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Fanconi Syndrome: Causes & Treatment

Fanconi Syndrome: Causes & Treatment Fanconi Syndrome is a metabolic disorder that affects the kidneys, specifically the proximal tubules. It disrupts the normal processing and reabsorption of essential substances, such as electrolytes, glucose, and amino acids. As a result, these substances are lost in the urine, leading to imbalances and deficiencies.

The causes of Fanconi Syndrome can vary, and it can be either hereditary or acquired. Some cases are caused by genetic mutations, while others can be triggered by kidney disease or exposure to certain medications or toxins.

Renal tubular dysfunction, which is central to Fanconi Syndrome, can result in electrolyte imbalances that affect multiple organ systems. One notable sign of Fanconi Syndrome is the presence of glucose in the urine, known as glucosuria.

Recognizing the symptoms and obtaining an accurate diagnosis are crucial for effective management. Common symptoms include excessive thirst, frequent urination, bone abnormalities, and growth retardation in children. Diagnosis often involves urine and blood tests to assess the levels of various substances.

When it comes to Fanconi Syndrome treatment, a multi-faceted approach is typically employed. Treatment options may include medication to replace the lost substances, such as electrolytes or vitamin D. Additionally, managing the underlying cause, such as treating kidney disease, is essential.

The Acibadem Healthcare Group is renowned for its expertise in treating Fanconi Syndrome and providing comprehensive care to patients. Their specialists offer personalized treatment plans and support, tailored to the unique needs of each individual.

Managing Fanconi Syndrome requires ongoing care and attention. As part of the treatment plan, strategies to address bone health issues and maintain a balanced diet may be recommended. It’s important to work closely with healthcare providers to optimize overall well-being.

Advancements in research are continuously improving our understanding of Fanconi Syndrome and leading to new treatment options. Current studies focus on identifying genetic markers, developing targeted therapies, and enhancing overall outcomes for individuals affected by this condition.

Living with Fanconi Syndrome can present challenges, but with the right support and resources, individuals can lead fulfilling lives. Practicing self-care, staying informed, and connecting with others through support groups can make a significant difference in managing the day-to-day realities of this condition.

By promoting awareness about Fanconi Syndrome, we can help facilitate earlier detection, accurate diagnosis, and access to timely treatment. Increased awareness can also drive research efforts and ultimately improve the lives of those affected by this condition.

In conclusion, Fanconi Syndrome is a complex condition involving renal tubular dysfunction. Through informed medical care, lifestyle management, and ongoing support, individuals with Fanconi Syndrome can lead healthy and fulfilling lives.

What is Fanconi Syndrome?

Fanconi Syndrome is a condition characterized by proximal tubular dysfunction in the kidneys. It is considered a metabolic disorder that can have significant impacts on overall health. The proximal tubules of the kidney play a crucial role in reabsorbing essential substances such as glucose, amino acids, and electrolytes back into the bloodstream. In individuals with Fanconi Syndrome, these tubules are unable to properly perform their reabsorption functions, leading to excessive loss of vital nutrients and electrolytes in the urine.

This metabolic disorder can be both hereditary or acquired, resulting from various genetic mutations or kidney diseases. The malfunctioning of the proximal tubules in Fanconi Syndrome disrupts the normal balance of electrolytes, including potassium, phosphate, calcium, and sodium in the body. It can also lead to the presence of glucose, amino acids, and other substances in the urine, which are typically reabsorbed under normal conditions.

Fanconi Syndrome affects individuals of all ages, from infants to adults. The symptoms can vary but may include excessive thirst and urination, stunted growth, weak bones, muscle weakness, fatigue, and electrolyte imbalances. If left untreated, Fanconi Syndrome can contribute to the development of serious complications such as kidney failure and osteoporosis.

Understanding the underlying mechanisms of Fanconi Syndrome is crucial for accurate diagnosis and effective management of the condition. Further research and advancements in treatment options are continuously being explored to improve the outcomes for individuals with this metabolic disorder.

The Causes of Fanconi Syndrome

Fanconi Syndrome is a complex condition that can arise from various causes, including both hereditary factors and acquired conditions such as kidney disease. Understanding the underlying causes is crucial in effectively managing this disorder and providing appropriate treatment.

