Division of Allergy and Immunology, Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH, 43205, USA.
Division of Allergy Immunology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA.
J Clin Immunol. 2023 Feb;43(2):247-270. doi: 10.1007/s10875-022-01418-y. Epub 2023 Jan 17.
Current practices vary widely regarding the immunological work-up and management of patients affected with defects in thymic development (DTD), which include chromosome 22q11.2 microdeletion syndrome (22q11.2del) and other causes of DiGeorge syndrome (DGS) and coloboma, heart defect, atresia choanae, retardation of growth and development, genital hypoplasia, ear anomalies/deafness (CHARGE) syndrome. Practice variations affect the initial and subsequent assessment of immune function, the terminology used to describe the condition and immune status, the accepted criteria for recommending live vaccines, and how often follow-up is needed based on the degree of immune compromise. The lack of consensus and widely varying practices highlight the need to establish updated immunological clinical practice guidelines. These guideline recommendations provide a comprehensive review for immunologists and other clinicians who manage immune aspects of this group of disorders.
目前,对于患有胸腺发育缺陷(DTD)的患者,免疫检查和管理的做法差异很大,这些患者包括 22q11.2 微缺失综合征(22q11.2del)和其他 DiGeorge 综合征(DGS)和眼裂缺损、心脏缺损、后鼻孔闭锁、生长发育迟缓、生殖器发育不全、耳部畸形/耳聋(CHARGE)综合征的病因。实践差异影响了免疫功能的初始和后续评估、用于描述病情和免疫状态的术语、推荐使用活疫苗的公认标准,以及根据免疫受损程度确定随访频率的依据。缺乏共识和广泛的实践差异突出表明,需要制定更新的免疫学临床实践指南。这些指南建议为管理这群疾病免疫方面的免疫学家和其他临床医生提供了全面的综述。