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Clinical practice — latest insights in optimizing the care of children with Down syndrome

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Abstract

An essential part of the care of children with Down syndrome is secondary screening for comorbidity. It is well known that comorbidity frequently occurs in these children. A new update of the Dutch Down syndrome medical guideline was developed to create a sound evidence base for several of these conditions. We present the latest insights and recommendations from this Dutch medical guideline which are based on the most relevant literature currently available and developed with rigorous methodology. The main focus of this revision of the guideline was on obstructive sleep apnea and other airway problems and hematologic disorders, such as transient abnormal myelopoiesis, leukemia, and thyroid disorders.

Conclusion: This is a short summary of the latest insights and recommendations from the updated Dutch medical guideline for children with Down syndrome.

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Data Availability

This publication is based on the Dutch Down syndrome medical guideline published in 2021. The complete guideline is available in Dutch on: https://richtlijnendatabase.nl/richtlijn/medische_begeleiding_van_kinderen_met_downsyndroom/startpagina_-_medische_begeleiding_van_kinderen_met_downsyndroom.html.

Abbreviations

DS:

Down syndrome

OSA:

Obstructive sleep apnea

ND:

Normal developing

AHI:

Apnea-hypopnea index

CPAP:

Continuous positive airway pressure

RSV:

Respiratory syncytial virus

TAM:

Transient abnormal myelopoiesis

ML-DS:

Myeloid leukemia of Down syndrome

TSH:

Thyroid stimulating hormone

fT4:

Free thyroxine

anti-TPO:

Anti-thyroid peroxidase antibodies

AAI:

Atlantoaxial instability

References

  1. Groot-van De, der Mooren M, de Graaf G, Weijerman ME, Hoffer MJV, Knijnenburg J, van der Kevie-Kersemaekers AMF, Kooper AJA, Voorhoeve E, Sikkema-Raddatz B, van Zutven LJCM, Srebniak MI, Huijsdens-van Amsterdam K, Engelen JJM, Smeets D, van Kaam AH, Cornel MC (2021) Does non-invasive prenatal testing affect the livebirth prevalence of Down syndrome in the Netherlands? A population-based register study. Prenat Diagn 41(10):1351–1359. https://doi.org/10.1002/pd.6003

    Article  Google Scholar 

  2. De Graaf G, Buckley F, Skotko BG (2021) Estimation of the number of people with Down syndrome in Europe. Eur J Hum Genet 29(3):402–410. https://doi.org/10.1038/s41431-020-00748-y

    Article  PubMed  Google Scholar 

  3. Borstlap R, Van Gameren-Oosterom HBM, Lincke C, Weijerman ME, Van Wieringen H, Van Wouwe JP (2011) Een update van de multidisciplinaire richtlijn voor de medische begeleiding van kinderen met Downsyndroom. TNO, Leiden

  4. Weijerman ME, de Winter JP (2010) Clinical practice. The care of children with Down syndrome. Eur J Pediatr 169(12):1445–52. https://doi.org/10.1007/s00431-010-1253-0

  5. Weijerman ME, Van Wieringen H, Van Gameren-Oosterom HBM, Van Wermeskerken AM, Coppus AMW, Lamberts RD (2021) Medische begeleiding van kinderen met downsyndroom. NVK, Utrecht. Available in Dutch on: https://richtlijnendatabase.nl/richtlijn/medische_begeleiding_van_kinderen_met_downsyndroom/startpagina_-_medische_begeleiding_van_kinderen_met_downsyndroom.html

  6. Van Gameren-Oosterom HB, Fekkes M, Buitendijk SE, Mohangoo AD, Bruil J, Van Wouwe JP (2011) Development, problem behavior, and quality of life in a population based sample of eight-year-old children with Down syndrome. PLoS One 6(7):e21879. https://doi.org/10.1371/journal.pone.0021879.

