Mielite flácida aguda (MFA) é uma condição séria da medula espinhal. Os sintomas incluem rápido início de fraqueza nos braços ou nas pernas e reflexos diminuídos. Dificuldade de mover os olhos, falar ou engolir também pode ocorrer. Ocasionalmente, dormência ou dor pode estar presente. Complicações podem incluir problemas ao respirar.
Introdução
O que você precisa saber de cara
Mielite flácida aguda é uma condição neurológica rara que causa fraqueza muscular súbita e paralisia em membros, afetando principalmente crianças. Geralmente associada a infecções virais, pode levar a sequelas neurológicas permanentes.
Escala de raridade
<1/50kMuito rara
1/20kRara
1/10kPouco freq.
1/5kIncomum
1/2k
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Sinais e sintomas
O que aparece no corpo e com que frequência cada sintoma acontece
Linha do tempo da pesquisa
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Genética e causas
O que está alterado no DNA e como passa nas famílias
Nenhum gene associado encontrado
Os dados genéticos desta condição ainda estão sendo catalogados.
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 — Mielite flácida aguda
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Publicações mais relevantes
Respiratory enterovirus D68: virology, clinical surveillance, host-pathogen interactions, and therapeutic prospects.
Enterovirus D68 (EV-D68), a unique enterovirus resembling human rhinoviruses, was long considered to cause only sporadic outbreaks of mild, self-limiting respiratory infections mainly in children. However, over the past decade, EV-D68 has exhibited a biennial outbreak pattern across multiple regions worldwide, coinciding with an increased incidence of severe respiratory illnesses and cases of acute flaccid myelitis (AFM) in children. The immune system plays a crucial role in providing rapid and effective defense. Nonetheless, our knowledge of the complex interactions between EV-D68 and the host immune responses is still very limited. Additionally, clinical detection of EV-D68 remains challenging, and there are no FDA-approved vaccines or antiviral treatments available. Therefore, ongoing research should focus on understanding the pathogenic mechanisms of EV-D68, as well as the development of reliable diagnostic methods and therapeutic options to control EV-D68 spread. This review intends to examine the initiatives undertaken for clinical surveillance of EV-D68 outbreaks, the immune responses elicited by EV-D68, and its strategies for immune evasion. Additionally, it explores recent advancements in antiviral drug development, thereby providing a comprehensive overview of current knowledge and identifying prospective directions for future research.
Enterovirus D68 in United States wastewater: a longitudinal surveillance study integrating climatic, demographic, and clinical data.
Enterovirus D68 (EV-D68) can cause severe respiratory illness and acute flaccid myelitis (AFM), but limited clinical testing and sparse surveillance data hinder the ability to address epidemiological questions about its circulation. This study aimed to characterize EV-D68 seasonality across the U.S. using wastewater data, evaluate the influence of climatic and sociodemographic factors, and compare trends with symptom-based clinical indicators. We analyzed 43,876 samples collected from 147 wastewater treatment plants across 40 U.S. states between July 2023 and July 2025 to quantify EV-D68 RNA in wastewater solids and estimate the seasonal peak and season duration. We evaluated climatic and sociodemographic drivers of variation and compared wastewater trends with symptom-based clinical diagnoses for AFM, wheezing, and enterovirus retrieved from Epic Cosmos, a nationwide electronic health record-based research network, representing 4.5 billion encounters during the same study period. We observed a biennial EV-D68 pattern with a national peak in September 2024 and an extended 20-month period of detection in California. Seasonal peaks occurred 28-31 days earlier in regions with 5 °C higher temperatures or dew points. Season duration was longer by 7-11 weeks in dense, urban catchments with more childcare facilities, crowded households, hospitals, and nursing homes. Wastewater concentrations correlated positively with enterovirus diagnoses (Spearman ρ = 0.34, p = 0.01) and negatively with wheezing in adults ≥65 years (ρ = -0.49, p < 0.0001). Wastewater surveillance can generate epidemiological metrics for EV-D68 without clinical surveillance data, identify where and when activity increases, and reveal the environmental and demographic factors driving these patterns. Wastewater surveillance offers high-resolution data for pathogens with diagnostic testing constraints and provides information that can strengthen epidemiological modeling and support preparedness for future disease waves. Sergey Brin Family Foundation.
