Unmasking chronic granulomatous disease: A routine diagnostic workup in a Brazilian children's hospital.

IF 2.1 4区 医学 Q3 ALLERGY
Allergologia et immunopathologia Pub Date : 2025-09-01 eCollection Date: 2025-01-01 DOI:10.15586/aei.v53i5.1338
Karina Mescouto de Melo, Anna C S Dias, Robéria P Mendonça, Cláudia F C Valente, Fabíola S Tavares, Agenor C M Santos Júnior, Laísa M Bomfim, Jeane S R Martins, Ricardo Camargo
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引用次数: 0

Abstract

The diagnosis of chronic granulomatous disease (CGD), a congenital immunodeficiency affecting phagocyte function, remains a challenge for patients in Latin America. It is well established that dihydrorhodamine (DHR) flow cytometry is the most commonly used screening assay; however, few pediatric immunology centers in Brazil perform this test. This study reports data from a routine diagnostic workup for CGD conducted at a Brazilian children's hospital. A three-year prospective study was performed, enrolling children with clinical features suggestive of immunodeficiency who were screened using DHR. Sanger sequencing of the NCF1 (neutrophil cytosolic factor 1) and CYBB (cytochrome b-245, beta chain) genes was conducted in children with two consecutive abnormal DHR results. A total of 255 patients-62% males-with a median age of 3.2 years (range: 1 month-17.8 years) were evaluated. Six patients (2.4%) had abnormal DHR tests, and four of them (1.6%) received a definitive diagnosis of CGD. Most children presented with pneumonia and/or abscesses during the first year of life as the clinical manifestation of CGD. Two of the four diagnosed patients were receiving continuous antibiotics and two underwent transplantation. Pathogenic variants were identified in NCF1 (three cases) and CYBB (one case). The hospital-based diagnostic workup for CGD identified approximately one new case per 60 tested patients, indicating a high frequency of the disease in the study population. This approach may represent a valuable strategy for identifying new pediatric CGD cases in resource-limited settings.

揭露慢性肉芽肿病:巴西儿童医院的常规诊断检查。
慢性肉芽肿病(CGD)是一种影响吞噬细胞功能的先天性免疫缺陷,对拉丁美洲患者的诊断仍然是一个挑战。二氢霍达明(DHR)流式细胞术是最常用的筛选方法;然而,巴西很少有儿科免疫学中心进行这项测试。本研究报告了在巴西儿童医院进行的CGD常规诊断检查的数据。进行了一项为期三年的前瞻性研究,招募具有提示免疫缺陷临床特征的儿童,使用DHR进行筛查。对连续两次DHR结果异常的儿童进行NCF1(中性粒细胞胞浆因子1)和CYBB(细胞色素b-245, β链)基因的Sanger测序。共评估了255例患者(62%为男性),中位年龄为3.2岁(范围:1个月17.8岁)。6例(2.4%)DHR检测异常,其中4例(1.6%)确诊为CGD。大多数儿童在出生后第一年表现为肺炎和/或脓肿,作为CGD的临床表现。四名确诊患者中有两名持续接受抗生素治疗,两名接受了移植手术。在NCF1(3例)和CYBB(1例)中鉴定出致病变异。以医院为基础的CGD诊断检查发现,每60名接受检测的患者中约有1例新病例,表明该疾病在研究人群中的发病率很高。在资源有限的情况下,这种方法可能是一种有价值的策略,用于识别新的儿科CGD病例。
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来源期刊
CiteScore
3.70
自引率
0.00%
发文量
131
审稿时长
6-12 weeks
期刊介绍: Founded in 1972 by Professor A. Oehling, Allergologia et Immunopathologia is a forum for those working in the field of pediatric asthma, allergy and immunology. Manuscripts related to clinical, epidemiological and experimental allergy and immunopathology related to childhood will be considered for publication. Allergologia et Immunopathologia is the official journal of the Spanish Society of Pediatric Allergy and Clinical Immunology (SEICAP) and also of the Latin American Society of Immunodeficiencies (LASID). It has and independent international Editorial Committee which submits received papers for peer-reviewing by international experts. The journal accepts original and review articles from all over the world, together with consensus statements from the aforementioned societies. Occasionally, the opinion of an expert on a burning topic is published in the "Point of View" section. Letters to the Editor on previously published papers are welcomed. Allergologia et Immunopathologia publishes 6 issues per year and is included in the major databases such as Pubmed, Scopus, Web of Knowledge, etc.
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