  7. Aoki S, Yamauchi Y, Hashimoto K (2018) Developmental trend of children with Down’s syndrome–how do sex and neonatal conditions influence their developmental patterns? Brain Develop 40(3):181–187. https://doi.org/10.1016/j.braindev.2017.10.001

    Article  Google Scholar 

  8. Dykens EM, Hodapp RM, Evans DW (1994) Profiles and development of adaptive behavior in children with Down. Am J Ment Retard 98(5):580–587

    CAS  PubMed  Google Scholar 

  9. Van Gameren-Oosterom HBM, Fekkes M, Buitendijk SE, Mohangoo AD, Bruil J, Van Wouwe JP (2011). Development, problem behavior, and quality of life in a population based sample of eight-year-old children with Down syndrome. PloS One 6(7):e21879. https://doi.org/10.1371/journal.pone.0021879

  10. Van Gameren-Oosterom HBM, Fekkes M, Reijneveld SA, Oudesluys-Murphy AM, Verkerk PH, Van Wouwe JP, Buitendijk SE (2013) Practical and social skills of 16–19-year-olds with Down syndrome: independence still far away. Res Dev Disabil 34(12):4599–4607. https://doi.org/10.1016/j.ridd.2013.09.041

    Article  PubMed  Google Scholar 

  11. De Graaf G, Levine SP, Goldstein R, Skotko BG (2019) Parents’ perceptions of functional abilities in people with Down syndrome. Am J Med Genet A 179(2):161–176. https://doi.org/10.1002/ajmg.a.61004

    Article  PubMed  Google Scholar 

  12. Malak R, Kotwicka M, Krawczyk-Wasielewska A, Mojs E, Samborski W (2013) Motor skills, cognitive development and balance functions of children with Down syndrome. Ann Agric Environ Med 20(4):803–806

    PubMed  Google Scholar 

  13. Marchal JP, Maurice-Stam H, Houtzager BA, van Rozenburg-Marres SLR, Oostrom KJ, Grootenhuis MA, van Trotsenburg AP (2016) Growing up with Down syndrome: development from 6 months to 10.7 years. Res Dev Disabil 59:437–450. https://doi.org/10.1016/j.ridd.2016.09.019

    Article  PubMed  Google Scholar 

  14. Sabat C, Tassé M, Tenorio M (2019) Adaptive behavior and intelligence in adolescents with down syndrome: an exploratory investigation. Intellect Dev Disabil 57(2):79–94. https://doi.org/10.1352/1934-9556-57.2.79

    Article  PubMed  Google Scholar 

  15. Wasant P, Boonyawat B, Tritilanunt S, Vatanavicharn N, Sathienkijakanchai A, Ratanarak P, Malilum O, Liammongkolkul S (2008) Factors influencing development of Down syndrome children in the first three years of life: Siriraj experience. J Med Assoc Thai 91(7):1030–1037

    PubMed  Google Scholar 

  16. Will EA, Caravella KE, Hahn LJ, Fidler DJ, Roberts JE (2018) Adaptive behavior in infants and toddlers with Down syndrome and fragile X syndrome. Am J Med Genet B Neuropsychiatr Genet 177(3):358–368. https://doi.org/10.1002/ajmg.b.32619

    Article  PubMed  PubMed Central  Google Scholar 

  17. Winders P, Wolter-Warmerdam K, Hickey F (2019) A schedule of gross motor development for children with Down syndrome. J Intellect Disabil Res 63(4):346–356. https://doi.org/10.1111/jir.12580

    Article  CAS  PubMed  Google Scholar 

  18. Maris M, Verhulst S, Wojciechowski M, Van de Heyning P, Boudewyns A (2016) Sleep problems and obstructive sleep apnea in children with Down syndrome, an overview. Int J Pediatr Otorhinolaryngol 82:12–15. https://doi.org/10.1016/j.ijporl.2015.12.014

    Article  PubMed  Google Scholar 

  19. Breslin J, Spanò G, Bootzin R, Anand P, Nadel L, Edgin J (2014) Obstructive sleep apnea syndrome and cognition in Down syndrome. Dev Med Child Neurol 56(7):657–664. https://doi.org/10.1111/dmcn.12376

