A doença de Tânger (DT) é um distúrbio raro do metabolismo das lipoproteínas, caracterizado bioquimicamente por uma ausência quase completa de lipoproteínas de alta densidade (HDL) plasmáticas e, clinicamente, por aumento do fígado, baço, linfonodos e amígdalas, juntamente com neuropatia periférica em crianças e adolescentes e, ocasionalmente, doença cardiovascular em adultos.
Introdução
O que você precisa saber de cara
A doença de Tânger (DT) é um distúrbio raro do metabolismo das lipoproteínas, caracterizado bioquimicamente por uma ausência quase completa de lipoproteínas de alta densidade (HDL) plasmáticas e, clinicamente, por aumento do fígado, baço, linfonodos e amígdalas, juntamente com neuropatia periférica em crianças e adolescentes e, ocasionalmente, doença cardiovascular em adultos.
Escala de raridade
<1/50kMuito rara
1/20kRara
1/10kPouco freq.
1/5kIncomum
1/2k
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Entender a doença
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Sinais e sintomas
O que aparece no corpo e com que frequência cada sintoma acontece
Partes do corpo afetadas
+ 17 sintomas em outras categorias
Características mais comuns
Os sintomas variam de pessoa para pessoa. Abaixo estão as 39 características clínicas mais associadas, ordenadas por frequência.
Linha do tempo da pesquisa
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Genética e causas
O que está alterado no DNA e como passa nas famílias
Genes associados
1 gene identificado com associação a esta condição. Padrão de herança: Autosomal recessive.
Catalyzes the translocation of specific phospholipids from the cytoplasmic to the extracellular/lumenal leaflet of membrane coupled to the hydrolysis of ATP (PubMed:24097981, PubMed:35974019). Thereby, participates in phospholipid transfer to apolipoproteins to form nascent high density lipoproteins/HDLs (PubMed:14754908). Transports preferentially phosphatidylcholine over phosphatidylserine (PubMed:24097981). May play a similar role in the efflux of intracellular cholesterol to apolipoproteins
Cell membraneEndosome
Tangier disease
An autosomal recessive disorder characterized by near absence of plasma high density lipoproteins, low serum HDL cholesterol, and massive tissue deposition of cholesterol esters. Clinical features include large yellow-orange tonsils, hepatomegaly, splenomegaly, enlarged lymph nodes, and often sensory polyneuropathy.
Variantes genéticas (ClinVar)
198 variantes patogênicas registradas no ClinVar.
Classificação de variantes (ClinVar)
Distribuição de 284 variantes classificadas pelo ClinVar.
Vias biológicas (Reactome)
4 vias biológicas associadas aos genes desta condição.
Diagnóstico
Os sinais que médicos procuram e os exames que confirmam
Tratamento e manejo
Remédios, cuidados de apoio e o que precisa acompanhar
Onde tratar no SUS
Hospitais de referência no Brasil e o protocolo oficial do SUS (PCDT)
🇧🇷 Atendimento SUS — Doença de Tangier
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Dados de DATASUS/CNES, SBGM, ABNeuro e Ministério da Saúde. Sempre confirme a disponibilidade diretamente com o estabelecimento.
Pesquisa ativa
Ensaios clínicos abertos e novidades científicas recentes
Ensaios em destaque
Pesquisa e ensaios clínicos
6 ensaios clínicos encontrados.
Publicações mais relevantes
Miglustat as a Treatment for Adults with Tangier Disease Neuropathy: The MUSTANG N-of-1 Trial with 21 months Clinical Observation.
