Skip to main content
Erschienen in: Journal of Clinical Immunology 5/2011

01.10.2011

Inheritance Pattern and Clinical Aspects of 93 Iranian Patients with Chronic Granulomatous Disease

verfasst von: Fatemeh Fattahi, Mohsen Badalzadeh, Leyla Sedighipour, Masoud Movahedi, Mohammad Reza Fazlollahi, Seyed Davood Mansouri, Ghamar Taj Khotaei, Mohammad Hassan Bemanian, Fatemeh Behmanesh, Amir Ali Hamidieh, Nasrin Bazargan, Setareh Mamishi, Fariborz Zandieh, Zahra Chavoshzadeh, Iraj Mohammadzadeh, Seyed Alireza Mahdaviani, Seyed Ahmad Tabatabaei, Najmeddin Kalantari, Shaghayegh Tajik, Marzieh Maddah, Zahra Pourpak, Mostafa Moin

Erschienen in: Journal of Clinical Immunology | Ausgabe 5/2011

Einloggen, um Zugang zu erhalten

Abstract

Background

Chronic granulomatous disease (CGD) is a rare immunodeficiency due to a genetic defect in one of the NADPH-oxidase components. We studied CGD inheritance forms (autosomal recessive (AR) or X-linked (XL)) and AR-CGD subtypes in Iran.

Methods

Clinical and functional investigations were conducted in 93 Iranian CGD patients from 75 families.

Results

Most of the patients were AR-CGD (87.1%). This was related to consanguineous marriages (p = 0.001). The age of onset of symptoms and diagnosis were lower in XL-CGD compared with AR-CGD (p < 0.0001 for both). Among AR-CGD patients, p47phox defect was the predominant subtype (55.5%). The most common clinical features in patients were lymphadenopathy (65.6%) and pulmonary involvement (57%). XL-CGD patients were affected more frequently with severe infectious manifestations.

