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Check out our original NPC Diaries series to the interviews conducted at the 2024 NPC Conference. Meet all types of community members here!

NPConf2024 NPC1 in Israel
20:46

NPConf2024 NPC1 in Israel

Niemann-Pick C1(NPC1) in Israel: what can we learn from this unique population? In-Person Presentation by Orna Staretz-Chacham, Soroka Medical Centre NPC1 is a pan-ethnic, autosomal recessive, ultra-rare disease. In Israel, several populations are affected by NPC, including the unique Bedouin communities and Ashkenazi Jews in addition to immigrants from eastern Europe (e.g., Russia, Ukraine). The Bedouin patients often harbor homozygous mutations due to consanguinity, leading to earlier diagnosis due to prior affected siblings and large families. This situation has led to the unique ability to diagnose patients at birth and initiate early intervention. Most Israeli patients have the neonatal and early- infantile phenotype, some of whom have interstitial lung disease (often fatal), similar to that seen in NPC2 patients. Premature infants with NPC1 may have a delayed presentation of a severe phenotype. In our population, NPC1 can present antenatally as hydrops, congenital thrombocytopenia, or congenital cholestasis. We have reported elevated alpha-feto-protein as a marker for NPC1 in cholestatic neonates. There is no definitive treatment for NPC, though there are promising emerging therapies. Miglustat is not well tolerated by all patients and may be ineffective in very young children. Population studies, such as the NPC Israeli cohort, contribute to our knowledge of the clinical and genetic heterogeneity of the disease, and in this case, also make significant contributions to the natural history and management of the very youngest patients who often have more unusual presentations and severe disease. The Israeli investigative sites are active participants in international clinical trials and contributing meaningful data needed to assess response to emerging therapeutics as well as assessment of safety in a varied (age, disease manifestations) population.
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