Tangier disease (TD) is an ultra-rare disease, characterised by progressive peripheral neuropathy with no established treatment. To determine whether miglustat improved the clinical status of a single patient with TD, and to investigate the possible mechanisms of miglustat in this patient. An n-of-1 ABAB study, alternating on and off treatment for 6-month periods, total study duration of 2 years with an additional compassionate-access period of 21 months. Miglustat, an orphan drug licenced to treat Gaucher disease and Niemann-Pick disease, was repurposed. The study was designed with two co-primary endpoints: (a) time taken to complete the nine-hole peg test (fine motor control and finger dexterity), and (b) hand strength: grip and three-point pinch strength tests. Secondary endpoints were quality-of-life measures and biomarkers. A 21-year-old (at baseline) left-handed male patient with TD, diagnosed at the age of 6 months, and disabling neuropathy was included in the study. Over 2 years, there was a small signal in our clinical measures that the drug may be beneficial. Compared with the 2 years prior to treatment, the patient had no relapse of neuropathy during his study period and further extension. During the 21-month treatment extension, he showed considerable improvement on primary endpoints. Biomarkers changed as expected based on the mechanism of action of miglustat. Nerve conduction studies showed a mild benefit. Importantly, the patient's reported experience suggested a meaningful benefit from miglustat. Miglustat may be used to treat neurological complications of TD. This study showed that an n-of-1 study to inform a policy decision is practical and may offer hope to patients with rare diseases. ClinicalTrials.gov Identifier: ISRCTN17945917. Registration date: 07/06/2021; 'retrospectively registered'.
Correction: Miglustat as a Treatment for Adults with Tangier Disease Neuropathy: The MUSTANG N‑of‑1 Trial with 21 months Clinical Observation.
ABCA1: A Therapeutic Target for Improving Cholesterol Homeostasis in Peripheral Neuropathies.
ATP-binding cassette A1 (ABCA1) is a critical molecule in facilitating cholesterol transport in a variety of organs. In the nervous system, cholesterol supply is essential and rate-limiting for myelin biogenesis, which underlies efficient conduction of nerve impulses. When myelin is damaged or improperly formed due to genetic defects, a host of neurological symptoms may arise. A rare form of peripheral neuropathy in Tangier disease (TD) patients is associated with autosomal recessive mutations in ABCA1. Accordingly, when ABCA1 loses its function due to misexpression, the neuropathic phenotype is over-represented. Independently, studies have revealed the altered expression of ABCA1 and dysregulation of cholesterol metabolism in a host of inherited peripheral neuropathies engaging the Peripheral Myelin Protein 22 (PMP22), suggesting shared pathophysiology. While the role of ABCA1 has not been investigated broadly in peripheral nerves, the transporter molecule is a therapeutic target for human disorders, including multiple sclerosis and Alzheimer's disease. Investigations in rodent models of type 1 Charcot-Marie-Tooth (CMT) neuropathies support the candidacy of this cholesterol transporter as a therapeutic target in efforts of peripheral myelin repair. Ongoing preclinical studies in central and peripheral nervous system disease models will provide critical information on the importance of ABCA1 as a target for disease modifying intervention.
A Novel Missense Mutation in a Compound Heterozygous Patient with Fish-Eye Disease: A Case Report.
Fish-eye disease (FED) is a rare autosomal recessive disorder caused by a partial deficiency of lecithin-cholesterol acyltransferase (LCAT) activity. It is characterized by progressive corneal opacification and dyslipidemia in the absence of systemic manifestations. We describe the clinical presentation, optical coherence tomography (OCT) imaging findings, and Scheimpflug-based corneal densitometry results in a patient with FED carrying both a pathogenic variant and a novel missense variant of the LCAT gene not reported in the current literature. We present a rare case of a 25-year-old female with bilateral corneal opacities, reduced plasma high-density lipoprotein cholesterol (<5 mg/dL), and elevated low-density lipoprotein cholesterol levels (>133 mg/dL). Visual acuity remained 20/20 in both eyes. Slit-lamp examination revealed diffuse subepithelial and anterior stromal deposits. The central corneal thickness was thinner than normal on Scheimpflug tomography, measuring 419 µm OD and 409 µm OS. OCT findings confirmed stromal thinning (479 µm OD and 470 µm OS), with preserved central epithelial thickness, and demonstrated corneal opacities throughout the cornea. Mean densitometry across the 12-mm corneal diameter was more than double that reported in healthy corneas. The cholesteryl ester-to-total cholesterol ratio remained within the normal range. Genetic analysis identified a previously reported pathogenic variant in exon 4 of LCAT (c.440C>T, p.Thr147Ile) and a novel missense mutation in exon 5 (c.715G>A, p.Gly239Ser), classified as a variant of uncertain significance. FED is a rare genetic disorder that is associated with corneal clouding and dyslipidemia. Genetic analysis confirmed the diagnosis with a compound heterozygous genotype, while OCT and corneal densitometry were effective modalities for quantifying and characterizing lipid deposits in FED.