Conclusions

Although XL-CGD is the most common type of the disease worldwide, only 12 patients (12.9%) were XL-CGD in our study. The relatively high frequency of AR-CGD is probable due to widely common consanguineous marriages in Iran.
Literatur
1.
Zurück zum Zitat Segal BH, Leto TL, Gallin JI, Malech HL, Holland SM. Genetic, biochemical, and clinical features of chronic granulomatous disease. Medicine (Baltimore). 2000;79(3):170–200.CrossRef Segal BH, Leto TL, Gallin JI, Malech HL, Holland SM. Genetic, biochemical, and clinical features of chronic granulomatous disease. Medicine (Baltimore). 2000;79(3):170–200.CrossRef
2.
Zurück zum Zitat Goldblatt D, Thrasher AJ. Chronic granulomatous disease. Clin Exp Immunol. 2000;122(1):1–9.PubMedCrossRef Goldblatt D, Thrasher AJ. Chronic granulomatous disease. Clin Exp Immunol. 2000;122(1):1–9.PubMedCrossRef
3.
Zurück zum Zitat Winkelstein JA, Marino MC, Johnston Jr RB, Boyle J, Curnutte J, Gallin JI, et al. Chronic granulomatous disease. Report on a national registry of 368 patients. Medicine (Baltimore). 2000;79(3):155–69.CrossRef Winkelstein JA, Marino MC, Johnston Jr RB, Boyle J, Curnutte J, Gallin JI, et al. Chronic granulomatous disease. Report on a national registry of 368 patients. Medicine (Baltimore). 2000;79(3):155–69.CrossRef
4.
Zurück zum Zitat Liese JG, Jendrossek V, Jansson A, Petropoulou T, Kloos S, Gahr M, et al. Chronic granulomatous disease in adults. Lancet. 1996;347(8996):220–3.PubMedCrossRef Liese JG, Jendrossek V, Jansson A, Petropoulou T, Kloos S, Gahr M, et al. Chronic granulomatous disease in adults. Lancet. 1996;347(8996):220–3.PubMedCrossRef
5.
Zurück zum Zitat van den Berg JM, van Koppen E, Ahlin A, Belohradsky BH, Bernatowska E, Corbeel L, et al. Chronic granulomatous disease: the European experience. PLoS One. 2009;4(4):e5234.PubMedCrossRef van den Berg JM, van Koppen E, Ahlin A, Belohradsky BH, Bernatowska E, Corbeel L, et al. Chronic granulomatous disease: the European experience. PLoS One. 2009;4(4):e5234.PubMedCrossRef
6.
7.
Zurück zum Zitat Matute JD, Arias AA, Wright NA, Wrobel I, Waterhouse CC, Li XJ, et al. A new genetic subgroup of chronic granulomatous disease with autosomal recessive mutations in p40 phox and selective defects in neutrophil NADPH oxidase activity. Blood. 2009;114(15):3309–15.PubMedCrossRef Matute JD, Arias AA, Wright NA, Wrobel I, Waterhouse CC, Li XJ, et al. A new genetic subgroup of chronic granulomatous disease with autosomal recessive mutations in p40 phox and selective defects in neutrophil NADPH oxidase activity. Blood. 2009;114(15):3309–15.PubMedCrossRef
8.
Zurück zum Zitat Martire B, Rondelli R, Soresina A, Pignata C, Broccoletti T, Finocchi A, et al. Clinical features, long-term follow-up and outcome of a large cohort of patients with chronic granulomatous disease: an Italian multicenter study. Clin Immunol. 2008;126(2):155–64.PubMedCrossRef Martire B, Rondelli R, Soresina A, Pignata C, Broccoletti T, Finocchi A, et al. Clinical features, long-term follow-up and outcome of a large cohort of patients with chronic granulomatous disease: an Italian multicenter study. Clin Immunol. 2008;126(2):155–64.PubMedCrossRef
9.
Zurück zum Zitat Levinsky RJ, Harvey BA, Rodeck CH, Soothill JF. Phorbol myristate acetate stimulated NBT test: a simple method suitable for antenatal diagnosis of chronic granulomatous disease. Clin Exp Immunol. 1983;54(2):595–8.PubMed Levinsky RJ, Harvey BA, Rodeck CH, Soothill JF. Phorbol myristate acetate stimulated NBT test: a simple method suitable for antenatal diagnosis of chronic granulomatous disease. Clin Exp Immunol. 1983;54(2):595–8.PubMed
10.
Zurück zum Zitat Koker MY, Sanal O, de Boer M, Tezcan I, Metin A, Ersoy F, et al. Mutations of chronic granulomatous disease in Turkish families. Eur J Clin Invest. 2007;37(7):589–95.PubMedCrossRef Koker MY, Sanal O, de Boer M, Tezcan I, Metin A, Ersoy F, et al. Mutations of chronic granulomatous disease in Turkish families. Eur J Clin Invest. 2007;37(7):589–95.PubMedCrossRef
11.
