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儿童慢性肉芽肿病的临床和影像学表现:来自伊朗的病例系列

Clinical and radiological aspects of chronic granulomatous disease in children: a case series from Iran.

作者信息

Khalilzadeh Soheila, Bloorsaz Mohammad Reza, Mansouri Davoud, Baghaie Noushin, Hakimi Shaheen, Velayati Ali Akbar

机构信息

Department of Pediatrics, National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shaheed Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Iran J Allergy Asthma Immunol. 2006 Jun;5(2):85-8.

Abstract

Chronic granulomatous disease (CGD) is a rare disorder of phagocytes, predisposes patients to bacterial and fungal infections. The main purpose of this study was to determine the clinical, radiological, pathological features, outcome and response to treatment of children with CGD. Thirteen patients with CGD, who had been referred to National Research Institute of Tuberculosis and Lung Disease (NRITLD), were reviewed during a 6 year period (1999-2005). There were 10 (76%) male and 3(24%) female cases. The median age of the patients was 9 years (1 month-12 years). Family history of CGD was reported by 7 patients. The median diagnostic age was 8 years, with a diagnostic delay of 4.5 years. The most common manifestations of CGD were pulmonary infections and skin involvement, followed by generalized lymphadenopathy. The most common radiological findings were multiple lymphadenopathy in mediastinal region and fibrotic changes in lung fields. Two patients died of pulmonary infections. Based on the results of this research, immunologic evaluations especially evaluation for CGD is highly recommended in children suffering from recurrent pulmonary infections, cutaneous or hepatic abscesses, or infections caused by uncommon pathogens. Early diagnosis and prophylactic treatment both, prevent further development of the lesions, irreversible complications and decreasing mortality and morbidity rates in children suffering from CGD.

摘要

慢性肉芽肿病(CGD)是一种罕见的吞噬细胞疾病,使患者易患细菌和真菌感染。本研究的主要目的是确定CGD患儿的临床、放射学、病理学特征、预后及治疗反应。在6年期间(1999 - 2005年),对转诊至国家结核病和肺部疾病研究所(NRITLD)的13例CGD患者进行了回顾性研究。其中男性10例(76%),女性3例(24%)。患者的中位年龄为9岁(1个月 - 12岁)。7例患者有CGD家族史。中位诊断年龄为8岁,诊断延迟4.5年。CGD最常见的表现是肺部感染和皮肤受累,其次是全身淋巴结肿大。最常见的放射学表现是纵隔区多发淋巴结肿大和肺野纤维化改变。2例患者死于肺部感染。基于本研究结果,强烈建议对反复发生肺部感染、皮肤或肝脓肿或由罕见病原体引起感染的儿童进行免疫学评估,尤其是针对CGD的评估。早期诊断和预防性治疗均可防止CGD患儿病变进一步发展、出现不可逆并发症,并降低死亡率和发病率。

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