Hereditary Disorders:

Some cases of Fanconi Syndrome are the result of hereditary disorders. Genetic mutations or abnormalities can disrupt the normal functioning of the kidneys, leading to renal tubular dysfunction characteristic of Fanconi Syndrome. These inherited conditions can be passed on from parents to their children, often presenting symptoms in early childhood.

Kidney Disease:

Kidney disease can also be a contributing factor in the development of Fanconi Syndrome. Damage to the kidneys, whether through infections, drug toxicity, or other medical conditions, can impair the proper functioning of the renal tubules. This disruption can lead to the leakage of important substances like glucose, amino acids, electrolytes, and other nutrients into the urine, resulting in Fanconi Syndrome.

It is important to note that while kidney disease can contribute to the development of Fanconi Syndrome, not all individuals with kidney disease will develop this disorder. The exact mechanisms and factors that trigger Fanconi Syndrome in those with kidney disease are still being extensively studied by researchers.

Causes of Fanconi Syndrome

Cause Explanation
Hereditary Disorders Genetic mutations or abnormalities that disrupt renal tubular function.
Kidney Disease Damage to the kidneys, impairing the proper functioning of renal tubules.

Understanding Renal Tubular Dysfunction

In Fanconi Syndrome, renal tubular dysfunction plays a crucial role in the manifestation of this condition. The renal tubules are responsible for reabsorbing important substances such as electrolytes and glucose back into the bloodstream while excreting waste products in the urine. However, in individuals with Fanconi Syndrome, this reabsorption process is impaired, leading to electrolyte imbalances and the presence of glucose in urine.

Electrolyte imbalances occur when the tubules fail to properly reabsorb essential electrolytes like sodium, potassium, and phosphate. This disruption can have wide-ranging effects on the body, impacting various bodily functions such as muscle contractions, nerve function, and maintaining fluid balance.

One of the key indicators of renal tubular dysfunction in Fanconi Syndrome is the presence of glucose in the urine. Normally, the renal tubules reabsorb glucose and prevent its excretion in the urine. However, when the tubules are unable to perform this function correctly, glucose bypasses reabsorption and ends up in the urine, resulting in a condition known as glucosuria.

Understanding the intricacies of renal tubular dysfunction is crucial in comprehending the underlying mechanisms of Fanconi Syndrome. By recognizing the impact of this dysfunction on electrolyte balances and the presence of glucose in urine, healthcare professionals can better diagnose and manage this condition, improving the overall quality of care for individuals affected by Fanconi Syndrome.

Symptoms and Diagnosis of Fanconi Syndrome

Fanconi Syndrome is characterized by various symptoms that can indicate renal tubular dysfunction and electrolyte imbalances. Recognizing these symptoms is crucial for early diagnosis and effective management of the condition. Some common symptoms associated with Fanconi Syndrome include:

  • Excessive thirst and frequent urination
  • Generalized weakness and fatigue
  • Failure to thrive in children
  • Growth retardation
  • Low bone density and increased risk of fractures
  • Metabolic acidosis

To confirm a diagnosis of Fanconi Syndrome, healthcare professionals rely on various diagnostic methods. These may include:

  1. Urinalysis: Analysis of urine samples to detect the presence of glucose, amino acids, and other substance abnormalities.
  2. Blood tests: Measuring levels of electrolytes, such as potassium and phosphorus, as well as markers of kidney function.
  3. Genetic testing: Identifying specific gene mutations that contribute to inherited forms of Fanconi Syndrome.
  4. Renal biopsy: Although less common, a renal biopsy may be performed to assess the extent of renal tubular damage and guide treatment decisions.

Early detection and diagnosis are critical for managing Fanconi Syndrome effectively. If you or someone you know is experiencing symptoms associated with the condition, it is important to consult with a healthcare professional for proper evaluation and diagnosis.

Treatment Options for Fanconi Syndrome

Acibadem Healthcare Group offers a comprehensive range of treatment options for individuals with Fanconi Syndrome. Our team of experienced medical professionals is dedicated to providing personalized care and managing the unique challenges associated with this condition.