Zurück zum Zitat Holland SM. Neutropenia and neutrophil defects. In: Rose NR, Hamilton RG, Detrick B, editors. Manual of clinical laboratory immunology. Washington: ASM; 2002. p. 861–2. Holland SM. Neutropenia and neutrophil defects. In: Rose NR, Hamilton RG, Detrick B, editors. Manual of clinical laboratory immunology. Washington: ASM; 2002. p. 861–2.
12.
Zurück zum Zitat Roesler J, Hecht M, Freihorst J, Lohmann-Matthes ML, Emmendorffer A. Diagnosis of chronic granulomatous disease and of its mode of inheritance by dihydrorhodamine 123 and flow microcytofluorometry. Eur J Pediatr. 1991;150(3):161–5.PubMedCrossRef Roesler J, Hecht M, Freihorst J, Lohmann-Matthes ML, Emmendorffer A. Diagnosis of chronic granulomatous disease and of its mode of inheritance by dihydrorhodamine 123 and flow microcytofluorometry. Eur J Pediatr. 1991;150(3):161–5.PubMedCrossRef
13.
Zurück zum Zitat Crockard AD, Thompson JM, Boyd NA, Haughton DJ, McCluskey DR, Turner CP. Diagnosis and carrier detection of chronic granulomatous disease in five families by flow cytometry. Int Arch Allergy Immunol. 1997;114(2):144–52.PubMedCrossRef Crockard AD, Thompson JM, Boyd NA, Haughton DJ, McCluskey DR, Turner CP. Diagnosis and carrier detection of chronic granulomatous disease in five families by flow cytometry. Int Arch Allergy Immunol. 1997;114(2):144–52.PubMedCrossRef
14.
Zurück zum Zitat Bittles A. Consanguinity and its relevance to clinical genetics. Clin Genet. 2001;60(2):89–98.PubMedCrossRef Bittles A. Consanguinity and its relevance to clinical genetics. Clin Genet. 2001;60(2):89–98.PubMedCrossRef
15.
Zurück zum Zitat Hoodfar E, Teebi AS. Genetic referrals of Middle Eastern origin in a western city: inbreeding and disease profile. J Med Genet. 1996;33(3):212–5.PubMedCrossRef Hoodfar E, Teebi AS. Genetic referrals of Middle Eastern origin in a western city: inbreeding and disease profile. J Med Genet. 1996;33(3):212–5.PubMedCrossRef
16.
Zurück zum Zitat El Kares R, Barbouche MR, Elloumi-Zghal H, Bejaoui M, Chemli J, Mellouli F, et al. Genetic and mutational heterogeneity of autosomal recessive chronic granulomatous disease in Tunisia. J Hum Genet. 2006;51(10):887–95.PubMedCrossRef El Kares R, Barbouche MR, Elloumi-Zghal H, Bejaoui M, Chemli J, Mellouli F, et al. Genetic and mutational heterogeneity of autosomal recessive chronic granulomatous disease in Tunisia. J Hum Genet. 2006;51(10):887–95.PubMedCrossRef
17.
Zurück zum Zitat Movahedi M, Aghamohammadi A, Rezaei N, Shahnavaz N, Jandaghi AB, Farhoudi A, et al. Chronic granulomatous disease: a clinical survey of 41 patients from the Iranian primary immunodeficiency registry. Int Arch Allergy Immunol. 2004;134(3):253–9.PubMedCrossRef Movahedi M, Aghamohammadi A, Rezaei N, Shahnavaz N, Jandaghi AB, Farhoudi A, et al. Chronic granulomatous disease: a clinical survey of 41 patients from the Iranian primary immunodeficiency registry. Int Arch Allergy Immunol. 2004;134(3):253–9.PubMedCrossRef
18.
Zurück zum Zitat Conley ME, Notarangelo LD, Etzioni A. Diagnostic criteria for primary immunodeficiencies. Representing PAGID (Pan-American Group for Immunodeficiency) and ESID (European Society for Immunodeficiencies). Clin Immunol. 1999;93(3):190–7.PubMedCrossRef Conley ME, Notarangelo LD, Etzioni A. Diagnostic criteria for primary immunodeficiencies. Representing PAGID (Pan-American Group for Immunodeficiency) and ESID (European Society for Immunodeficiencies). Clin Immunol. 1999;93(3):190–7.PubMedCrossRef
19.
Zurück zum Zitat Vowells SJ, Fleisher TA, Sekhsaria S, Alling DW, Maguire TE, Malech HL. Genotype-dependent variability in flow cytometric evaluation of reduced nicotinamide adenine dinucleotide phosphate oxidase function in patients with chronic granulomatous disease. J Pediatr. 1996;128(1):104–7.PubMedCrossRef Vowells SJ, Fleisher TA, Sekhsaria S, Alling DW, Maguire TE, Malech HL. Genotype-dependent variability in flow cytometric evaluation of reduced nicotinamide adenine dinucleotide phosphate oxidase function in patients with chronic granulomatous disease. J Pediatr. 1996;128(1):104–7.PubMedCrossRef
