospasm, airway obstruction, hypoxia, hypotension, bradycardia, and urticaria. Interventions have included: resuscitation, mechanical ventilatory support, emergency tracheotomy, hospitalization, and treatment with inhaled beta-adrenergic agonists, epinephrine, and intravenous corticosteroids.
In clinical trials and postmarketing safety experience with ALDURAZYME, approximately 1% of patients experienced severe or serious allergic reactions. In patients with MPS I, pre-existing upper airway obstruction may have contributed to the severity of some reactions. Due to the potential for severe allergic reactions, appropriate medical support should be readily available when ALDURAZYME is administered. Because of the potential for recurrent reactions, some patients who experience initial severe reactions may require prolonged observation. The risks and benefits of re-administering ALDURAZYME following an anaphylactic or severe allergic reaction should be considered.
Patients with an acute illness at the time of ALDURAZYME infusion may be at greater risk for infusion-related reactions. Careful consideration should be given to the patient’s clinical status prior to administration of ALDURAZYME.
Patients should receive antipyretics and/or antihistamines prior to infusion. If an infusion reaction occurs, regardless of pretreatment, decreasing the infusion rate, temporarily stopping the infusion, and/or administration of additional antipyretics and/or antihistamines may ameliorate the symptoms.
The most common adverse reactions associated with ALDURAZYME treatment in the clinical studies were upper respiratory tract infection, rash, and injection site reaction The most common adverse reactions requiring intervention were infusion-related reactions involving flushing, fever, headache, and rash.
In postmarketing experience with ALDURAZYME, severe and serious infusion-related reactions have been reported, some of which were life-threatening. The most frequently reported adverse reactions included: chills, vomiting, nausea, arthralgia, diarrhea, tachycardia, abdominal pain, blood pressure increased, and oxygen saturation decreased.
Approximately 91% of patients treated with ALDURAZYME in clinical studies were positive for antibodies to laronidase. The clinical significance of antibodies to ALDURAZYME is not known, including the potential for product neutralization. Adverse events should be reported promptly to Genzyme Medical Information at 800-745-4447, option 2. ALDURAZYME is available by prescription only. To learn more, please see the full prescribing information (PDF) including boxed warning, visit www.ALDURAZYME.com or contact Genzyme at 1-800-745-4447. |
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