A novel ABCA1 variant associated with impaired platelet production contributing to thrombocytopenia in a family with Tangier disease.
ATP-binding cassette A1 (ABCA1) is a membrane-associated cholesterol efflux pump that is crucial for high-density lipoprotein (HDL) biogenesis and cellular cholesterol homeostasis. Pathogenic variants in the ABCA1 gene cause Tangier disease (TD), a rare autosomal recessive disorder characterized by nearly absent HDL in plasma and cholesteryl ester accumulation in tissue macrophages. Clinical manifestations vary among patients with TD, including splenomegaly, thrombocytopenia, and cardiovascular disease (CVD), with no clear association with specific ABCA1 pathogenic variants. Thrombocytopenia is attributed to hypersplenism-mediated platelet clearance; however, there is controversy regarding platelet production and function in TD. To identify and functionally characterize the suspected alteration in ABCA1, and to study platelet production and function in a Spanish family with HDL deficiency and thrombocytopenia. Lipid and apolipoprotein profile analyses, next-generation/Sanger sequencing, in vitro ABCA1 expression and cholesterol efflux assays, primary megakaryocyte differentiation cultures, and platelet functional studies were performed. We identified a novel variant, ABCA1:NM_005502.4c.3306del:p.(Ile1103Serfs*16), which results in a truncated protein with defective apolipoprotein AI-dependent cholesterol efflux. Mild to severe thrombocytopenia and splenomegaly were observed in homozygous carriers; however, there was no clinical history of CVD. Platelet degranulation was overtly normal, although a distinct aggregation profile was observed in ABCA1:p.(Ile1103Serfs*16) carriers. Impaired megakaryocyte differentiation associated with aberrant accumulation of neutral lipids in megakaryocytes was observed in primary cell cultures from homozygous carriers. The ABCA1:NM_005502.4c.3306del:p.(Ile1103Serfs*16) variant causes TD. Our findings suggest that thrombocytopenia in TD is not merely due to platelet clearance but also a consequence of ineffective megakaryopoiesis due to ABCA1 dysfunction.
Publicações recentes
ABCA1: A Therapeutic Target for Improving Cholesterol Homeostasis in Peripheral Neuropathies.
A Novel Missense Mutation in a Compound Heterozygous Patient with Fish-Eye Disease: A Case Report.
A novel ABCA1 variant associated with impaired platelet production contributing to thrombocytopenia in a family with Tangier disease.
Assessing rare disease understanding: a novel disease readiness level framework.
📚 EuropePMC273 artigos no totalmostrando 100
ABCA1: A Therapeutic Target for Improving Cholesterol Homeostasis in Peripheral Neuropathies.
BiomoleculesA Novel Missense Mutation in a Compound Heterozygous Patient with Fish-Eye Disease: A Case Report.
Case reports in ophthalmologyA novel ABCA1 variant associated with impaired platelet production contributing to thrombocytopenia in a family with Tangier disease.
Journal of clinical lipidologyAssessing rare disease understanding: a novel disease readiness level framework.
Orphanet journal of rare diseasesDeficiency of the Tangier Disease Gene Abca1 Is Associated With Microglial Defects in Mice.
International journal of developmental neuroscience : the official journal of the International Society for Developmental NeuroscienceMiglustat as a Treatment for Adults with Tangier Disease Neuropathy: The MUSTANG N-of-1 Trial with 21 months Clinical Observation.
Neurology and therapyA novel ABCA1 mutation in Tangier disease associated with severe premature and rapidly progressive neurodegenerative disorder.
Journal of clinical lipidologyProgressive histiocytosis in Tangier disease: a 17-year follow-up.
PathologyFunctional characterization of genetic variants affecting the intracellular domains of ATP-binding cassette transporter A1 (ABCA1).
Journal of lipid researchIs Tangier disease a rare cause of premature ovarian insufficiency?: A case report.
Journal of clinical lipidologyQuantitative Sensory Testing in a Girl With Tangier Disease: A Case Report.
CureusExpect the unexpected: Tangier disease and monoclonal gammopathy of undetermined significance.
British journal of haematologyLipid Dysregulation in Tangier Disease: A Case Series and Metabolic Characterization.