Rational design and in vivo validation of capsid inhibitors for enterovirus D68.
Enterovirus D68 (EV-D68) is a respiratory virus that causes neurological complications such as acute flaccid myelitis (AFM) and death in children. No vaccine or antiviral is available for EV-D68. We report the structure-based design of the EV-D68 VP1 capsid inhibitors with in vivo antiviral efficacy in a neonatal mouse model of EV-D68-associated paralytic myelitis. Cryo-EM structures show that Jun11787 and Jun11695 bind the hydrophobic canyon region in VP1 and display nanomolar potency against multiple EV-D68 strains and single-digit micromolar potency against EV-A71 and CVB3 in vitro. Jun11787 and Jun11695 also significantly reduce the spinal cord viral titer, prevent the progression of paralysis, and improve weight gain in EV-D68-infected male and female mice when treatment is initiated immediately, 24 h, and even 4-6 days post-infection. Overall, Jun11787 and Jun11695 represent promising leads for treating EV-D68 infection.
Diaphragm Interventions in Acute Flaccid Myelitis: A Single-Center Retrospective Case Series of Diaphragm Pacing Systems and Phrenic Nerve Transfers.
Acute flaccid myelitis (AFM) affects anterior horn cells of the spinal cord, leading to paralysis of proximal extremity and respiratory musculature. Patients can have chronic respiratory insufficiency and remain dependent on mechanical ventilation. We aim to report outcomes of diaphragm pacing systems (DPSs) and/or phrenic nerve transfers to augment diaphragm function in patients with AFM. This is a single-center, retrospective series of patients with AFM and chronic respiratory insufficiency who underwent operative intervention to augment diaphragm function. Patients underwent placement of DPS, phrenic nerve transfer, or both. We collected information on demographics, clinical characteristics, electrodiagnostic results, and operative findings. We assessed outcomes of diaphragm ultrasound excursion and respiratory mechanics. Six patients underwent operative intervention between 2014 and 2023. Four (66%) were male. Median age of onset was 4.3 years (range 2.8-5.7). Median follow-up was 29.3 months (range 8.1-48). There were 5 DPS placements and 3 phrenic nerve transfer operations performed, including two patients who received both procedures. Patients who underwent DPS as the primary intervention did not show improvement attributable to pacing, as similar outcomes were observed in matched controls who did not receive interventions. One patient with complete denervation had diaphragm reanimation following phrenic nerve transfer, achieving voluntary and spontaneous respiration. Patients with AFM and chronic respiratory insufficiency may benefit from operative intervention to improve respiratory function. DPS alone did not show consistent improvement in respiratory outcomes. Phrenic nerve transfer is feasible to reanimate the paralyzed diaphragm and restore spontaneous respiration or facilitate pacing.
Enterovirus D68 VP1 and VP3 determine neurotropism in human spinal cord organoids.
Enterovirus D68 (EV-D68) is a non-polio enterovirus that can cause a polio-like paralysis condition, acute flaccid myelitis (AFM). EV-D68 associated AFM cases waned in the US after 2018 and the reasons for this are unknown. It has recently been demonstrated that EV-D68 containing point mutations in viral structural proteins VP1 and VP3 resulted in decreased paralysis in different neonatal mouse models. However, phenotypes of these mutations in a human multicellular central nervous system (CNS) model are unknown. We hypothesized that mutations in VP1 and VP3 will similarly direct neurotropism in human spinal cord organoids (hSCO). To investigate this, we recreated viruses with mutations in VP3 (I88V) or VP1 (L1I/N2D/T98A/E283K or L1P/V148A/K282R) and infected hSCOs. We found that VP3 I88V and VP1 L1I/N2D/T98A/E283K resulted in decreased titer and viral protein staining, consistent with attenuated neurovirulence in previously published murine models. When these mutations were combined, their effects on neurotropism were not additive. Sequence analysis of recently circulating EV-D68 strains reveals that VP3 I88 and VP1 E283 have remained the dominant amino acid residues since 2014, whereas VP1 sites 1, 2, and 98 have higher population diversity, indicating that these residues may be contributing to newly reduced neurovirulence after 2018.