Medical Interventions

Medical interventions play a crucial role in managing Fanconi Syndrome. Treatment options may include:

  1. Fluid and electrolyte management: Maintaining proper hydration and restoring electrolyte balance are essential for individuals with Fanconi Syndrome. Our healthcare professionals will create a personalized plan to address specific electrolyte imbalances.
  2. Pharmacological therapy: Medications may be prescribed to manage symptoms and optimize kidney function in individuals with Fanconi Syndrome. Our specialists will tailor the treatment plan to individual needs, ensuring the safest and most effective results.
  3. Vitamin and mineral supplementation: Fanconi Syndrome can lead to deficiencies in essential vitamins and minerals. Our healthcare team will develop a supplementation plan to address these deficiencies and support overall health.

Lifestyle Interventions

In addition to medical interventions, certain lifestyle changes can enhance the management of Fanconi Syndrome. These may include:

  • Dietary modifications: Following a balanced diet is crucial for individuals with Fanconi Syndrome. Our nutritionists will provide guidance on appropriate food choices to mitigate the impact of the condition on kidney function.
  • Physical activity: Regular exercise and physical activity can support overall health and wellbeing. Our healthcare professionals will provide personalized recommendations for appropriate physical activity levels based on individual needs and abilities.
  • Regular monitoring: Ongoing monitoring of kidney function and electrolyte levels is essential for individuals with Fanconi Syndrome. Our healthcare team will ensure regular check-ups and provide necessary guidance and support.

Expertise at Acibadem Healthcare Group

At Acibadem Healthcare Group, we understand the complexities of Fanconi Syndrome and offer comprehensive treatment options to improve the quality of life for those affected by this condition. Our multidisciplinary team, consisting of nephrologists, endocrinologists, nutritionists, and other specialists, collaborates to provide individualized care and support throughout your treatment journey.

To learn more about our treatment options for Fanconi Syndrome or to schedule a consultation, contact Acibadem Healthcare Group today.

Management of Fanconi Syndrome

In order to effectively manage Fanconi Syndrome and optimize overall well-being, it is crucial to address bone health issues and other related complications. By implementing targeted strategies and treatment options, individuals with Fanconi Syndrome can experience improved outcomes and a better quality of life.

Strategies for Bone Health

Ensuring healthy bone development and preventing bone-related problems is a key aspect of managing Fanconi Syndrome. Here are some strategies that can help:

  • Regular bone density screenings to monitor bone health and detect any abnormalities
  • Adopting a balanced diet rich in calcium, vitamin D, and other essential nutrients to support bone strength
  • Engaging in weight-bearing exercises, such as walking or resistance training, to promote bone density
  • Taking prescribed supplements, like calcium or phosphate, as recommended by healthcare professionals

By incorporating these strategies into daily life, individuals with Fanconi Syndrome can minimize the risk of bone fractures and maintain healthy bone density.

Addressing Other Complications

Aside from bone health issues, Fanconi Syndrome may also lead to other complications that require managing:

  • Electrolyte Imbalances: Close monitoring and proper supplementation of essential electrolytes, such as potassium and phosphate, can help maintain electrolyte balance.
  • Growth and Development: Working closely with pediatric specialists to ensure proper growth and development in children with Fanconi Syndrome.
  • Anemia: Regular blood tests and possible iron supplementation may be necessary to manage anemia.
  • Renal Function: Regular follow-ups with nephrologists to monitor kidney function and detect any changes or complications.

By addressing all these complications and working closely with healthcare professionals, individuals with Fanconi Syndrome can achieve better overall management and long-term health outcomes.


Management Strategies Benefits
Regular bone density screenings Monitor and detect bone health abnormalities
Healthy diet with essential nutrients Support bone strength and density
Weight-bearing exercises Promote bone density and overall musculoskeletal health
Supplementation as recommended Meet nutritional requirements and support bone health

By implementing these management strategies and addressing related complications, individuals with Fanconi Syndrome can enhance their overall well-being and lead fulfilling lives.

Research and Advancements in Fanconi Syndrome

In recent years, the field of research in Fanconi Syndrome has made significant progress, leading to a deeper understanding of this condition and the development of innovative treatment options. Scientists and medical professionals are dedicated to unraveling the complexities of Fanconi Syndrome to improve the lives of those affected by this rare renal tubular dysfunction.

One area of ongoing research focuses on identifying the underlying causes of Fanconi Syndrome, including hereditary factors and kidney disease. By understanding these causes at a cellular and molecular level, researchers hope to develop targeted therapies that address the specific mechanisms contributing to this condition.

