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中国西部连续临床疑似儿童队列中的原发性纤毛运动障碍的临床和遗传特征。

Clinical and genetic features of primary ciliary dyskinesia in a cohort of consecutive clinically suspect children in western China.

机构信息

Department of Respiratory, Children's Hospital of Chongqing Medical University, No. 136, Zhongshan 2nd Road, Yuzhong District, Chongqing, 400014, China.

Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, 400014, China.

出版信息

BMC Pediatr. 2022 Jul 8;22(1):402. doi: 10.1186/s12887-022-03469-x.

Abstract

BACKGROUND

Primary ciliary dyskinesia (PCD) is a rare, inherited disorder of the motile cilia that exhibits genetic and clinical heterogeneity among different populations. PCD diagnosis remains challenging owing to the heterogeneity of associated clinical features and lack of a gold standard diagnostic test.

OBJECTIVE

The aim of this study was to analyze the clinical and genetic characteristics of a group of children with clinically suspected PCD in one region of China, with the goal of providing a more robust knowledge base regarding the genetic stratification underlying this disease in Chinese populations.

METHODS

We retrospectively analyzed the data from 38 patients with clinically suspected PCD who had undergone next-generation sequencing (NGS) between November 2016 and March 2021 in the respiratory department of a tertiary Children's hospital in Western China. The genetic features of the confirmed cases were summarized by reviewing data associated with other cohorts of Chinese children.

RESULTS

Overall, 16 patients were ultimately diagnosed with PCD with a median age of 8.5 years. All patients presented with a chronic wet cough, 93.75% exhibited chronic or recurrent sinusitis/rhinitis, 43.75% experienced recurrent wheezing, 56.25% reported respiratory symptoms present since infancy, 31.25% had a history of neonatal respiratory distress (NRD), and 25% exhibited otitis media. Only 18.75% of these patients exhibited laterality defects. High frequencies of DNAH11 mutations were detected by integrating data from PCD patient cohorts in China.

CONCLUSION

The high frequency of DNAH11 mutations may limit the utility of transmission electron microscopy (TEM) as a first-line approach to diagnosing PCD in China in the absence of other indicators.

摘要

背景

原发性纤毛运动障碍(PCD)是一种罕见的、遗传性的运动纤毛疾病,在不同人群中表现出遗传和临床异质性。由于相关临床特征的异质性和缺乏金标准诊断测试,PCD 的诊断仍然具有挑战性。

目的

本研究旨在分析中国一个地区一组临床疑似 PCD 儿童的临床和遗传特征,旨在为中国人群中该疾病的遗传分层提供更可靠的知识库。

方法

我们回顾性分析了 2016 年 11 月至 2021 年 3 月在中国西部一家三级儿童医院呼吸科接受下一代测序(NGS)的 38 例临床疑似 PCD 患者的数据。通过回顾与中国其他儿童队列相关的数据,总结确诊病例的遗传特征。

结果

总体而言,最终有 16 例患者被诊断为 PCD,中位年龄为 8.5 岁。所有患者均表现为慢性湿性咳嗽,93.75%存在慢性或复发性鼻窦炎/鼻炎,43.75%出现反复喘息,56.25%的呼吸道症状自婴儿期出现,31.25%有新生儿呼吸窘迫(NRD)病史,25%有中耳炎。这些患者中只有 18.75%存在侧位缺陷。通过整合中国 PCD 患者队列的数据,发现 DNAH11 突变的频率较高。

结论

在没有其他指标的情况下,高频 DNAH11 突变可能限制了透射电子显微镜(TEM)作为诊断 PCD 的一线方法在中国的应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/40fd/9264530/164fb1c37f0f/12887_2022_3469_Fig1_HTML.jpg

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