Forgotten Diseases Research Foundation, Santa Clara, CA, USA.
UCL Great Ormond Street Institute of Child Health, London, UK.
Orphanet J Rare Dis. 2021 Mar 10;16(1):123. doi: 10.1186/s13023-021-01716-5.
Ataxia telangiectasia (A-T) is a DNA repair disorder that affects multiple body systems. Neurological problems and immunodeficiency are two important features of this disease. At this time, two main severity groups are defined in A-T: classic (the more severe form) and mild. Poor growth is a common problem in classic A-T. An objective of this study was to develop growth references for classic A-T. Another objective was to compare growth patterns in classic A-T and mild A-T with each other and with the general population, using the CDC growth references. A final objective was to examine the effects of chronic infection on height.
We found that classic A-T patients were smaller overall, and suffered from height and weight faltering that continued throughout childhood and adolescence. When compared to the CDC growth references, the median heights and weights for both male and female patients eventually fell to or below the 3rd centile on the CDC charts. Height faltering was more pronounced in females. Birthweight was lower in the classic A-T group compared to mild A-T and the general population, whereas birth length was not. Finally, we investigated height and BMI faltering in relation to number of infections and found no association.
Classic A-T appears to affect growth in utero. Although children appear to grow well in very early life, faltering begins early, and is unrelenting.
毛细血管扩张性共济失调(A-T)是一种影响多个身体系统的 DNA 修复障碍。神经问题和免疫缺陷是这种疾病的两个重要特征。此时,A-T 被定义为两种主要的严重程度组:经典型(更严重的形式)和轻度。生长不良是经典 A-T 的常见问题。本研究的目的之一是为经典 A-T 制定生长参考值。另一个目的是使用 CDC 生长参考值,比较经典 A-T 和轻度 A-T 之间以及与普通人群之间的生长模式。最后一个目的是检查慢性感染对身高的影响。
我们发现,经典 A-T 患者总体上较小,身高和体重都在波动,从儿童期到青春期持续不断。与 CDC 生长参考值相比,男性和女性患者的身高和体重中位数最终降至或低于 CDC 图表上的第 3 百分位。女性身高波动更为明显。与轻度 A-T 和普通人群相比,经典 A-T 组的出生体重较低,而出生长度则没有。最后,我们研究了身高和 BMI 波动与感染次数的关系,未发现相关性。
经典 A-T 似乎会影响宫内生长。尽管儿童在生命早期似乎生长良好,但波动很早就开始了,并且持续不断。