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
{"title":"Unmasking chronic granulomatous disease: A routine diagnostic workup in a Brazilian children's hospital.","authors":"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","doi":"10.15586/aei.v53i5.1338","DOIUrl":null,"url":null,"abstract":"<p><p>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 <i>NCF1</i> (neutrophil cytosolic factor 1) and <i>CYBB</i> (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 <i>NCF1</i> (three cases) and <i>CYBB</i> (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.</p>","PeriodicalId":7536,"journal":{"name":"Allergologia et immunopathologia","volume":"53 5","pages":"87-93"},"PeriodicalIF":2.1000,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Allergologia et immunopathologia","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.15586/aei.v53i5.1338","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"ALLERGY","Score":null,"Total":0}
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.
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.