    Article  PubMed  Google Scholar 

  20. Kuroda H, Sawatari H, Ando S, Ohkusa T, Rahmawati A, Ono J, Nishizaka M, Hashiguchi N, Matsuoka F, Chishaki A (2017) A nationwide, cross-sectional survey on unusual sleep postures and sleep-disordered breathing-related symptoms in people with Down syndrome. J Intellect Disabil Res 61(7):656–667. https://doi.org/10.1111/jir.12379

    Article  CAS  PubMed  Google Scholar 

  21. Lee CF, Lee CH, Hsueh WY, Lin MT, Kang KT (2018) Prevalence of obstructive sleep apnea in children with Down syndrome: a meta-analysis. J Clin Sleep Med 15;14(5):867–875. https://doi.org/10.5664/jcsm.7126

  22. Hill CM, Evans HJ, Elphick H, Farquhar M, Pickering RM, Kingshott R, Martin J, Reynolds J, Joyce A, Rush C (2016) Prevalence and predictors of obstructive sleep apnoea in young children with Down syndrome. Sleep Med 27:99–106. https://doi.org/10.1016/j.sleep.2016.10.001

    Article  PubMed  Google Scholar 

  23. Esbensen AJ, Hoffman EK, Beebe DW, Byars KC, Epstein J (2018) Links between sleep and daytime behaviour problems in children with Down syndrome. J Intellect Disabil Res 62(2):115–125. https://doi.org/10.1111/jir.12463

    Article  CAS  PubMed  Google Scholar 

  24. Churchill SS, Kieckhefer GM, Bjornson KF, Herting JR (2015) Relationship between sleep disturbance and functional outcomes in daily life habits of children with Down syndrome. Sleep 38(1):61–71. https://doi.org/10.5665/sleep.4326

    Article  PubMed  PubMed Central  Google Scholar 

  25. Joyce A, Elphick H, Farquhar M, Gringras P, Evans H, Bucks RS, Kreppner J, Kingshott R, Martin J, Reynolds J, Rush C, Gavlak J, Hill CM (2019) Obstructive sleep apnoea contributes to executive function impairment in young children with Down syndrome. Behav Sleep Med 18(5):611–621. https://doi.org/10.1080/15402002.2019

    Article  PubMed  Google Scholar 

  26. Brooks LJ, Olsen MN, Bacevice AM, Beebe A, Konstantinopoulou S, Taylor HG (2015) Relationship between sleep, sleep apnea, and neuropsychological function in children with Down syndrome. Sleep Breath 19(1):197–204. https://doi.org/10.1007/s11325-014-0992-y

    Article  PubMed  Google Scholar 

  27. Horne RS, Wijayaratne P, Nixon GM, Walter LM (2019) Sleep and sleep disordered breathing in children with Down syndrome: effects on behaviour, neurocognition and the cardiovascular system. Sleep Med Rev 44:1–11. https://doi.org/10.1016/j.smrv.2018.11.002

    Article  PubMed  Google Scholar 

  28. Bull MJ, the Committee on Genetics (2011) Health supervision for children with Down syndrome. Pediatrics 128(2):393–406. https://doi.org/10.1542/peds.2011-1605

  29. Royal College of Paediatric and Child Health (2009) Working party on sleep physiology and respiratory control disorders in childhood. Standards for Services for Children with Disorders of Sleep Physiology. Royal College of Paediatrics and Child Health London

  30. CBO (2013) Richtlijn OSAS bij kinderen. Nederlandse Vereniging voor KNO-heelkunde en Heelkunde van het Hoofd-Halsgebied, Utrecht

    Google Scholar 

  31. Brockmann PE, Damiani F, Nunez F, Moya A, Pincheira E, Paul MA, Lizama M (2016) Sleep-disordered breathing in children with Down syndrome: usefulness of home polysomnography. Int J Pediatr Otorhinolaryngol 83:47–50. https://doi.org/10.1016/j.ijporl.2016.01.030

