Department of Immunology and Gene Therapy, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
Division of Immunology and the Children's Research Centre, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland.
J Clin Immunol. 2024 Mar 8;44(3):79. doi: 10.1007/s10875-024-01678-w.
Congenital athymia is a rare T-lymphocytopaenic condition, which requires early corrective treatment with thymus transplantation (TT). Athymic patients are increasingly identified through newborn screening (NBS) for severe combined immunodeficiency (SCID). Lack of relatable information resources contributes to challenging patient and family journeys during the diagnostic period following abnormal NBS results. Patient and Public Involvement and Engagement (PPIE) activities, including parental involvement in paediatrics, are valuable initiatives to improve clinical communication and parental information strategies. Parents of infants with suspected athymia were therefore invited to discuss the information they received during the diagnostic period following NBS with the aim to identify parental information needs and targeted strategies to address these adequately. Parents reported that athymia was not considered with them as a possible differential diagnosis until weeks after initial NBS results. Whilst appropriate clinical information about athymia and TT was available upon referral to specialist immunology services, improved access to easy-to-understand information from reliable sources, including from clinical nurse specialists and peer support systems, remained desirable. A roadmap concept, with written or digital information, addressing parental needs in real time during a potentially complex diagnostic journey, was proposed and is transferrable to other inborn errors of immunity (IEI) and rare diseases. This PPIE activity provides insight into the information needs of parents of infants with suspected athymia who are identified through SCID NBS, and highlights the role for PPIE in promoting patient- and family-centred strategies to improve IEI care.
先天性无胸腺是一种罕见的 T 淋巴细胞减少症,需要早期进行胸腺移植 (TT) 矫正治疗。通过新生儿筛查 (NBS) 对严重联合免疫缺陷 (SCID) 进行筛查,越来越多地发现无胸腺患者。缺乏相关信息资源导致在 NBS 结果异常后的诊断期间,患者和家庭的旅程充满挑战。包括父母参与儿科在内的患者和公众参与和参与 (PPIE) 活动是改善临床沟通和父母信息策略的有价值的举措。因此,邀请疑似无胸腺婴儿的父母讨论他们在 NBS 后的诊断期间收到的信息,目的是确定父母的信息需求,并制定有针对性的策略来充分满足这些需求。父母报告说,直到最初的 NBS 结果几周后,才将无胸腺作为可能的鉴别诊断与他们一起考虑。虽然在向专门的免疫学服务机构转诊时可以获得有关无胸腺和 TT 的适当临床信息,但仍希望改善获得来自可靠来源的通俗易懂的信息的途径,包括临床护士专家和同伴支持系统。提出了一个路线图概念,其中包含针对潜在复杂诊断过程中实时父母需求的书面或数字信息,并且可转移到其他先天性免疫缺陷 (IEI) 和罕见疾病。这项 PPIE 活动深入了解了通过 SCID NBS 确定的疑似无胸腺婴儿的父母的信息需求,并强调了 PPIE 在促进以患者和家庭为中心的策略以改善 IEI 护理方面的作用。