Liu Qing-Hua, Peng Li, Huang Han, Deng Liang-Ji, Zhong Li-Li
Pediatric Medical Center, First Hospital Affiliated to Hunan Normal University/Hunan Provincial People's Hospital/Hunan Provincial Key Laboratory of Pediatric Respiratory Disease, Changsha 410005, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2024 May 15;26(5):499-505. doi: 10.7499/j.issn.1008-8830.2312065.
To summarize the clinical data of 7 children with activated phosphoinositide 3-kinase delta syndrome (APDS) and enhance understanding of the disease.
A retrospective analysis was conducted on clinical data of 7 APDS children admitted to Hunan Provincial People's Hospital from January 2019 to August 2023.
Among the 7 children (4 males, 3 females), the median age of onset was 30 months, and the median age at diagnosis was 101 months. Recurrent respiratory tract infections, hepatosplenomegaly, and multiple lymphadenopathy were observed in all 7 cases. Sepsis was observed in 5 cases, otitis media and multiple caries were observed in 3 cases, and diarrhea and joint pain were observed in 2 cases. Lymphoma and systemic lupus erythematosus were observed in 1 case each. Fiberoptic bronchoscopy was performed in 4 cases, revealing scattered nodular protrusions in the bronchial lumen. The most common respiratory pathogen was (4 cases). Six patients had a p.E1021K missense mutation, and one had a p.434-475del splice site mutation.
p.E1021K is the most common mutation site in APDS children. Children who present with one or more of the following symptoms: recurrent respiratory tract infections, hepatosplenomegaly, multiple lymphadenopathy, otitis media, and caries, and exhibit scattered nodular protrusions on fiberoptic bronchoscopy, should be vigilant for APDS. .
总结7例活化磷脂酰肌醇3激酶δ综合征(APDS)患儿的临床资料,提高对该疾病的认识。
对2019年1月至2023年8月在湖南省人民医院收治的7例APDS患儿的临床资料进行回顾性分析。
7例患儿(男4例,女3例),发病年龄中位数为30个月,诊断年龄中位数为101个月。7例均有反复呼吸道感染、肝脾肿大及多处淋巴结肿大。5例发生脓毒症,3例有中耳炎及多处龋齿,2例有腹泻及关节痛。各有1例发生淋巴瘤及系统性红斑狼疮。4例行纤维支气管镜检查,显示支气管腔内有散在结节状突起。最常见的呼吸道病原体为(4例)。6例有p.E1021K错义突变,1例有p.434 - 475del剪接位点突变。
p.E1021K是APDS患儿最常见的突变位点。出现反复呼吸道感染、肝脾肿大、多处淋巴结肿大、中耳炎及龋齿等一种或多种症状,且纤维支气管镜检查显示有散在结节状突起的患儿,应警惕APDS。