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原发性纤毛运动障碍的临床和分子特征:一家三级医疗中心的经验

Clinical and molecular characteristics of primary ciliary dyskinesia: A tertiary care centre experience.

作者信息

Alzaid Mohammed, Al-Mobaireek Khalid, Almannai Mohammed, Mukhtar Gawahir, Eltahir Safa, Zafar Adnan, Zada Abdulali P, Alotaibi Wadha

机构信息

Pulmonary Division of the Pediatric Department, Children Specialized Hospital, King Fahad Medical City, Saudi Arabia.

Pulmonary Division of the Pediatric Department, King Khalid University Hospital, Saudi Arabia.

出版信息

Int J Pediatr Adolesc Med. 2021 Dec;8(4):258-263. doi: 10.1016/j.ijpam.2021.03.002. Epub 2021 Mar 11.

Abstract

BACKGROUND

Primary ciliary dyskinesia (PCD) is a ciliopathy with diverse clinical and genetic findings caused by abnormal motile cilia structure and function. In this study, we describe the clinical characteristics of confirmed PCD cases in our population and report the radiological, genetic, and laboratory findings.

METHODS

This was a retrospective, observational, single-centre study. We enrolled 18 patients who were diagnosed with confirmed PCD between 2015 and 2019. We then analyzed their data, including clinical findings and workup.

RESULTS

In our cohort, 56% of patients had molecularly confirmed PCD, and RSPH9 was the most common gene identified. Transmission electron microscopy (TEM) showed an ultrastructural defect in 64% of samples, all of which matched the genetic background of the patient. Situs inversus (SI) was observed in 50% of patients, and congenital heart disease was observed in 33%. The median body mass index (BMI) was 15.87 kg/m, with a median z score of -1.48. The median FEV1 value was 67.6% (z score - 2.43). Radiologically, bronchiectasis was noted in 81% of patients at a variable degree of severity. Lung bases were involved in 91% of patients. We were unable to correlate the genotype-phenotype findings.

CONCLUSION

We describe the clinical and molecular characteristics of patients with confirmed PCD in a tertiary centre in Saudi Arabia and report 9 new pathogenic or likely pathogenic variants in one of the PCD-associated genes.

摘要

背景

原发性纤毛运动障碍(PCD)是一种由于运动性纤毛结构和功能异常导致的具有多样临床和基因表现的纤毛病。在本研究中,我们描述了我们人群中确诊的PCD病例的临床特征,并报告了影像学、遗传学和实验室检查结果。

方法

这是一项回顾性、观察性、单中心研究。我们纳入了2015年至2019年间被诊断为确诊PCD的18例患者。然后我们分析了他们的数据,包括临床发现和检查。

结果

在我们的队列中,56%的患者经分子学确诊为PCD,RSPH9是最常鉴定出的基因。透射电子显微镜(TEM)显示64%的样本存在超微结构缺陷,所有这些都与患者的基因背景相匹配。50%的患者观察到内脏反位(SI),33%的患者观察到先天性心脏病。中位体重指数(BMI)为15.87kg/m,中位z评分为-1.48。中位第一秒用力呼气容积(FEV1)值为67.6%(z评分-2.43)。影像学上,81%的患者有不同程度的支气管扩张。91%的患者肺底部受累。我们无法将基因型-表型结果相关联。

结论

我们描述了沙特阿拉伯一家三级中心确诊的PCD患者的临床和分子特征,并报告了一个PCD相关基因中的9个新的致病或可能致病变异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4de2/8356118/92aff69752e8/gr1.jpg

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