Publicações recentes
An RNA-to-RNA Pipeline for Rapid Antiviral Antibody Development.
Respiratory enterovirus D68: virology, clinical surveillance, host-pathogen interactions, and therapeutic prospects.
🥉 Relato de casoEnterovirus D68 in United States wastewater: a longitudinal surveillance study integrating climatic, demographic, and clinical data.
Rational design and in vivo validation of capsid inhibitors for enterovirus D68.
Enterovirus D68 VP1 and VP3 determine neurotropism in human spinal cord organoids.
📚 EuropePMC247 artigos no totalmostrando 195
Respiratory enterovirus D68: virology, clinical surveillance, host-pathogen interactions, and therapeutic prospects.
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Diagnostic microbiology and infectious diseaseSpinal Cord Injury in Enterovirus D68 Infection: Mechanisms and Pathophysiology in a Mouse Model.
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European journal of neurologyA case of enterovirus D68-associated acute flaccid myelitis in an immunocompromised adult, Australia.
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NatureEV68-228-N monoclonal antibody treatment halts progression of paralysis in a mouse model of EV-D68 induced acute flaccid myelitis.
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Comparative medicineAcute flaccid myelitis in low- to middle-income countries: diagnosis and surveillance.
Brain communications[Clinical characteristics analysis of 4 cases with acute flaccid myelitis in children].
Zhonghua er ke za zhi = Chinese journal of pediatricsQuadriparesis and paraparesis following chimeric antigen receptor T-cell therapy in children and adolescents.
BloodTranscription factor EB (TFEB) interaction with RagC is disrupted during enterovirus D68 infection.
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The Journal of infectious diseasesOccurrence of poliovirus and non-polio enterovirus among children with acute flaccid paralysis in Cameroon from 2015 to 2020.
Journal of infection in developing countriesAn inactivated whole-virion vaccine for Enterovirus D68 adjuvanted with CpG ODN or AddaVax elicits potent protective immunity in mice.
VaccineAcute Flaccid Myelitis With Human Rhinovirus A19 Detection: Case Report and Literature Review.
The Pediatric infectious disease journalMultimodal Surveillance Model for Enterovirus D68 Respiratory Disease and Acute Flaccid Myelitis among Children in Colorado, USA, 2022.
Emerging infectious diseasesA First Case of Acute Flaccid Myelitis Related to Enterovirus D68 in Belgium: Case Report.
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Pediatric neurologySurveillance for Acute Flaccid Myelitis - United States, 2018-2022.
MMWR. Morbidity and mortality weekly reportAcute Ascending Flaccid Paralysis in a Healthy 16-year-old.
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Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical NeurophysiologyAcute Flaccid Paralysis, Seizures, and Encephalopathy in a Pediatric Patient With Influenza A and Coronavirus Disease 2019 Infection.
Pediatric neurologyHuman B cells and dendritic cells are susceptible and permissive to enterovirus D68 infection.
mSphereNon-Polio Enteroviruses Isolated by Acute Flaccid Paralysis Surveillance Laboratories in the Russian Federation in 1998-2021: Distinct Epidemiological Features of Types.
VirusesModeling undetected poliovirus circulation following the 2022 outbreak in the United States.
Expert review of vaccinesPredicting the impact of COVID-19 non-pharmaceutical intervention on short- and medium-term dynamics of enterovirus D68 in the US.
EpidemicsA novel mucosal bivalent vaccine of EV-A71/EV-D68 adjuvanted with polysaccharides from Ganoderma lucidum protects mice against EV-A71 and EV-D68 lethal challenge.
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The Pan African medical journalNon-polio enteroviruses circulation in acute flaccid paralysis cases and sewage in Senegal from 2013 to 2021.
International journal of infectious diseases : IJID : official publication of the International Society for Infectious DiseasesNerve Transfer Surgery in Acute Flaccid Myelitis: Prognostic Factors, Long-Term Outcomes, Comparison With Natural History.
Pediatric neurologyThe Effect of Disease on the Developing Nervous System: Challenges and Opportunities, a Foreward.