Advancements in treatment options are also being explored to enhance the management of Fanconi Syndrome. Clinical trials and studies are underway to evaluate the effectiveness of therapeutic interventions such as medications, dietary modifications, and lifestyle interventions. These research efforts aim to alleviate symptoms, prevent complications, and improve patients’ overall quality of life.

Advances in Genetic Research

Genetic research plays a crucial role in understanding the hereditary aspects of Fanconi Syndrome. Scientists are identifying the specific genes and mutations associated with this condition, providing valuable insights into its pathophysiology. This breakthrough has paved the way for targeted genetic therapies, such as gene editing and gene replacement, which hold promise for future treatment options.

Emerging Therapies

Researchers are exploring innovative approaches to treat Fanconi Syndrome, including the use of stem cells and regenerative medicine. These emerging therapies aim to repair and regenerate damaged renal tubules, offering potential long-term solutions for individuals with this condition. While still in the early stages of development, these therapies show great promise and may revolutionize the field of Fanconi Syndrome treatment.

Moreover, advancements in technology and diagnostic techniques have improved the accuracy and efficiency of diagnosing Fanconi Syndrome. These advancements enable healthcare professionals to identify the condition at an early stage, allowing for timely intervention and better management.

As research progresses, it is essential to stay informed about the latest breakthroughs and treatment options. By collaborating with leading experts and institutions, such as the Acibadem Healthcare Group, patients with Fanconi Syndrome can access cutting-edge research and benefit from the most advanced treatment strategies available.

Living with Fanconi Syndrome

While Fanconi Syndrome can present significant challenges, individuals with this condition can manage their symptoms and lead fulfilling lives. By adopting certain strategies and making necessary lifestyle adjustments, individuals with Fanconi Syndrome can enhance their overall well-being and improve their quality of life.

Self-Care Tips for Fanconi Syndrome

Effective management of Fanconi Syndrome starts with self-care. Taking proactive steps to support kidney health and manage symptoms can greatly contribute to a better quality of life. Here are some self-care tips for individuals with Fanconi Syndrome:

  • Stay hydrated: Drinking plenty of water throughout the day helps prevent dehydration and supports healthy kidney function.
  • Eat a balanced diet: Following a well-balanced diet, with the guidance of a healthcare professional, can help maintain proper nutrient levels and minimize electrolyte imbalances.
  • Monitor glucose levels: Regularly checking blood sugar levels and monitoring glucose in urine can help detect any abnormalities and guide appropriate management.
  • Exercise regularly: Engaging in regular physical activity, with the approval of a healthcare professional, can help maintain overall health and support bone health.
  • Work closely with healthcare providers: Regular check-ups with healthcare providers who specialize in kidney disease are essential for ongoing care and to address any emerging issues.

Maintaining a Healthy Lifestyle

Living with Fanconi Syndrome involves maintaining a healthy lifestyle to minimize symptoms and complications. Here are some lifestyle considerations for individuals with this condition:

  • Avoid nephrotoxic substances: Limiting exposure to substances that can harm the kidneys, such as certain medications or toxins, is crucial for kidney health.
  • Get enough rest: Sufficient rest and sleep are essential for overall well-being and can help manage fatigue and other symptoms associated with Fanconi Syndrome.
  • Manage stress: Practicing stress management techniques, such as meditation or deep breathing exercises, can help reduce stress levels and promote overall mental and physical health.
  • Join a support group: Connecting with others who have Fanconi Syndrome can provide emotional support, share experiences, and offer practical tips for living with the condition. Online communities and support groups can be valuable resources.

By implementing these self-care tips and making adjustments to their lifestyle, individuals with Fanconi Syndrome can improve their overall well-being and effectively manage their symptoms.

Expert Insights from Dr. Jane Doe

Dr. Jane Doe, a renowned nephrologist at the XYZ Medical Center, emphasizes the importance of a multidisciplinary approach in the management of Fanconi Syndrome. She explains, “It is crucial for individuals with Fanconi Syndrome to work closely with a healthcare team that includes nephrologists, dieticians, and other specialists, to develop a comprehensive treatment plan that addresses their unique needs.”

Dr. Doe adds, “Regular follow-up appointments with healthcare providers, adherence to treatment recommendations, and ongoing monitoring of kidney function are key components of successful management. Additionally, staying proactive through self-care measures, such as maintaining a balanced diet, staying hydrated, and managing stress, can contribute to better long-term outcomes.”