The Journal of clinical endocrinology and metabolismA novel variant in the ABCA1 gene for Tangier Disease with diffuse histiocytosis of bone marrow.
Journal of clinical lipidologyThe clinical presentation and genetic diagnosis of Tangier disease in the pediatric age group.
Journal of pediatric endocrinology & metabolism : JPEMPrimary Hypoalphalipoproteinemia With Significant Premature Atherosclerosis.
JACC. Case reportsNovel pathogenic variant in the LCAT gene in a compound heterozygous patient with fish-eye disease and a mild phenotype.
Journal of clinical lipidology[Homozygous ABCA1 gene mutated Tangier disease complicated with diabetes mellitus: a case report].
Zhonghua nei ke za zhiA novel splicing variant in ABCA1 in the first reported Hong Kong Chinese patient with high-density lipoprotein deficiency.
Endocrinology, diabetes & metabolism case reportsABCA1 deficiency causes tissue-specific dysregulation of the SREBP2 pathway in mice.
Biochimica et biophysica acta. Molecular and cell biology of lipidsATP-Binding Cassette Transporter of Clinical Significance: Sideroblastic Anemia.
Journal of personalized medicineGenetic and Functional Analyses of Patients with Marked Hypo-High-Density Lipoprotein Cholesterolemia.
Journal of atherosclerosis and thrombosisRole of ABCA1 in Atherosclerosis: Novel Mutations and Potential Plant-derived Therapies.
Current medicinal chemistryA case report of Tangier disease presents with acute sensorimotor polyneuropathy and its treatment approach.
Journal of clinical lipidologyFunctional characterization of missense variants affecting the extracellular domains of ABCA1 using a fluorescence-based assay.
Journal of lipid researchInterpreting New Thoughts on HDL Through the Lens of Chesapeake Bay's Tangier Disease.
Journal of community hospital internal medicine perspectivesThe expanding boundaries of sphingolipid lysosomal storage diseases; insights from Niemann-Pick disease type C.
Biochemical Society transactionsAtypical Presentation of Tangier Disease-Expanding the Clinical Spectrum.
Journal of clinical neuromuscular diseaseHepatocyte ABCA1 deficiency is associated with reduced HDL sphingolipids.
Frontiers in physiologyABCA1 Deficiency: A Rare Cause of Premature Coronary Artery Disease.
JACC. Case reportsRare primary dyslipidaemias associated with low LDL and HDL cholesterol values in Portugal.
Frontiers in geneticsAssociation of a Novel Homozygous Variant in ABCA1 Gene with Tangier Disease.
Journal of clinical medicineEarly-onset atherosclerosis in a patient with Tangier disease: Not all that is gold glitters.
Kardiologia polskaBiomedical Advances in ABCA1 Transporter: From Bench to Bedside.
BiomedicinesVery low HDL levels: clinical assessment and management.
Archives of endocrinology and metabolismA rare case of nephrotic syndrome and Tangier disease.
CEN case reportsHDL, cholesterol efflux, and ABCA1: Free from good and evil dualism.
Journal of pharmacological sciencesSensory-motor not length-dependent multineuropathy followed by the syringomyelia-like phenotype: a novel presentation of Tangier disease.
Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical NeurophysiologyMolecular Mechanisms of Sphingolipid Transport on Plasma Lipoproteins.
Advances in experimental medicine and biologyA case of mesenteric panniculitis in a patient with Tangier disease.
Journal of clinical lipidologyCholesterol efflux mechanism revealed by structural analysis of human ABCA1 conformational states.
Nature cardiovascular researchTangier Disease: An Unusual Cause of Chronic Diarrhea.
ACG case reports journalProspective Registry Study of Primary Dyslipidemia (PROLIPID): Rationale and Study Design.
Journal of atherosclerosis and thrombosisCurrent Diagnosis and Management of Tangier Disease.
Journal of atherosclerosis and thrombosisPhospholipid transfer to high-density lipoprotein (HDL) upon triglyceride lipolysis is directly correlated with HDL-cholesterol levels and is not associated with cardiovascular risk.
AtherosclerosisThe Role of the ATP-Binding Cassette A1 (ABCA1) in Human Disease.
International journal of molecular sciencesA case of premature and recurrent myocardial infarction associated with ABCA.1 gene mutation.