Pediatric neurologyEvaluation of the Acute flaccid paralysis surveillance indicators in Zambia from 2015-2021: a retrospective analysis.
BMC public healthAn unexpected, pH-sensitive step of the enterovirus D68 lifecycle.
mBioEvaluation of Direct Detection Protocols for Poliovirus from Stool Samples of Acute Flaccid Paralysis Patients.
VirusesTrends of Enterovirus D68 Concentrations in Wastewater, California, USA, February 2021-April 2023.
Emerging infectious diseasesDuration of Enterovirus D68 RNA Shedding in the Upper Respiratory Tract and Transmission among Household Contacts, Colorado, USA.
Emerging infectious diseasesAcute flaccid myelitis: not uncommon in rural Uganda?
Brain communicationsIn vitro and in vivo models for the study of EV-D68 infection.
PathologySIRT-1 is required for release of enveloped enteroviruses.
eLifeThe Picornaviridae Family: Knowledge Gaps, Animal Models, Countermeasures, and Prototype Pathogens.
The Journal of infectious diseasesEnterovirus D68 capsid formation and stability requires acidic compartments.
mBioAustralian Paediatric Surveillance Unit (APSU) Annual Surveillance Report 2022.
Communicable diseases intelligence (2018)Brain Magnetic Resonance Imaging Abnormalities in Acute Flaccid Myelitis.
Pediatric neurologyAcute Flaccid Paralysis due to Pyruvate Dehydrogenase E1-Alpha Deficiency.
Indian journal of pediatricsCoexistence of longitudinally extensive transverse myelitis and diffuse midline glioma in the brainstem in an adolescent boy with acute flaccid paralysis.
Child's nervous system : ChNS : official journal of the International Society for Pediatric NeurosurgeryFirst Detection of Enterovirus D68 in Korean Children, September 2022.
Infection & chemotherapySelective nerve transfers to restore shoulder abduction and flexion in acute flaccid myelitis: A case report.
MicrosurgeryNeurological and neuromuscular manifestations in patients with West Nile neuroinvasive disease, Belgrade area, Serbia, season 2022.
Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical NeurophysiologyCerebrospinal fluid cytokines in COVID-19: a review and meta-analysis.
Journal of neurologyContemporary enterovirus-D68 isolates infect human spinal cord organoids.
mBioSabin polio virus protein 1 (VP1) evolution in patients with acute flaccid paralysis from 2010 to 2016 in Uganda.
Virology journalBotulism mimicking Guillain-Barre syndrome: The question of plasma exchange in an unusual case of acute paralysis.
Journal of clinical apheresisEnterovirus A71-associated acute flaccid paralysis in a pediatric patient: a case report.
Journal of medical case reportsNeutralizing activity of intravenous immune globulin products against enterovirus D68 strains isolated in Japan.
BMC infectious diseasesClinical and molecular epidemiologic features of enterovirus D68 infection in children with acute lower respiratory tract infection in China.
Archives of virologyCOVID-19 and the Pandemic-Related Aspects in Pediatric Demyelinating Disorders.
Seminars in pediatric neurologySimultaneous detection of enterovirus-D68 and vaccine-related poliovirus 3 in the stool samples of a 5-month hospitalized child with acute respiratory disease: A case report.
Biosafety and healthAntibody response to SARS-CoV-2 vaccination or infection in a prospective cohort of children with neuroinflammatory diseases.
European journal of paediatric neurology : EJPN : official journal of the European Paediatric Neurology SocietyAcute flaccid paralysis due to multifactorial hyperkalaemia.
BMJ case reportsEmerging trends and insights in acute flaccid myelitis: a comprehensive review of neurologic manifestations.
Infectious diseases (London, England)Efficacy of an isoxazole-3-carboxamide analog of pleconaril in mouse models of Enterovirus-D68 and Coxsackie B5.
Antiviral researchChanges in transmission of Enterovirus D68 (EV-D68) in England inferred from seroprevalence data.
eLifeCase report: training neck and head control in children with chronic paralysis due to acute flaccid myelitis.
Frontiers in rehabilitation sciencesRehabilitation Outcomes in Children With Acute Flaccid Myelitis From 2014 to 2019: A Multicenter Retrospective Review.
