Health problems in children with Down's syndrome

Turner, Stephen; Sloper, Patricia; Cunningham, Cliff; Knussen, Christina

doi:10.1111/j.1365-2214.1990.tb00641.x

Cited by 50 publications

(27 citation statements)

References 7 publications

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“…Unfortunately these problems are aggravated by systemic weakness such as immunological deficiency. In one study, 24% of subjects with DS had suffered an ear or throat infection in the previous year 68 . There is a particularly high frequency of upper-respiratory-tract infection, ear infection, pneumonia, bronchitis 14,49 , and leukaemia 69 .…”

Section: Aetiologymentioning

confidence: 99%

Significance of oral health in persons with Down syndrome: a literature review

Hennequin

Faulks

Veyrune

et al. 1999

Develop Med Child Neuro

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Section: Aetiologymentioning

confidence: 99%

Significance of oral health in persons with Down syndrome: a literature review

Hennequin

Faulks

Veyrune

et al. 1999

Develop Med Child Neuro

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“…67,68 Coping with the symptoms of dementia is particularly burdensome for carers, 69 especially when parents who are themselves quite elderly attempt to fulfil this role. The financial impact of de-institutionalization on carers and the effect of transferring individuals into residential care during middle or old age have yet to be fully examined.…”

Section: Comorbid Disorders and Ageingmentioning

confidence: 99%

Clinical, social, and ethical implications of changing life expectancy in Down syndrome

Bittles

Glasson

2004

Develop Med Child Neuro

320

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Between 1 and 4% of the populations of developed nations are diagnosed with learning disability*. 1,2 In Australia, an estimated 1.9% of the population exhibit learning disability either as a primary disability or as a secondary condition, and approximately half of these people require continuing support in daily living, including mobility, self-care, and socialization. 3 After improvements in basic public health measures, life expectancy in most developed nations increased over the course of the 20th century, and this trend included people with learning disability. Thus, by the end of that century, the survival estimates for people with mild learning disability living in developed countries was 70 years, and nearly 60 years of age for those with severe learning disability. 4,5 The estimates of increased life expectancy mirror improved access to medical treatment for those with learning disability, and a shift in public attitude during the past 20 to 30 years that has resulted in better care within the community. The increased availability of more appropriate medication, surgical intervention, and overall health care management strategies have led to a positive effect on general health and have decreased mortality. More recently, national and international agencies have strongly argued for further improvements in health care opportunities for individuals with disabilities, and for the narrowing of health differentials between people with learning disability and the general population. 6-9 However, this is a complex issue with challenging social, economic, and ethical ramifications, because many people with learning disability are affected by major adverse health issues throughout their lives. As a result, increased survival is not only associated with a longer period of care, but is also related to a longer period of more specialized needs. Here we discuss these issues with specific reference to the circumstances of people with Down syndrome, although it should be emphasized that to a large degree they equally apply to a wide range of inherited disorders resulting in learning disability. EpidemiologyDown syndrome is the most commonly inherited form of learning disability, with an incidence rate of 1 out of every 650 to 1000 live births, 10-12 and in developed countries it accounts for 12 to 15% of the population of those with learning disability. 4,13,14 The actual number of Down syndrome conceptions is unknown, but occurrence of the disorder increases significantly with advancing maternal age, 15 and there is some evidence that advanced paternal age might also be involved. 16 There is a high rate of spontaneous prenatal loss and, for example, in one study 43% of Down syndrome pregnancies detected by chorionic villus sampling at 10 weeks gestation failed to reach term. 17 The trisomy 21 karyotype is present in 93 to 95% of people with Down syndrome; a further 3 to 4% exhibit translocation anomalies, and 1 to 3% are mosaic. 18-20 Down syndrome is usually associated with moderate to severe levels of learning disab...

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“…In addition, various immunological impairments are associated with DS. Children with DS have a high incidence of hematologic malignancies and autoimmune diseases like hypothyroidism, celiac disease, and diabetes mellitus (3)(4)(5)(6)(7).…”

mentioning

confidence: 99%

Decreased Thymic Output Accounts for Decreased Naive T Cell Numbers in Children with Down Syndrome

Bloemers

Bont

Weger

et al. 2011

The Journal of Immunology

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Children with Down syndrome (DS) have low numbers of naive T cells and abnormal thymus development and function. Because next to thymic production, peripheral proliferation greatly contributes to naive T cell generation in healthy children, we examined the cause of reduced naive T cell numbers in children with DS. Compared with aged matched controls, the total number of signal joint TCR excision circles (sjTREC) per ml blood was reduced in DS. Reduced frequencies and absolute numbers of protein tyrosine kinase 7-positive recent thymic emigrants, but similar levels of naive T cell apoptosis and Ag-driven activation in DS, suggested that reduced thymic output and not increased peripheral loss of naive T cells caused the reduced sjTREC numbers. We found no support for defective peripheral generation of naive T cells in DS. In DS the naive T cells responded to IL-7 and, based on Ki-67 expression, had similar proliferation rates as in healthy controls. sjTREC content per naive CD8+ T cells was not increased, but even decreased, pointing to increased survival or peripheral generation of naive T cells in DS. In conclusion, we show in this study that reduced thymic output, but not reduced peripheral generation nor increased loss of naive T cells, results in the low naive T cell numbers found in DS.

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Health problems in children with Down's syndrome

Cited by 50 publications

References 7 publications

Significance of oral health in persons with Down syndrome: a literature review

Significance of oral health in persons with Down syndrome: a literature review

Clinical, social, and ethical implications of changing life expectancy in Down syndrome

Decreased Thymic Output Accounts for Decreased Naive T Cell Numbers in Children with Down Syndrome

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