    Article  PubMed  Google Scholar 

  32. Ikizoglu NB, Kiyan E, Polat B, Ay P, Karadag B, Ersu R (2019) Are home sleep studies useful in diagnosing obstructive sleep apnea in children with down syndrome? Pediatr Pulmonol 54(10):1541–1546. https://doi.org/10.1002/ppul.24440

    Article  PubMed  Google Scholar 

  33. Kingshott RN, Gahleitner F, Elphick HE, Gringras P, Farquhar M, Pickering RM, Martin J, Reynolds J, Joyce A, Gavlak JC, Evans HJ, Hill CM (2019) Cardiorespiratory sleep studies at home: Experience in research and clinical cohorts. Arch Dis Child 104(5):476–481. https://doi.org/10.1136/archdischild-2018-315676

    Article  PubMed  Google Scholar 

  34. Coverstone AM, Bird M, Sicard M, Tao Y, Grange DK, Cleveland C, Molter D, Kemp JS (2014) Overnight pulse oximetry for evaluation of sleep apnea among children with trisomy 21. J Clin Sleep Med 10(12):1309–1315. https://doi.org/10.5664/jcsm.4286

    Article  PubMed  PubMed Central  Google Scholar 

  35. Hill CM, Elphick HE, Farquhar M, Gringras P, Pickering RM, Kingshott RN, Martin J, Reynolds J, Joyce A, Gavlak JC, Evans HJ (2018) Home oximetry to screen for obstructive sleep apnoea in Down syndrome. Arch Dis Child 103(10):962–967. https://doi.org/10.1136/archdischild-2017-314409

    Article  PubMed  Google Scholar 

  36. Nation J, Brigger M (2017) The efficacy of adenotonsillectomy for obstructive sleep apnea in children with Down syndrome: a systematic review. Otolaryngol Head Neck Surg 157(3):401–408. https://doi.org/10.1177/0194599817703921

    Article  PubMed  Google Scholar 

  37. Shete MM, Stocks RM, Sebelik ME, Schoumacher RA (2010) Effects of adeno-tonsillectomy on polysomnography patterns in Down syndrome children with obstructive sleep apnea: a comparative study with children without Down syndrome. Int J Pediatr Otorhinolaryngol 74(3):241–244. https://doi.org/10.1016/j.ijporl.2009.11.006

    Article  PubMed  Google Scholar 

  38. Dudoignon B, Amaddeo A, Frapin A, Thierry B, de Sanctis L, Arroyo JO, Khirani S, Fauroux B (2017) Obstructive sleep apnea in Down syndrome: benefits of surgery and noninvasive respiratory support. Am J Med Genet A 173(8):2074–2080. https://doi.org/10.1002/ajmg.a.38283

    Article  PubMed  Google Scholar 

  39. Trucco F, Chatwin M, Semple T, Rosenthal M, Bush A, Tan HL (2018) Sleep disordered breathing and ventilatory support in children with Down syndrome. Pediatr Pulmonol 53(10):1414–1421. https://doi.org/10.1002/ppul.24122

    Article  PubMed  Google Scholar 

  40. Van den Broek N, Broer L, Vandenbussche N, Tan I, Overeem S, Pillen S (2021) Obstructive sleep apnea in people with intellectual disabilities: adherence to and effect of CPAP. Sleep Breath 25(3):1257–1265. https://doi.org/10.1007/s11325-020-02221-y

    Article  PubMed  Google Scholar 

  41. Nixon GM, Kermack AS, Davis GM, Manoukian JJ, Brown KA, Brouillette RT (2004) Planning adenotonsillectomy in children with obstructive sleep apnea: the role of overnight oximetry. Pediatrics 113:e19-25. https://doi.org/10.1542/peds.113.1.e19

    Article  PubMed  Google Scholar 

  42. Alsubie HS, Rosen D (2018) The evaluation and management of respiratory disease in children with Down syndrome. Paediatr Respir Rev 26:49–54. https://doi.org/10.1016/j.prrv.2017.07.003

