Clinical and Genotypic Spectrum of Chronic Granulomatous Disease in 71 Latin American Patients: First Report from the LASID Registry

Pediatr Blood Cancer. 2015 Dec;62(12):2101-7. doi: 10.1002/pbc.25674. Epub 2015 Jul 15.

Abstract

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.

Keywords: NADPH oxidase; bacillus Calmette-Guérin vaccine; chronic granulomatous disease; infections; mutations; registry.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abscess / epidemiology
  • Abscess / etiology
  • Abscess / genetics
  • Adolescent
  • Age of Onset
  • Child
  • Child, Preschool
  • Diarrhea / epidemiology
  • Diarrhea / etiology
  • Diarrhea / genetics
  • Female
  • Granulomatous Disease, Chronic* / complications
  • Granulomatous Disease, Chronic* / epidemiology
  • Granulomatous Disease, Chronic* / genetics
  • Hispanic or Latino
  • Humans
  • Infant
  • Infant, Newborn
  • Lymphatic Diseases / epidemiology
  • Lymphatic Diseases / etiology
  • Lymphatic Diseases / genetics
  • Male
  • Membrane Glycoproteins / genetics*
  • Mutation*
  • NADPH Oxidase 2
  • NADPH Oxidases / genetics*
  • Osteomyelitis / epidemiology
  • Osteomyelitis / etiology
  • Osteomyelitis / genetics
  • Otitis / epidemiology
  • Otitis / etiology
  • Otitis / genetics
  • Pneumonia / epidemiology
  • Pneumonia / etiology
  • Pneumonia / genetics
  • Registries*
  • Sepsis / epidemiology
  • Sepsis / etiology
  • Sepsis / genetics
  • Skin Diseases / epidemiology
  • Skin Diseases / etiology
  • Skin Diseases / genetics
  • Urinary Tract Infections / epidemiology
  • Urinary Tract Infections / etiology
  • Urinary Tract Infections / genetics

Substances

  • Membrane Glycoproteins
  • CYBB protein, human
  • NADPH Oxidase 2
  • NADPH Oxidases
  • CYBA protein, human