20.
Zurück zum Zitat Jirapongsananuruk O, Malech HL, Kuhns DB, Niemela JE, Brown MR, Anderson-Cohen M, et al. Diagnostic paradigm for evaluation of male patients with chronic granulomatous disease, based on the dihydrorhodamine 123 assay. J Allergy Clin Immunol. 2003;111(2):374–9.PubMedCrossRef Jirapongsananuruk O, Malech HL, Kuhns DB, Niemela JE, Brown MR, Anderson-Cohen M, et al. Diagnostic paradigm for evaluation of male patients with chronic granulomatous disease, based on the dihydrorhodamine 123 assay. J Allergy Clin Immunol. 2003;111(2):374–9.PubMedCrossRef
21.
Zurück zum Zitat Bakri FG, Martel C, Khuri-Bulos N, Mahafzah A, El Khateeb MS, Al Wahadneh AM, et al. First report of clinical, functional, and molecular investigation of chronic granulomatous disease in nine Jordanian families. J Clin Immunol. 2009;29(2):215–30.PubMedCrossRef Bakri FG, Martel C, Khuri-Bulos N, Mahafzah A, El Khateeb MS, Al Wahadneh AM, et al. First report of clinical, functional, and molecular investigation of chronic granulomatous disease in nine Jordanian families. J Clin Immunol. 2009;29(2):215–30.PubMedCrossRef
22.
Zurück zum Zitat Liese J, Kloos S, Jendrossek V, Petropoulou T, Wintergerst U, Notheis G, et al. Long-term follow-up and outcome of 39 patients with chronic granulomatous disease. J Pediatr. 2000;137(5):687–93.PubMedCrossRef Liese J, Kloos S, Jendrossek V, Petropoulou T, Wintergerst U, Notheis G, et al. Long-term follow-up and outcome of 39 patients with chronic granulomatous disease. J Pediatr. 2000;137(5):687–93.PubMedCrossRef
23.
Zurück zum Zitat Ahlin A, de Boer M, Roos D, Leusen J, Smith CI, Sundin U, et al. Prevalence, genetics and clinical presentation of chronic granulomatous disease in Sweden. Acta Paediatr. 1995;84(12):1386–94.PubMedCrossRef Ahlin A, de Boer M, Roos D, Leusen J, Smith CI, Sundin U, et al. Prevalence, genetics and clinical presentation of chronic granulomatous disease in Sweden. Acta Paediatr. 1995;84(12):1386–94.PubMedCrossRef
24.
Zurück zum Zitat Cale CM, Jones AM, Goldblatt D. Follow up of patients with chronic granulomatous disease diagnosed since 1990. Clin Exp Immunol. 2000;120(2):351–5.PubMedCrossRef Cale CM, Jones AM, Goldblatt D. Follow up of patients with chronic granulomatous disease diagnosed since 1990. Clin Exp Immunol. 2000;120(2):351–5.PubMedCrossRef
25.
Zurück zum Zitat Jones LB, McGrogan P, Flood TJ, Gennery AR, Morton L, Thrasher A, et al. Special article: chronic granulomatous disease in the United Kingdom and Ireland: a comprehensive national patient-based registry. Clin Exp Immunol. 2008;152(2):211–8.PubMedCrossRef Jones LB, McGrogan P, Flood TJ, Gennery AR, Morton L, Thrasher A, et al. Special article: chronic granulomatous disease in the United Kingdom and Ireland: a comprehensive national patient-based registry. Clin Exp Immunol. 2008;152(2):211–8.PubMedCrossRef
26.
Zurück zum Zitat Kannengiesser C, Gerard B, El Benna J, Henri D, Kroviarski Y, Chollet-Martin S, et al. Molecular epidemiology of chronic granulomatous disease in a series of 80 kindreds: identification of 31 novel mutations. Hum Mutat. 2008;29(9):E132–49.PubMedCrossRef Kannengiesser C, Gerard B, El Benna J, Henri D, Kroviarski Y, Chollet-Martin S, et al. Molecular epidemiology of chronic granulomatous disease in a series of 80 kindreds: identification of 31 novel mutations. Hum Mutat. 2008;29(9):E132–49.PubMedCrossRef
27.
Zurück zum Zitat Kobayashi S, Murayama S, Takanashi S, Takahashi K, Miyatsuka S, Fujita T, et al. Clinical features and prognoses of 23 patients with chronic granulomatous disease followed for 21 years by a single hospital in Japan. Eur J Pediatr. 2008;167(12):1389–94.PubMedCrossRef Kobayashi S, Murayama S, Takanashi S, Takahashi K, Miyatsuka S, Fujita T, et al. Clinical features and prognoses of 23 patients with chronic granulomatous disease followed for 21 years by a single hospital in Japan. Eur J Pediatr. 2008;167(12):1389–94.PubMedCrossRef
28.