    Article  Google Scholar 

  43. Bertrand P, Navarro H, Caussade S, Holmgren N, Sanchez I (2003) Airway anomalies in children with Down syndrome: endoscopic findings. Pediatr Pulmonol 36:137–141. https://doi.org/10.1002/ppul.10332

    Article  PubMed  Google Scholar 

  44. Biko DM, Schwartz M, Anupindi SA, Altes TA (2008) Subpleural lung cysts in Down syndrome: prevalence and association with coexisting diagnoses. Pediatr Radiol 38:280–284. https://doi.org/10.1007/s00247-007-0699-3

    Article  PubMed  Google Scholar 

  45. Cooney TP, Thurlbeck WM (1982) Pulmonary hypoplasia in Down’s syndrome. N Engl J Med 307:1170–1173. https://doi.org/10.1056/NEJM198211043071902

    Article  CAS  PubMed  Google Scholar 

  46. Galleguillos C, Galleguillos B, Larios G, Menchaca G, Bont L, Castro-Rodriguez JA (2016) Down’s syndrome is a risk factor for severe lower respiratory tract infection due to respiratory syncytial virus. Acta Paediatr 105(11):e531–e535. https://doi.org/10.1111/apa.13552

    Article  PubMed  Google Scholar 

  47. Yi H, Lanctôt KL, Bont L, Bloemers BL, Weijerman M, Broers C, Li A, Kiss A, Mitchell I, Paes B, CARESS investigators (2014) Respiratory syncytial virus prophylaxis in Down syndrome: a prospective cohort study. Pediatrics 133(6):1031–1037. https://doi.org/10.1542/peds.2013-3916

    Article  PubMed  Google Scholar 

  48. Luna MS, Manzoni P, Paes B, Baraldi E, Cossey V, Kugelman A, Chawla R, Dotta A, Rodríguez Fernández R, Resch B, Carbonell-Estrany X (2020) Expert consensus on palivizumab use for respiratory syncytial virus in developed countries. Paediatr Respir Rev 33:35–44. https://doi.org/10.1016/j.prrv.2018.12.001

    Article  PubMed  Google Scholar 

  49. Hasle H, Clemmensen IH, Mikkelsen M (2000) Risks of leukaemia and solid tumours in individuals with Down's syndrome. Lancet 15;355(9199):165–9. https://doi.org/10.1016/S0140-6736(99)05264-2

  50. Goemans BF, Noort S, Blink M, Wang YD, Peters STCJ, van Wouwe JP, Kaspers G, de Haas V, Kollen WJ, van der Velden VHJ, Gruber TA, Zwaan CM (2021) Sensitive GATA1 mutation screening reliably identifies neonates with Down syndrome at risk for myeloid leukemia. Leukemia 35(8):2403–2406. https://doi.org/10.1038/s41375-021-01128-1

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  51. Roberts I, Alford K, Hall G, Juban G, Richmond H, Norton A, Vallance G, Perkins K, Marchi E, McGowan S, Roy A, Cowan G, Anthony M, Gupta A, Ho J, Uthaya S, Curley A, Rasiah SV, Watts T, Nicholl R, Bedford-Russell A, Blumberg R, Thomas A, Gibson B, Halsey C, Lee PW, Godambe S, Sweeney C, Bhatnagar N, Goriely A, Campbell P, Vyas P; Oxford-Imperial Down Syndrome Cohort Study Group (2013) GATA1-mutant clones are frequent and often unsuspected in babies with Down syndrome: identification of a population at risk of leukemia. Blood 5;122(24):3908–17. https://doi.org/10.1182/blood-2013-07-515148

  52. Tunstall O, Bhatnagar N, James B, Norton A, O’Marcaigh AS, Watts T, Greenough A, Vyas P, Roberts I, Wright M; British Society for Haematology (2018) Guidelines for the investigation and management of Transient Leukaemia of Down Syndrome. Br J Haematol 182(2):200–211. https://doi.org/10.1111/bjh.15390

