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拉丁美洲的共济失调毛细血管扩张症:一项多中心研究中的临床特征、免疫缺陷和死亡率。

Ataxia-telangiectasia in Latin America: clinical features, immunodeficiency, and mortality in a multicenter study.

机构信息

Universidade Federal de Ciências da Saúde, Porto Alegre, Brazil.

Hospital Israelita Albert Einstein, São Paulo, Brazil.

出版信息

Immunol Res. 2024 Aug;72(4):864-873. doi: 10.1007/s12026-024-09494-5. Epub 2024 Jun 4.

Abstract

Ataxia-telangiectasia (AT) is a rare genetic disorder leading to neurological defects, telangiectasias, and immunodeficiency. We aimed to study the clinical and immunological features of Latin American patients with AT and analyze factors associated with mortality. Referral centers from 9 Latin American countries participated in this retrospective cohort study, and 218 patients were included.  Median (IQR) ages at symptom onset and diagnosis were 1.0 (1.0-2.0)  and 5.0 (3.0-8.0) years, respectively. Most patients presented recurrent airway infections, which was significantly associated with IgA deficiency. IgA deficiency was observed in 60.8% of patients and IgG deficiency in 28.6%. T- and B-lymphopenias were also present in most cases. Mean survival was 24.2 years, and Kaplan-Meier 20-year-survival rate was 52.6%, with higher mortality associated with female gender and low IgG levels. These findings suggest that immunologic status should be investigated in all patients with AT.

摘要

共济失调毛细血管扩张症(AT)是一种罕见的遗传疾病,可导致神经缺陷、毛细血管扩张和免疫缺陷。我们旨在研究拉丁美洲 AT 患者的临床和免疫学特征,并分析与死亡率相关的因素。来自 9 个拉丁美洲国家的转诊中心参与了这项回顾性队列研究,共纳入 218 名患者。症状发作和诊断的中位(IQR)年龄分别为 1.0(1.0-2.0)和 5.0(3.0-8.0)岁。大多数患者出现反复呼吸道感染,这与 IgA 缺乏显著相关。60.8%的患者存在 IgA 缺乏,28.6%的患者存在 IgG 缺乏。大多数情况下也存在 T 和 B 淋巴细胞减少症。平均生存时间为 24.2 年,Kaplan-Meier 20 年生存率为 52.6%,女性和低 IgG 水平与更高的死亡率相关。这些发现表明,应在所有 AT 患者中检查免疫状态。

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