Pediatric neurologySleep Characteristics in Pediatric Anti-N-methyl-d-aspartate (NMDA) Receptor Encephalitis: A Retrospective Cohort Study.
Journal of child neurologyAcute Flaccid Myelitis in a Pediatric Patient With Coronavirus Disease 2019.
Pediatric neurologyEV-D68 virus-like particle vaccines elicit cross-clade neutralizing antibodies that inhibit infection and block dissemination.
Science advancesSix- and 12-month functional outcomes among patients with confirmed acute flaccid myelitis (AFM) with onset in 2018, United States.
Journal of pediatric rehabilitation medicineAcute flaccid myelitis: Consensus diagnostic criteria is helpful but careful evaluation of disease course is as important.
European journal of paediatric neurology : EJPN : official journal of the European Paediatric Neurology SocietyComparison of acute flaccid myelitis and transverse myelitis in children and evaluation of diagnostic criteria.
European journal of neurologyTelaprevir Treatment Reduces Paralysis in a Mouse Model of Enterovirus D68 Acute Flaccid Myelitis.
Journal of virologyPoliovirus surveillance in patients with primary immunodeficiencies, India.
Bulletin of the World Health OrganizationThe Association of Acute Motor Axonal Neuropathy (Guillain-Barre' Syndrome Variant) with Coronavirus (SARS-Cov-2) in a Child: A Case Report.
Iranian journal of child neurologyEnvironmental surveillance detects circulating vaccine-derived poliovirus type 2 that was undetected by acute flaccid paralysis surveillance in 2021 in Uganda.
Archives of virologyMolecular characterization & recombination analysis of complete enterovirus-88 isolated from acute flaccid paralysis cases in India.
The Indian journal of medical researchEnterovirus D68 Infection Induces TDP-43 Cleavage, Aggregation, and Neurotoxicity.
Journal of virologyCurrent perspectives on the diagnosis and management of acute transverse myelitis.
Expert review of neurotherapeuticsBilateral Dega and Varus Derotational Osteotomies for Painful Hip Subluxation in Acute Flaccid Myelitis: A Case Report.
Journal of orthopaedic case reportsPediatric acute flaccid myelitis: Evaluation of diagnostic criteria and differentiation from other causes of acute flaccid paralysis.
European journal of paediatric neurology : EJPN : official journal of the European Paediatric Neurology SocietyDiagnostic Accuracy of Manual Muscle Testing to Identify Nerve Transfer Candidates in Children with Acute Flaccid Myelitis.
Plastic and reconstructive surgeryClinical progress note: Enterovirus D68 and acute flaccid myelitis.
Journal of hospital medicineEnterovirus D-68 Infection of Primary Rat Cortical Neurons: Entry, Replication, and Functional Consequences.
mBioRNA Structure in the 5' Untranslated Region of Enterovirus D68 Strains with Differing Neurovirulence Phenotypes.
VirusesPterostilbene, an active constituent of blueberries, enhances innate immune activation and restricts enterovirus D68 infection.
Frontiers in immunologyGlobal trends in poliomyelitis research over the past 20 years: A bibliometric analysis.
Human vaccines & immunotherapeuticsDevelopment of Enterovirus Antiviral Agents That Target the Viral 2C Protein.
ChemMedChemAcute flaccid myelitis in Switzerland - association with enterovirus D68.
Swiss medical weeklyThe complete acute and post-acute care course of children affected by acute flaccid myelitis in Western Pennsylvania: A case series.
Journal of pediatric rehabilitation medicineAssessment of cognitive status in pediatric anti-NMDA receptor encephalitis during inpatient rehabilitation: A retrospective cohort.
Journal of neuroimmunologyReview of Machine Learning and Artificial Intelligence (ML/AI) for the Pediatric Neurologist.
Pediatric neurologyEvaluation of acute flaccid paralysis surveillance system in the River Nile State - Northern Sudan, 2021.
BMC public healthAcute flaccid myelitis a review of the literature.
Frontiers in neurologyAcute Flaccid Paralysis in Australian Children from 2007 to 2017.
NeuroepidemiologyPoliomyelitis Is an Enterovirus Acute Flaccid Myelitis and Enterovirus D68.
