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Familial amyloid polyneuropathy (FAP): clinical features, pathophysiology and treatment

dc.contributor.authorTomás, Maria Teresa
dc.contributor.authorSanta-Clara, Helena
dc.contributor.authorMateus, Élia
dc.contributor.authorMonteiro, Estela
dc.date.accessioned2014-01-17T14:32:41Z
dc.date.available2014-01-17T14:32:41Z
dc.date.issued2014
dc.description.abstractIn the literature, concepts of “polyneuropathy”, “peripheral neuropathy” and “neuropathy” are often mistakenly used as synonyms. Polyneuropathy is a specific term that refers to a relatively homogenous process that affects multiple peripheral nerves. Most of these tend to present as symmetric polyneuropathies that first manifest in the distal portions of the affected nerves. Many of these distal symmetric polyneuropathies are due to toxic-metabolic causes such as alcohol abuse and diabetes mellitus. Other distal symmetric polyneuropathies may result from an overproduction of substances that result in nerve pathology such as is observed in anti-MAG neuropathy and monoclonal gammopathy of undetermined significance. Other “overproduction” disorders are hereditary such as noted in the Portuguese type of familial amyloid polyneuropathy (FAP). FAP is a manifestation of a group of hereditary amyloidoses; an autosomal dominant, multisystemic disorder wherein the mutant amyloid precursor, transthyretin, is produced in excess primarily by the liver. The liver accounts for approximately 98% of all transthyretin production. FAP is confirmed by detecting a transthyretin variant with a methionine for valine substitution at position 30 [TTR (Met30)]. Familial Amyloidotic Polyneuropathy (FAP) – Portuguese type was first described by a Portuguese neurologist, Corino de Andrade in 1939 and published in 1951. Most persons with this disorder are descended from Portuguese sailors who sired offspring in various locations, primarily in Sweden, Japan and Mallorca. Their descendants emigrated worldwide such that this disorder has been reported in other countries as well. More than 2000 symptomatic cases have been reported in Portugal. FAP progresses rapidly with an average time course from symptom onset to multi-organ involvement and death between ten and twenty years. Treatments directed at removing this aberrant protein such as plasmapheresis and immunoadsorption proved to be unsuccessful. Liver transplantation has been the only effective solution as evidenced by almost 2000 liver transplants performed worldwide. A therapy for FAP with a novel agent, “Tafamidis” has shown some promise in ongoing phase III clinical trials. It is well recognized that regular physical activity of moderate intensity has a positive effect on physical fitness as gauged by body composition, aerobic capacity, muscular strength and endurance and flexibility. Physical fitness has been reported to result in the reduction of symptoms and lesser impairment when performing activities of daily living. Exercise has been advocated as part of a comprehensive approach to the treatment of chronic diseases. Therefore, this chapter concludes with a discussion of the role of exercise training on FAP.por
dc.identifier.citationTomás MT, Santa Clara H, Mateus E, Monteiro E. Familial amyloid polyneuropathy (FAP): clinical features, pathophysiology and treatment. In Menkes DL, editor. Contemporary issues in peripheral neuropathy. New York: NOVA Science Publishers; 2014. p. 209-24.por
dc.identifier.isbn978-1-62948-681-9
dc.identifier.urihttp://hdl.handle.net/10400.21/3118
dc.language.isoengpor
dc.peerreviewedyespor
dc.publisherNOVA Science Publisherspor
dc.relation.publisherversionhttps://www.novapublishers.com/catalog/product_info.php?products_id=46986por
dc.subjectPhysiotherapypor
dc.subjectRehabilitationpor
dc.subjectFamilial amyloid polyneuropathypor
dc.subjectPhysical activitypor
dc.titleFamilial amyloid polyneuropathy (FAP): clinical features, pathophysiology and treatmentpor
dc.typebook part
dspace.entity.typePublication
oaire.citation.endPage224por
oaire.citation.startPage209por
person.familyNameTomás
person.givenNameMaria Teresa
person.identifier438585
person.identifier.ciencia-id3010-19D6-C7A5
person.identifier.orcid0000-0003-0491-8903
person.identifier.ridN-1940-2013
person.identifier.scopus-author-id36700434200
rcaap.rightsclosedAccesspor
rcaap.typebookPartpor
relation.isAuthorOfPublication64ad74a4-4cd4-426e-a1ee-2ec846fdc6dd
relation.isAuthorOfPublication.latestForDiscovery64ad74a4-4cd4-426e-a1ee-2ec846fdc6dd

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