Abstract
Background
Chronic granulomatous disease (CGD), one of the phagocytic system defects, is the primary immunodeficiency caused by dysfunction of the NADPH oxidase complex which generates reactive oxygen species (ROS), which are essential for killing pathogenic microorganisms, especially catalase-positive bacteria and fungi.
Objective
The objective of our study was to assess the clinical and laboratory characteristics, treatment modalities, and prognosis of patients with CGD.
Methods
We retrospectively reviewed 63 patients with CGD who have been diagnosed, treated, and/or followed-up between 1984 and 2018 in Hacettepe University, Ankara, in Turkey, as a developing country.
Results
The number of female and male patients was 26/37. The median age at diagnosis was 3.8 (IQR: 1.0–9.6) years. The rate of consanguinity was 63.5%. The most common physical examination finding was lymphadenopathy (44/63), growth retardation (33/63), and hepatomegaly (27/63). One adult patient had squamous cell carcinoma of the lung. The most common infections were lung infection (53/63), skin abscess (43/63), and lymphadenitis (19/63). Of the 63 patients with CGD, 6 patients had inflammatory bowel disease (IBD). Twelve of the 63 patients died during follow-up. CYBA, NCF1, CYBB, and NCF2 mutations were detected in 35%, 27.5%, 25%, and 12.5% of the patients, respectively.
Conclusion
We identified 63 patients with CGD from a single center in Turkey. Unlike other cohort studies in Turkey, due to the high consanguineous marriage rate in our study group, AR form of CGD was more frequent, and gastrointestinal involvement were found at relatively lower rates. The rate of patients who treated with HSCT was lower in our research than in the literature. A majority of the patients in this study received conventional prophylactic therapies, which highlight on the outcome of individuals who have not undergone HSCT.
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Abbreviations
- AR-CGD:
-
Autosomal recessive chronic granulomatous disease
- CGD:
-
Chronic granulomatous disease
- CT:
-
Computed tomography
- DHR:
-
Dihydrorhodamine
- DIC:
-
Diffuse intravascular coagulation
- ESID:
-
European Society of Immunodeficiencies
- GIS:
-
Gastrointestinal system
- HSCT:
-
Hematopoietic stem cell transplantation
- IBD:
-
Inflammatory bowel disease
- IFNγ:
-
Interferon-gamma
- NBT:
-
Nitroblue tetrazolium
- NIH:
-
National Institutes of Health
- ROS:
-
Reactive oxygen species
- SIFT:
-
Sorting intolerant from tolerant
- TMP-SMX:
-
Trimethoprim-sulfamethoxazole
- TNGS:
-
Targeted next-generation sequencing
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HTA, SE, DC, and IT compiled and reviewed the clinical findings of the patients. SOH and BO reviewed the genetic and laboratory findings of the patients. KvL, MdB, CST, YK, and DR made genetic analysis of the patients.
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Akar, H.T., Esenboga, S., Cagdas, D. et al. Clinical and Immunological Characteristics of 63 Patients with Chronic Granulomatous Disease: Hacettepe Experience. J Clin Immunol 41, 992–1003 (2021). https://doi.org/10.1007/s10875-021-01002-w
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DOI: https://doi.org/10.1007/s10875-021-01002-w