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[原发性纤毛运动障碍]

[Primary ciliary dyskinesia].

作者信息

Raidt Johanna, Staar Ben O, Omran Heymut, Ringshausen Felix C

机构信息

Klinik für Kinder- und Jugendmedizin, Allgemeine Pädiatrie, Universitätsklinikum Münster, Münster, Deutschland.

European Reference Network on Rare and Complex Respiratory Diseases (ERN-LUNG), Frankfurt, Deutschland.

出版信息

Inn Med (Heidelb). 2024 Jun;65(6):545-559. doi: 10.1007/s00108-024-01726-y. Epub 2024 May 27.

Abstract

Primary ciliary dyskinesia (PCD) is a rare genetic disorder with a variable clinical phenotype that is accompanied by reduced motility of the cilia in the respiratory tract and numerous other organs. This leads to various characteristic symptoms and disease manifestations, primarily affecting the lungs (chronic persistent productive cough, bronchiectasis), the nose and paranasal sinuses (chronic persistent rhinitis or rhinosinusitis) as well as the middle ear (chronic otitis media, middle ear effusion). Moreover, PCD is associated with impaired fertility or lateralization defects (situs anomalies, congenital heart defects). The diagnostics of PCD are complex and require a combination of several sophisticated instrument-based diagnostic procedures. Through thorough history taking and evaluation, suspected cases can be comparatively well identified based on typical clinical features and referred to further diagnostics. In recent years, molecular genetic analysis through panel diagnostics or whole exome and whole genome sequencing, has gained in importance as this enables affected individuals to participate in disease-specific and genotype-specific clinical trials. Although the current treatment is purely symptomatic, the earliest possible diagnosis is crucial for connecting patients to specialized PCD centers, which can have a significant impact on the clinical course of the affected individuals.

摘要

原发性纤毛运动障碍(PCD)是一种罕见的遗传性疾病,具有可变的临床表型,伴有呼吸道和许多其他器官纤毛运动能力下降。这会导致各种特征性症状和疾病表现,主要影响肺部(慢性持续性咳痰、支气管扩张)、鼻子和鼻窦(慢性持续性鼻炎或鼻窦炎)以及中耳(慢性中耳炎、中耳积液)。此外,PCD与生育能力受损或偏侧化缺陷(内脏反位、先天性心脏缺陷)有关。PCD的诊断很复杂,需要结合几种复杂的基于仪器的诊断程序。通过全面的病史采集和评估,根据典型的临床特征可以相对较好地识别疑似病例,并转诊进行进一步诊断。近年来,通过基因panel诊断或全外显子组和全基因组测序进行的分子遗传学分析变得越来越重要,因为这使受影响的个体能够参与特定疾病和特定基因型的临床试验。尽管目前的治疗纯粹是对症治疗,但尽早诊断对于将患者与专门的PCD中心联系起来至关重要,这可能会对受影响个体的临床病程产生重大影响。

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