Pediatric annalsAcute flaccid paralysis incidence rate and epidemiology in children in Lebanon: a rise in numbers in the post-vaccination and refugee crisis era.
African health sciencesWastewater Testing and Detection of Poliovirus Type 2 Genetically Linked to Virus Isolated from a Paralytic Polio Case - New York, March 9-October 11, 2022.
MMWR. Morbidity and mortality weekly reportEnteroviruses: The role of receptors in viral pathogenesis.
Advances in virus researchEpidemiology of acute flaccid myelitis in children in the Netherlands, 2014 to 2019.
Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletinAcute Flaccid Myelitis: Review of Clinical Features, Diagnosis, and Management with Nerve Transfers.
Plastic and reconstructive surgeryIncrease in Acute Respiratory Illnesses Among Children and Adolescents Associated with Rhinoviruses and Enteroviruses, Including Enterovirus D68 - United States, July-September 2022.
MMWR. Morbidity and mortality weekly report[Acute Flaccid Paralysis].
Brain and nerve = Shinkei kenkyu no shinpoVaccine-associated paralytic poliomyelitis in a child: fast transformation from Sabin-like virus to vaccine-derived poliovirus triggered an epidemiological response in two countries of the European region.
International journal of infectious diseases : IJID : official publication of the International Society for Infectious DiseasesContribution of Auto-Visual AFP Detection and Reporting (AVADAR) on polio surveillance in South Sudan.
The Pan African medical journalAcute flaccid paralysis surveillance performance from 2011 to 2020 in Jonglei State, South Sudan: progress and challenges encountered.
The Pan African medical journalThe sensitivity of acute flaccid paralysis surveillance - the case of South Sudan: retrospective secondary analysis of AFP surveillance data 2014-2019.
The Pan African medical journalEnhancing acute flaccid paralysis surveillance system towards polio eradication: reverse cold chain monitoring in Nigeria, 2017 to 2019.
The Pan African medical journalEnhancing acute flaccid paralysis surveillance through the use of pictorial surveillance reminder cards during supplementary immunization activities, December 2014: a survey in Jigawa State, Nigeria.
The Pan African medical journalRevelation of an important weakness in polio elimination efforts in Nigeria: a descriptive cross-sectional study of nomadic dynamics in Sokoto and Taraba States, May 2013.
The Pan African medical journalEnterovirus D68 Infection in Human Primary Airway and Brain Organoids: No Additional Role for Heparan Sulfate Binding for Neurotropism.
Microbiology spectrumAcute Flaccid Paralysis in a 12-Month-Old.
Clinical pediatricsRe-Emergence of Poliovirus in the United States: Considerations and Implications.
Annals of neurologyChallenges in the Clinical Recognition of Acute Flaccid Myelitis and its Implications.
The Journal of pediatricsTrends of key surveillance performance indicators of acute flaccid paralysis: a descriptive analysis, Uganda, 2015-2020.
BMC public healthEpidemiology of type 2 vaccine-derived poliovirus outbreaks between 2016 and 2020.
VaccineSerial Neurologic Examination in a Child With Acute Flaccid Weakness.
Clinical pediatricsAssociações
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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.
- Respiratory enterovirus D68: virology, clinical surveillance, host-pathogen interactions, and therapeutic prospects.
- Enterovirus D68 in United States wastewater: a longitudinal surveillance study integrating climatic, demographic, and clinical data.
- Rational design and in vivo validation of capsid inhibitors for enterovirus D68.
- Diaphragm Interventions in Acute Flaccid Myelitis: A Single-Center Retrospective Case Series of Diaphragm Pacing Systems and Phrenic Nerve Transfers.
- Enterovirus D68 VP1 and VP3 determine neurotropism in human spinal cord organoids.
- An RNA-to-RNA Pipeline for Rapid Antiviral Antibody Development.
Bases de dados e fontes oficiais
Identificadores e referências canônicas usadas para montar este verbete.
- ORPHA:623801(Orphanet)
- MONDO:0100115(MONDO)
- GARD:13142(GARD (NIH))
- Busca completa no PubMed(PubMed)
- Artigo Wikipedia(Wikipedia)
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
