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NCT02450851RecruitingAccepts Healthy Volunteers

Clinical and Genetic Evaluation of Individuals With Undiagnosed Disorders Through the Undiagnosed Diseases Network

National Human Genome Research Institute (NHGRI)

Start Date

9/16/2015

Completion Date

12/31/2028

Summary

Without an explanation for severe and sometimes life-threatening symptoms, patients and their families are left in a state of unknown. Many individuals find themselves being passed from physician to physician, undergoing countless and often repetitive tests in the hopes of finding answers and insight about what the future may hold. This long and arduous journey to find a diagnosis does not end for many patients- the Office of Rare Diseases Research (ORDR) notes that 6% of individuals seeking their assistance have an undiagnosed disorder. In 2008, the National Institutes of Health (NIH) Undiagnosed Diseases Program (UDP) was established with the goal of providing care and answers for these individuals with mysterious conditions who have long eluded diagnosis. The NIH UDP is a joint venture of the NIH ORDR, the National Human Genome Research Institute Intramural Research Program (NHGRI-IRP), and the NIH Clinical Research Center (CRC) (1-3). The goals of the NIH UDP are to: (1) provide answers for patients with undiagnosed diseases; (2) generate new knowledge about disease mechanisms; (3) assess the application of new approaches to phenotyping and the use of genomic technologies; and (4) identify potential therapeutic targets, if possible. To date, the UDP has evaluated 3300 medical records and admitted 750 individuals with rare and undiagnosed conditions to the NIH Clinical Center. The NIH UDP has identified more than 70 rare disease diagnoses and several new conditions. The success of the NIH UDP prompted the NIH Common Fund to support the establishment of a network of medical research centers, the Undiagnosed Diseases Network (UDN), for fiscal years 2013-2020. The clinical sites will perform extensive phenotyping, genetic analyses, and functional studies of potential disease-causing variants. The testing performed on patients involves medically indicated studies intended to help reach a diagnosis, as well as research investigations that include a skin biopsy, blood draws, and DNA analysis. In addition, the UDN will further the goals of the UDP by permitting the sharing of personally identifiable phenotypic and genotypic information within the network. By sharing participant information and encouraging collaboration, the UDN hopes to improve the understanding of rare conditions and advance the diagnostic process and care for individuals with undiagnosed diseases.

Detailed Description

Without an explanation for severe and sometimes life-threatening symptoms, patients and their families are left in a state of unknown. Many individuals find themselves being passed from physician to physician, undergoing countless and often repetitive tests in the hopes of finding answers and insight about what the future may hold. This long and arduous journey to find a diagnosis does not end for many patients- the Office of Rare Diseases Research (ORDR) notes that 6% of individuals seeking their assistance have an undiagnosed disorder. In 2008, the National Institutes of Health (NIH) Undiagnosed Diseases Program (UDP) was established with the goal of providing care and answers for these individuals with mysterious conditions who have long eluded diagnosis. The NIH UDP is a joint venture of the NIH ORDR, the National Human Genome Research Institute Intramural Research Program (NHGRI-IRP), and the NIH Clinical Research Center (CRC) (1-3). The goals of the NIH UDP are to: (1) provide answers for patients with undiagnosed diseases; (2) generate new knowledge about disease mechanisms; (3) assess the application of new approaches to phenotyping and the use of genomic technologies; and (4) identify potential therapeutic targets, if possible.1-3 Prior to formation of the Undiagnosed Diseases Network (UDN), the UDP had evaluated 3300 medical records, admitted 750 individuals with rare and undiagnosed conditions to the NIH, and identified more than 70 rare disease diagnoses and several new conditions. The success of the NIH UDP prompted the NIH Common Fund to support the establishment of a network of medical research centers, the UDN, for fiscal years 2013-2022. The clinical sites perform extensive phenotyping, genetic analyses, and functional studies of potential disease-causing variants. The testing performed on patients involves medically indicated studies intended to help reach a diagnosis, as well as research investigations that include a skin biopsy, blood draws, and DNA analysis. In addition, the UDN is furthering the goals of the UDP by permitting the sharing of personally identifiable phenotypic and genotypic information within the network. By sharing participant information and encouraging collaboration, the UDN hopes to improve the understanding of rare conditions and advance the diagnostic process and care for individuals with undiagnosed diseases.

Eligibility Criteria

Age Range: No minimum to 100 years

* INCLUSION CRITERIA: Ideal participants for tier 2-4 evaluations include individuals with: * One or more objective findings pertinent to the phenotype for which a case was submitted. * No diagnosis despite evaluation by specialists who assessed the patient for the objective finding(s). * Agreement for the storage and sharing of information and biomaterials, in an identified fashion amongst the UDN centers, and in a de-identified fashion to research sites beyond the network. Participants unable to consent can be enrolled. EXCLUSION CRITERIA: Individuals who are unlikely to be assigned to tier 2-4 evaluations include those with: * Reported symptoms with no relevant objective findings. * A diagnosis explaining objective findings. * A diagnosis suggested on record review. * Unwillingness to share data.

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Conditions

Genetic Disease

Locations

University of Alabama at Birmingham

Birmingham, Alabama 35233

United States

HudsonAlpha Institute for Biotechnology, Inc.

Huntsville, Alabama 35806

United States

University of California, Los Angeles

Los Angeles, California 90095

United States

University of California, Irvine Medical Center

Orange, California 92668

United States

Lucile Salter Packard Children's Hospital at Stanford

Stanford, California 94020

United States

Stanford University

Stanford, California 94305-5584

United States

Leland Stanford Junior University

Stanford, California 94305

United States

Stanford Hospital and Clinics

Stanford, California 94305

United States

Childrens National Medical Center

Washington D.C., District of Columbia 20010

United States

University of Miami Miller School of Medicine

Miami, Florida 33136

United States

Lurie Children s Hospital

Chicago, Illinois 60611

United States

Indiana University

Indianapolis, Indiana 46202-5262

United States

National Institutes of Health Clinical Center

Bethesda, Maryland 20892

United States

Massachusetts General Hospital

Boston, Massachusetts 02114

United States

Boston Children s Hospital

Boston, Massachusetts 02115

United States

Brigham and Women's Hospital

Boston, Massachusetts 02115

United States

Harvard T.H. Chan School of Public Health

Boston, Massachusetts 02115

United States

Harvard U Faculty of Medicine

Boston, Massachusetts 02115

United States

Mayo Clinic

Rochester, Minnesota 55905

United States

Washington University in St. Louis

St Louis, Missouri 63110

United States

New York Genome Center

New York, New York 10013

United States

Duke University Health System

Durham, North Carolina 27710

United States

University of Oregon

Eugene, Oregon 97403

United States

Oregon Health Sciences University

Portland, Oregon 97201-3098

United States

University of Pennsylvania

Philadelphia, Pennsylvania 19104-6056

United States

Children's Hospital of Philadelphia

Philadelphia, Pennsylvania 19104

United States

Vanderbilt University Medical Center

Nashville, Tennessee 37232

United States

Baylor College of Medicine

Houston, Texas 77030

United States

University of Utah

Salt Lake City, Utah 84112

United States

Pacific Northwest National Laboratory

Richland, Washington 99354

United States

Seattle Children's Hospital

Seattle, Washington 98101

United States

University of Washington

Seattle, Washington 98195

United States

Medical College of Wisconsin

Milwaukee, Wisconsin 53226

United States