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Clinical and Genotypic Spectrum of Chronic Granulomatous Disease in 71 Latin American Patients: First Report from the LASID Registry
Author(s) -
OliveiraJunior Edgar Borges,
Zurro Nuria Bengala,
Prando Carolina,
CabralMarques Otavio,
Pereira Paulo Vitor Soeiro,
Schimke LenaFriederick,
Klaver Stefanie,
Buzolin Marcia,
BlancasGalicia Lizbeth,
SantosArgumedo Leopoldo,
PietropaoloCienfuegos Dino Roberto,
EspinosaRosales Francisco,
King Alejandra,
Sorensen Ricardo,
Porras Oscar,
RoxoJunior Persio,
Forte Wilma Carvalho Neves,
Orellana Julio Cesar,
Lozano Alejandro,
Galicchio Miguel,
Regairaz Lorena,
Grumach Anete Sevciovic,
CostaCarvalho Beatriz Tavares,
Bustamante Jacinta,
Bezrodnik Liliana,
Oleastro Matias,
Danielian Silvia,
CondinoNeto Antonio
Publication year - 2015
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.25674
Subject(s) - chronic granulomatous disease , medicine , primary immunodeficiency , immunology , disease
Aim We analyzed data from 71 patients with chronic granulomatous disease (CGD) with a confirmed genetic diagnosis, registered in the online Latin American Society of Primary Immunodeficiencies (LASID) database. Results Latin American CGD patients presented with recurrent and severe infections caused by several organisms. The mean age at disease onset was 23.9 months, and the mean age at CGD diagnosis was 52.7 months. Recurrent pneumonia was the most frequent clinical condition (76.8%), followed by lymphadenopathy (59.4%), granulomata (49.3%), skin infections (42%), chronic diarrhea (41.9%), otitis (29%), sepsis (23.2%), abscesses (21.7%), recurrent urinary tract infection (20.3%), and osteomyelitis (15.9%). Adverse reactions to bacillus Calmette‐Guérin (BCG) vaccination were identified in 30% of the studied Latin American CGD cases. The genetic diagnoses of the 71 patients revealed 53 patients from 47 families with heterogeneous mutations in the CYBB gene (five novel mutations: p.W361G, p.C282X, p.W483R, p.R226X, and p.Q93X), 16 patients with the common deletion c.75_76 del.GT in exon 2 of NCF1 gene, and two patients with mutations in the CYBA gene. Conclusion The majority of Latin American CGD patients carry a hemizygous mutation in the CYBB gene. They also presented a wide range of clinical manifestations most frequently bacterial and fungal infections of the respiratory tract, skin, and lymph nodes. Thirty percent of the Latin American CGD patients presented adverse reactions to BCG, indicating that this vaccine should be avoided in these patients. Pediatr Blood Cancer © 2015 Wiley Periodicals, Inc.