Popatia Rizwana, Haver Kenan, Casey Alicia
Division of Pulmonary Medicine, Boston Children's Hospital , Boston, Massachusetts.
Pediatr Allergy Immunol Pulmonol. 2014 Jun 1;27(2):51-59. doi: 10.1089/ped.2013.0314.
Primary ciliary dyskinesia (PCD) is a genetic condition affecting approximately 1 in 15,000-20,000 individuals, and the majority of cases exhibit an autosomal recessive inheritance pattern. However, genetic heterogenicity is seen in PCD and reflects the complexity of ciliary structure and biogenesis. There have been many recent advances in the diagnosis and management of PCD in the last few years, including advanced genetic sequencing, nasal nitric oxide assay, and ciliary motility tests. This article focuses on the ultrastructure and pathophysiology of ciliary dyskinesias, along with a review of clinical features, screening, and diagnostic tests. It also reflects upon the diagnostic challenge caused by the diverse clinical presentation, which will be of great value to pediatricians for considering PCD in their differential list, henceforth leading to early recognition and management, along with awareness of the recent advances in the field of genetics and other techniques for diagnosis of this condition.
原发性纤毛运动障碍(PCD)是一种遗传性疾病,每15000至20000人中约有1人受其影响,大多数病例呈现常染色体隐性遗传模式。然而,PCD存在基因异质性,这反映了纤毛结构和生物发生的复杂性。在过去几年中,PCD的诊断和管理有了许多新进展,包括先进的基因测序、鼻一氧化氮检测和纤毛运动测试。本文重点关注纤毛运动障碍的超微结构和病理生理学,同时回顾其临床特征、筛查和诊断测试。文章还反思了因临床表现多样所带来的诊断挑战,这对于儿科医生在鉴别诊断中考虑PCD具有重要价值,从而实现早期识别和管理,并了解该疾病在遗传学领域及其他诊断技术方面的最新进展。