    Article  Google Scholar 

  53. Flasinski M, Scheibke K, Zimmermann M, Creutzig U, Reinhardt K, Verwer F, de Haas V, van der Velden VHJ, von Neuhoff C, Zwaan CM, Reinhardt D, Klusmann JH (2018) Low-dose cytarabine to prevent myeloid leukemia in children with Down syndrome: TMD Prevention 2007 study. Blood Adv 10;2(13):1532–1540. https://doi.org/10.1182/bloodadvances.2018018945

  54. Iughetti L, Predieri B, Bruzzi P, Predieri F, Vellani G, Madeo SF, Garavelli L, Biagioni O, Bedogni G, Bozzola M (2014) Ten-year longitudinal study of thyroid function in children with Down’s syndrome. Hormone research in paediatrics 82(2):113–121. https://doi.org/10.1159/000362450

    Article  CAS  PubMed  Google Scholar 

  55. Cebeci AN, Güven A, Yıldız M (2013) Profile of hypothyroidism in Down’s syndrome. J Clin Res Pediatr Endocrinol 5(2):116–120. https://doi.org/10.4274/Jcrpe.884

    Article  PubMed  PubMed Central  Google Scholar 

  56. Dias V, Nunes JC, Araújo SS, Goulart E (2005) Etiological assessment of hyperthyrotropinemia in children with Down’s syndrome. Jornal de Pediatria 81(1):79–84

    Article  PubMed  Google Scholar 

  57. Sarici D, Akin MA, Kurtoglu S, Gunes T, Ozturk MA, Akcakus M (2012) Thyroid functions of neonates with Down syndrome. Ital J Pediatr 38(1):44. https://doi.org/10.1186/1824-7288-38-44

    Article  PubMed  PubMed Central  Google Scholar 

  58. Zwaveling-Soonawala N, Witteveen ME, Marchal JP, Klouwer FC, Ikelaar NA, Smets AM, Van Rijn RR, Endert E, Fliers E, Van Trotsenburg AS (2017) Early thyroxine treatment in Down syndrome and thyroid function later in life. Eur J Endocrinol 176(5):505–513. https://doi.org/10.1530/EJE-16-0858

    Article  CAS  PubMed  Google Scholar 

  59. De Luca F, Corrias A, Salerno M, Wasniewska M, Gastaldi R, Cassio A, Mussa A, Aversa T, Radetti G, Arrigo T (2010) Peculiarities of Graves’ disease in children and adolescents with Down’s syndrome. Eur J Endocrinol 162(3):591–595. https://doi.org/10.1530/EJE-09-0751

    Article  CAS  PubMed  Google Scholar 

  60. Torfs CP, Christianson RE (1998) Anomalies in Down syndrome individuals in a large population-based registry. Am J Med Genet 5;77(5):431–8

  61. Petreschi F, Digilio MC, Marino B, Di Ciommo V, Ravà L, Palka G, Rossi C, Chiesa PL, Giannotti A (2002) Prevalence of major malformations in infants with Down’s syndrome. Ital J Pediatr 28(6):488–493

    Google Scholar 

  62. Goede J, Weijerman ME, Broers CJ, de Winter JP, van der Voort-Doedens LM, Hack WW (2012) Testicular volume and testicular microlithiasis in boys with Down syndrome. J Urol 187(3):1012–1017. https://doi.org/10.1016/j.juro.2011.10.167

    Article  PubMed  Google Scholar 

  63. Lauteslager PEM, Volman MCJM, Lauteslager T, Van den Heuvel ME, Jongerling J, Klugkist IG (2020) Basic motor skills of children with down syndrome: creating a motor growth curve. Pediatr Phys Ther 32(4):375–380. https://doi.org/10.1097/PEP.0000000000000743