Tips for Living with Fanconi Syndrome Expert Advice from Dr. Doe
Stay hydrated Drinking plenty of water is essential for kidney health and overall well-being.
Eat a balanced diet A well-balanced diet, tailored to the individual’s needs, helps maintain proper nutrient levels and minimize complications.
Monitor glucose levels Regular monitoring of glucose levels can help detect any abnormality and guide appropriate management.
Exercise regularly Engaging in regular physical activity, with professional guidance, supports overall health and bone health.
Work closely with healthcare providers Regular check-ups with specialists in kidney disease are crucial for ongoing care and addressing emerging issues.
Avoid nephrotoxic substances Limiting exposure to harmful substances protects kidney health.
Get enough rest Proper rest and sleep are essential for managing symptoms and overall well-being.
Manage stress Stress management techniques promote mental and physical health.
Join a support group Connecting with others who have Fanconi Syndrome provides emotional support and practical tips.

By implementing these strategies and seeking guidance from healthcare professionals, individuals with Fanconi Syndrome can live fulfilling lives and effectively manage their condition.

Support and Resources for Fanconi Syndrome

Individuals diagnosed with Fanconi Syndrome and their families can find valuable support and resources to navigate this condition.

Organizations

There are several organizations dedicated to providing support and information for individuals with Fanconi Syndrome. These organizations offer a range of resources, including educational materials, online forums, and support networks. Some notable organizations include:

  • Fanconi Hope: A non-profit organization focused on supporting individuals and families affected by Fanconi Syndrome. They provide invaluable resources, community support, and funding for research.

These organizations play a crucial role in raising awareness, funding research, and providing support to those living with Fanconi Syndrome.

Online Communities

Connecting with others who are facing similar challenges can provide a sense of belonging and understanding. Online communities dedicated to Fanconi Syndrome offer a platform for individuals to share experiences, seek advice, and provide support. These communities can be found on social media platforms such as Facebook and Reddit.

Medical Professionals

Medical professionals, including nephrologists and genetic counselors, are essential resources for individuals and families dealing with Fanconi Syndrome. These healthcare providers have expertise in managing kidney diseases and can offer guidance on treatment options, lifestyle changes, and ongoing care.

Therapy and Counseling

Living with a chronic condition like Fanconi Syndrome can be emotionally challenging. Therapists and counselors can provide support and guidance in managing the emotional aspects of the condition. They can help individuals develop coping strategies, address feelings of stress and anxiety, and navigate the impact of the condition on daily life.

It’s important for individuals with Fanconi Syndrome and their families to explore the available resources and seek support. By connecting with others and accessing the appropriate resources, individuals with Fanconi Syndrome can better manage their condition and improve their overall well-being.

Promoting Awareness of Fanconi Syndrome

Fanconi Syndrome is a rare kidney disease that can have a significant impact on a person’s health and well-being. While it may not be as well-known as other kidney diseases, raising awareness about Fanconi Syndrome is crucial for early detection and accurate diagnosis.

Early detection of Fanconi Syndrome is vital because it allows for timely treatment interventions that can help manage the condition and improve outcomes for those affected. By promoting awareness, we can ensure that healthcare professionals and individuals are familiar with the symptoms and risk factors associated with Fanconi Syndrome.

Increased awareness about Fanconi Syndrome also plays a crucial role in supporting ongoing research and advancements in treatment options. When individuals are aware of the condition, they can actively participate in clinical trials, share their experiences, and contribute to the development of new therapies.

Furthermore, promoting awareness leads to greater support and understanding within the community. Individuals living with Fanconi Syndrome and their families benefit from connecting with others who share similar experiences. Online communities and support groups provide a valuable platform for sharing information, seeking advice, and finding emotional support.

To enhance awareness of Fanconi Syndrome, organizations and healthcare professionals should collaborate to create educational materials and resources. These resources can educate the public, medical professionals, and individuals with kidney disease about the signs, symptoms, and available treatment options for Fanconi Syndrome.

How can you help raise awareness?

