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Treatment decision-making for patients with the Herlitz subtype of junctional epidermolysis bullosa.
[junctional epidermolysis bullosa]
The
Herlitz
subtype
of
junctional
epidermolysis
bullosa
(
JEB-H
)
is
a
lethal
genetic
disorder
characterized
by
recurrent
and
persistent
erosions
of
the
epithelial
surfaces
that
heal
with
exuberant
granulation
tissue
.
In
addition
,
respiratory
distress
,
refractory
anemia
and
failure
to
thrive
are
often
seen
.
Mortality
in
the
first
year
of
life
approaches
90
%
.
JEB-H
is
caused
by
mutations
in
the
genes
that
encode
the
protein
laminin
5
,
a
structural
molecule
involved
in
the
adhesion
of
epidermis
to
dermis
.
There
is
currently
no
cure
for
JEB-H
.
Medical
interventions
treat
complications
but
do
not
ultimately
limit
mortality
.
Ethical
principles
contend
that
offering
comfort
and
company
to
the
patient
and
family
,
not
aggressive
therapies
,
should
comprise
the
mainstay
of
care
for
affected
infants
.
Diseases
Validation
Diseases presenting
"first year"
symptom
22q11.2 deletion syndrome
achondroplasia
alpha-thalassemia
aniridia
benign recurrent intrahepatic cholestasis
child syndrome
cohen syndrome
congenital adrenal hyperplasia
congenital diaphragmatic hernia
congenital toxoplasmosis
cowden syndrome
dystrophic epidermolysis bullosa
epidermolysis bullosa simplex
erythropoietic protoporphyria
gm1 gangliosidosis
hirschsprung disease
homocystinuria without methylmalonic aciduria
junctional epidermolysis bullosa
kabuki syndrome
kindler syndrome
krabbe disease
lymphangioleiomyomatosis
megacystis-microcolon-intestinal hypoperistalsis syndrome
neonatal adrenoleukodystrophy
phenylketonuria
pleomorphic liposarcoma
pyruvate dehydrogenase deficiency
severe combined immunodeficiency
sneddon syndrome
waldenström macroglobulinemia
wolf-hirschhorn syndrome
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