Journal of postgraduate medicine[Tangier disease in family with the phenotype of familial hypercholesterolemia].
Vnitrni lekarstviUnusual White-Yellowish Dots in the Colon Reveal a Rare Metabolic Disease.
GastroenterologyThe ABCs of Sterol Transport.
Annual review of physiologyOrphan Peripheral Neuropathies.
Journal of neuromuscular diseasesThe impact of ATP-binding cassette transporters on metabolic diseases.
Nutrition & metabolismHuman Insulin Growth Factor 2 mRNA Binding Protein 2 Increases MicroRNA 33a/b Inhibition of Liver ABCA1 Expression and Alters Low-Density Apolipoprotein Levels in Mice.
Molecular and cellular biologyTangier disease: update for 2020.
Current opinion in lipidologyLCAT, ApoD, and ApoA1 Expression and Review of Cholesterol Deposition in the Cornea.
BiomoleculesMechanistic convergence and shared therapeutic targets in Niemann-Pick disease.
Journal of inherited metabolic disease[Inborn errors of high-density lipoprotein metabolism].
Der InternistATP-binding cassette A1 deficiency causes cardiolipin-driven mitochondrial dysfunction in podocytes.
The Journal of clinical investigationFunctionally Significant Features in the 5' Untranslated Region of the ABCA1 Gene and Their Comparison in Vertebrates.
CellsNerve high-resolution ultrasonography in tangier disease.
Muscle & nerveA novel splicing mutation in the ABCA1 gene, causing Tangier disease and familial HDL deficiency in a large family.
Biochemical and biophysical research communicationsOcular and Genetic Characteristics Observed in Two Cases of Fish-Eye Disease.
CorneaIdentification of the first Tangier disease patient in Lebanon carrying a new pathogenic variant in ABCA1.
Journal of clinical lipidologyATP binding cassette family A protein 1 determines hexosylceramide and sphingomyelin levels in human and mouse plasma.
Journal of lipid researchTangier disease may cause early onset of atherosclerotic cerebral infarction: A case report.
MedicineA novel homozygous ABCA1 variant in an asymptomatic man with profound hypoalphalipoproteinemia.
Journal of clinical lipidologyUndetectable high-density lipoprotein cholesterol in acute malaria.
Journal of clinical lipidologyCholesterol Efflux Pathways Suppress Inflammasome Activation, NETosis, and Atherogenesis.
CirculationPeripheral neuropathy in Tangier disease: A literature review and assessment.
Journal of the peripheral nervous system : JPNSAccelerated Atherogenicity in Tangier Disease.
Journal of atherosclerosis and thrombosisATP-binding cassette transporter A1: A promising therapy target for prostate cancer.
Molecular and clinical oncologyUnusual yellow scaly colonic mucosal appearance: Tangier disease.
Gastrointestinal endoscopyCan Tangier disease cause male infertility? A case report and an overview on genetic causes of male infertility and hormonal axis involved.
Molecular genetics and metabolismSteryl ester synthesis, storage and hydrolysis: A contribution to sterol homeostasis.
Biochimica et biophysica acta. Molecular and cell biology of lipids[Valve Replacement for Severe Aortic Stenosis in a Patient with Tangier Disease].
Kyobu geka. The Japanese journal of thoracic surgeryHepatic ABCA1 deficiency is associated with delayed apolipoprotein B secretory trafficking and augmented VLDL triglyceride secretion.
Biochimica et biophysica acta. Molecular and cell biology of lipidsThe usefulness of advanced lipid and oxidative stress testing for diagnosis and management of low HDL-cholesterol phenotype: A case report.
Clinical biochemistryReduced platelet count, but no major platelet function abnormalities, are associated with loss-of-function ATP-binding cassette-1 gene mutations.
Clinical science (London, England : 1979)Structure of the Human Lipid Exporter ABCA1.
CellClinical utility gene card for: Tangier disease.
European journal of human genetics : EJHGThe iPSC Awakens ANGPTL3 in Tangier Disease.
EBioMedicineATP-Binding Cassette Transporter A1 Deficiency in Human Induced Pluripotent Stem Cell-Derived Hepatocytes Abrogates HDL Biogenesis and Enhances Triglyceride Secretion.