    Article  PubMed  Google Scholar 

  64. Foley C, Killeen OG (2019) Musculoskeletal anomalies in children with Down syndrome: an observational study. Arch Dis Child 104(5):482–487. https://doi.org/10.1136/archdischild-2018-315751

    Article  PubMed  Google Scholar 

  65. Caird MS, Wills BP, Dormans JP (2006) Down syndrome in children: the role of the orthopaedic surgeon. J Am Acad Orthop Surg 14(11):610–619. https://doi.org/10.5435/00124635-200610000-00003

    Article  PubMed  Google Scholar 

  66. Abousamra O, Bayhan IA, Rogers KJ, Miller F (2016) Hip instability in Down Syndrome: a focus on acetabular retroversion. J Pediatr Orthop 36(5):499–504. https://doi.org/10.1097/BPO.0000000000000484

    Article  PubMed  Google Scholar 

  67. Van Gijzen AFM, Rouers EDM, van Douveren FQMP, Dieleman J, Hendriks JGE, Halbertsma FJJ, Bok LA (2019) Developmental dysplasia of the hip in children with Down syndrome: comparison of clinical and radiological examinations in a local cohort. Eur J Pediatr 178(4):559–564. https://doi.org/10.1007/s00431-019-03322-x

    Article  PubMed  Google Scholar 

  68. Merrick J, Ezra E, Josef B, Hendel D, Steinberg DM, Wientroub S (2000) Musculoskeletal problems in Down Syndrome European Paediatric Orthopaedic Society Survey: the Israeli sample. J Pediatr Orthop B 9(3):185–192. https://doi.org/10.1097/01202412-200006000-00008

    Article  CAS  PubMed  Google Scholar 

  69. Shaw ED, Beals RK (1992) The hip joint in Down’s syndrome. A study of its structure and associated disease. Clin Orthop Relat Res 278:101–107

    Article  Google Scholar 

  70. Duque Orozco MDP, Abousamra O, Chen BP, Rogers KJ, Sees JP, Miller F (2018) Knee deformities in children with Down syndrome: a focus on knee malalignment. J Pediatr Orthop 38(5):266–273. https://doi.org/10.1097/BPO.0000000000000814

    Article  PubMed  Google Scholar 

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Acknowledgements

The authors would like to thank all professionals who contributed to the development of the new update of the Dutch Down syndrome medical guideline.

Funding

The Stichting Kwaliteitsgelden Medisch Specialisten financed the development of this revision of these modules in the guideline. This foundation is funded by the Dutch government. They did not have any influence on the content.

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Authors and Affiliations

  1. Department of Pediatrics, Groene Hart Ziekenhuis, P.O. Box 1098, 2800 BB, Gouda, The Netherlands

    Helma B. M. van Gameren-Oosterom

  2. Department of Pediatrics, Alrijne, Leiderdorp, The Netherlands

    Michel E. Weijerman

  3. Department of Pediatrics, St. Antonius, Utrecht, The Netherlands

    Hester van Wieringen

  4. Department of Pediatrics, Spaarne Gasthuis, Haarlem/Hoofddorp, The Netherlands

    J Peter de Winter

  5. Leuven Child and Health Institute, KU Leuven, Leuven, Belgium

    J Peter de Winter

  6. Department of Development and Regeneration, KU Leuven, Leuven, Belgium

    J Peter de Winter

  7. Department of Pediatrics, Flevoziekenhuis, Almere, The Netherlands

    Anne-Marie van Wermeskerken

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  1. Helma B. M. van Gameren-Oosterom
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Contributions

H.G, M.W., H.W, and A.W. wrote the main manuscript text. All authors reviewed the manuscript.

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Correspondence to Helma B. M. van Gameren-Oosterom.

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Communicated by Gregorio Milani.

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van Gameren-Oosterom, H.B.M., Weijerman, M.E., van Wieringen, H. et al. Clinical practice — latest insights in optimizing the care of children with Down syndrome. Eur J Pediatr 182, 2027–2039 (2023). https://doi.org/10.1007/s00431-023-04890-9

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