You can make a difference in promoting awareness of Fanconi Syndrome by:

  • Sharing information about Fanconi Syndrome with your friends, family, and community
  • Participating in local health fairs or community events to educate others
  • Supporting organizations conducting research on Fanconi Syndrome
  • Engaging with online communities and support groups to offer support and share your experiences
  • Raising funds for research and patient support initiatives

Remember, every effort counts in raising awareness and improving the lives of individuals affected by Fanconi Syndrome. Together, we can make a difference and ensure that those living with this condition receive the support and care they need.

Signs and Symptoms of Fanconi Syndrome Risk Factors for Fanconi Syndrome
  • Excessive thirst
  • Frequent urination
  • Loss of appetite
  • Weakness and fatigue
  • Growth delays in children
  • Genetic mutations
  • Acquired kidney damage
  • Chemotherapy treatment
  • Heavy metal exposure
  • Certain medications

Conclusion

Throughout this article, we have explored the complexities of Fanconi Syndrome, a rare kidney disease characterized by renal tubular dysfunction. We have discussed its causes, symptoms, and the importance of early diagnosis. Furthermore, we have highlighted the available treatment options and the significance of ongoing management.

Individuals with Fanconi Syndrome may experience a range of symptoms, including electrolyte imbalances and bone health issues. However, with proper medical care and lifestyle interventions, it is possible to mitigate these challenges and optimize overall well-being.

For those affected by Fanconi Syndrome, it is essential to stay informed and seek support. The Acibadem Healthcare Group offers expertise in the diagnosis and treatment of this condition, along with various resources and treatment options.

By raising awareness and promoting early detection, we can improve outcomes for individuals living with Fanconi Syndrome. Together, we can work towards enhanced understanding, research advancements, and improved treatment options for this rare kidney disease.

 

FAQ

What is Fanconi Syndrome?

Fanconi Syndrome is a metabolic disorder characterized by proximal tubular dysfunction, resulting in the improper reabsorption of essential substances in the kidneys. The dysfunction leads to electrolyte imbalances, glucose in the urine, and other complications.

What causes Fanconi Syndrome?

Fanconi Syndrome can have hereditary causes or be acquired due to kidney disease or certain medications. It can also be caused by other underlying conditions like cystinosis, tyrosinemia, or Wilson disease.

How does Fanconi Syndrome affect the body?

Fanconi Syndrome affects the body by disrupting the normal functioning of the kidneys, particularly the proximal tubules responsible for reabsorbing essential substances. This disruption can lead to electrolyte imbalances, bone health issues, and impaired growth in children.

What are the symptoms of Fanconi Syndrome?

Common symptoms of Fanconi Syndrome include excessive thirst and urination, stunted growth in children, bone pain, muscle weakness, and electrolyte imbalances. These imbalances can result in weakness, fatigue, and abnormal heart rhythms.

How is Fanconi Syndrome diagnosed?

Diagnosis of Fanconi Syndrome involves a comprehensive evaluation of symptoms, medical history, and laboratory tests. Tests may include a urine analysis to detect glucose and other substances, blood tests to assess electrolyte levels, and genetic testing to identify underlying genetic mutations.

What are the treatment options for Fanconi Syndrome?

Treatment of Fanconi Syndrome aims to manage symptoms, prevent complications, and correct underlying electrolyte imbalances. This may involve a combination of medications, dietary modifications, and regular monitoring of kidney function. In severe cases, kidney transplantation may be necessary.

How can Fanconi Syndrome be managed?

The management of Fanconi Syndrome requires a multidisciplinary approach involving nephrologists, endocrinologists, and dietitians. It includes regular check-ups, monitoring of kidney function and electrolyte levels, maintaining a balanced diet, and taking prescribed medications as directed.

Are there any advancements in the treatment of Fanconi Syndrome?

Research into Fanconi Syndrome is ongoing, aiming to better understand its causes and develop more effective treatments. Advancements in genetic testing and targeted therapies show promise in improving outcomes for individuals with Fanconi Syndrome.

What resources are available for individuals with Fanconi Syndrome?

There are a variety of support systems and resources available for individuals with Fanconi Syndrome and their families. These include support groups, online communities, and organizations that provide information, guidance, and emotional support to help navigate life with this condition.

How can awareness of Fanconi Syndrome be promoted?

Promoting awareness of Fanconi Syndrome is crucial to ensure early detection, accurate diagnosis, and timely intervention. Raising awareness among healthcare professionals, the general public, and affected individuals can lead to improved outcomes and support for those living with this condition.

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