EBioMedicineMethods for Monitoring ABCA1-Dependent Sterol Release.
Methods in molecular biology (Clifton, N.J.)A Novel Mutation in ABCA1 Gene Causing Tangier Disease in an Italian Family with Uncommon Neurological Presentation.
Frontiers in neurologyCell lipid metabolism modulators 2-bromopalmitate, D609, monensin, U18666A and probucol shift discoidal HDL formation to the smaller-sized particles: implications for the mechanism of HDL assembly.
Biochimica et biophysica actaDiagnosis and treatment of high density lipoprotein deficiency.
Progress in cardiovascular diseasesHuman serum preβ1-high density lipoprotein levels are independently and negatively associated with coronary artery diseases.
Nutrition & metabolismTangier's disease: An uncommon cause of facial weakness and non-length dependent demyelinating neuropathy.
Annals of Indian Academy of NeurologyATP-binding cassette transporter 1 (ABCA1) deficiency decreases platelet reactivity and reduces thromboxane A2 production independently of hematopoietic ABCA1.
Journal of thrombosis and haemostasis : JTHAn uncommon cause of bifacial weakness and non-length-dependent demyelinating neuropathy.
Annals of Indian Academy of NeurologySubfraction analysis of circulating lipoproteins in a patient with Tangier disease due to a novel ABCA1 mutation.
Clinica chimica acta; international journal of clinical chemistryUpdate on the molecular biology of dyslipidemias.
Clinica chimica acta; international journal of clinical chemistryClinical, Electrodiagnostic, and Genetic Features of Tangier Disease in an Adolescent Girl with Presentation of Peripheral Neuropathy.
NeuropediatricsThe Role of Cardiolipin in Cardiovascular Health.
BioMed research internationalDeficiency in the Lipid Exporter ABCA1 Impairs Retrograde Sterol Movement and Disrupts Sterol Sensing at the Endoplasmic Reticulum.
The Journal of biological chemistryExtreme clinical chemistry.
Clinica chimica acta; international journal of clinical chemistryABCA1 and Inflammation: From Animal Models to Humans.
Arteriosclerosis, thrombosis, and vascular biologyFunctional analysis and transcriptomic profiling of iPSC-derived macrophages and their application in modeling Mendelian disease.
Circulation researchWhole exome sequencing combined with integrated variant annotation prediction identifies asymptomatic Tangier disease with compound heterozygous mutations in ABCA1 gene.
AtherosclerosisHDL particle size is a critical determinant of ABCA1-mediated macrophage cellular cholesterol export.
Circulation researchAssociações
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Referências e fontes
Bases de dados externas citadas neste artigo
Publicações científicas
Artigos indexados no PubMed ligados a esta doença no grafo RarasNet — título, periódico e PMID direto da fonte, sem intermediação de IA.
- Miglustat as a Treatment for Adults with Tangier Disease Neuropathy: The MUSTANG N-of-1 Trial with 21 months Clinical Observation.
- Correction: Miglustat as a Treatment for Adults with Tangier Disease Neuropathy: The MUSTANG N‑of‑1 Trial with 21 months Clinical Observation.
- ABCA1: A Therapeutic Target for Improving Cholesterol Homeostasis in Peripheral Neuropathies.
- A Novel Missense Mutation in a Compound Heterozygous Patient with Fish-Eye Disease: A Case Report.
- A novel ABCA1 variant associated with impaired platelet production contributing to thrombocytopenia in a family with Tangier disease.
- Assessing rare disease understanding: a novel disease readiness level framework.
Bases de dados e fontes oficiais
Identificadores e referências canônicas usadas para montar este verbete.
- ORPHA:31150(Orphanet)
- OMIM OMIM:205400(OMIM)
- MONDO:0008783(MONDO)
- GARD:7731(GARD (NIH))
- Variantes catalogadas(ClinVar)
- Busca completa no PubMed(PubMed)
- Q1442621(Wikidata)
Dados compilados pelo RarasNet a partir de fontes abertas (Orphanet, OMIM, MONDO, PubMed/EuropePMC, ClinicalTrials.gov, DATASUS, PCDT/MS). Este conteúdo é informativo e não substitui avaliação médica.
Conteúdo mantido por Agente Raras · Médicos e pesquisadores podem colaborar