Zurück zum Zitat Saadat M, Ansari-Lari M, Farhud DD. Consanguineous marriage in Iran. Ann Hum Biol. 2004;31(2):263–9.PubMedCrossRef Saadat M, Ansari-Lari M, Farhud DD. Consanguineous marriage in Iran. Ann Hum Biol. 2004;31(2):263–9.PubMedCrossRef
29.
Zurück zum Zitat Wolach B, Gavrieli R, de Boer M, Gottesman G, Ben Ari J, Rottem M, et al. Chronic granulomatous disease in Israel: clinical, functional and molecular studies of 38 patients. Clin Immunol. 2008;129(1):103–14.PubMedCrossRef Wolach B, Gavrieli R, de Boer M, Gottesman G, Ben Ari J, Rottem M, et al. Chronic granulomatous disease in Israel: clinical, functional and molecular studies of 38 patients. Clin Immunol. 2008;129(1):103–14.PubMedCrossRef
30.
Zurück zum Zitat Soler-Palacin P, Margareto C, Llobet P, Asensio O, Hernandez M, Caragol I, et al. Chronic granulomatous disease in pediatric patients: 25 years of experience. Allergol Immunopathol (Madr). 2007;35(3):83–9.CrossRef Soler-Palacin P, Margareto C, Llobet P, Asensio O, Hernandez M, Caragol I, et al. Chronic granulomatous disease in pediatric patients: 25 years of experience. Allergol Immunopathol (Madr). 2007;35(3):83–9.CrossRef
31.
Zurück zum Zitat Hasui M. Chronic granulomatous disease in Japan: incidence and natural history. The Study Group of Phagocyte Disorders of Japan. Pediatr Int. 1999;41(5):589–93.PubMedCrossRef Hasui M. Chronic granulomatous disease in Japan: incidence and natural history. The Study Group of Phagocyte Disorders of Japan. Pediatr Int. 1999;41(5):589–93.PubMedCrossRef
32.
Zurück zum Zitat Carnide EG, Jacob CA, Castro AM, Pastorino AC. Clinical and laboratory aspects of chronic granulomatous disease in description of eighteen patients. Pediatr Allergy Immunol. 2005;16(1):5–9.PubMedCrossRef Carnide EG, Jacob CA, Castro AM, Pastorino AC. Clinical and laboratory aspects of chronic granulomatous disease in description of eighteen patients. Pediatr Allergy Immunol. 2005;16(1):5–9.PubMedCrossRef
33.
Zurück zum Zitat Agudelo-Florez P, Prando-Andrade CC, Lopez JA, Costa-Carvalho BT, Quezada A, Espinosa FJ, et al. Chronic granulomatous disease in Latin American patients: clinical spectrum and molecular genetics. Pediatr Blood Cancer. 2006;46(2):243–52.PubMedCrossRef Agudelo-Florez P, Prando-Andrade CC, Lopez JA, Costa-Carvalho BT, Quezada A, Espinosa FJ, et al. Chronic granulomatous disease in Latin American patients: clinical spectrum and molecular genetics. Pediatr Blood Cancer. 2006;46(2):243–52.PubMedCrossRef
34.
Zurück zum Zitat Takeya R, Sumimoto H. Molecular mechanism for activation of superoxide-producing NADPH oxidases. Mol Cells. 2003;16(3):271–7.PubMed Takeya R, Sumimoto H. Molecular mechanism for activation of superoxide-producing NADPH oxidases. Mol Cells. 2003;16(3):271–7.PubMed
35.
Zurück zum Zitat Lee PP, Chan KW, Jiang L, Chen T, Li C, Lee TL, et al. Susceptibility to mycobacterial infections in children with X-linked chronic granulomatous disease: a review of 17 patients living in a region endemic for tuberculosis. Pediatr Infect Dis J. 2008;27(3):224–30.PubMedCrossRef Lee PP, Chan KW, Jiang L, Chen T, Li C, Lee TL, et al. Susceptibility to mycobacterial infections in children with X-linked chronic granulomatous disease: a review of 17 patients living in a region endemic for tuberculosis. Pediatr Infect Dis J. 2008;27(3):224–30.PubMedCrossRef
36.
Zurück zum Zitat Finn A, Hadzic N, Morgan G, Strobel S, Levinsky RJ. Prognosis of chronic granulomatous disease. Arch Dis Child. 1990;65(9):942–5.PubMedCrossRef Finn A, Hadzic N, Morgan G, Strobel S, Levinsky RJ. Prognosis of chronic granulomatous disease. Arch Dis Child. 1990;65(9):942–5.PubMedCrossRef
37.
Zurück zum Zitat Mouy R, Fischer A, Vilmer E, Seger R, Griscelli C. Incidence, severity, and prevention of infections in chronic granulomatous disease. J Pediatr. 1989;114(4 Pt 1):555–60.PubMed Mouy R, Fischer A, Vilmer E, Seger R, Griscelli C. Incidence, severity, and prevention of infections in chronic granulomatous disease. J Pediatr. 1989;114(4 Pt 1):555–60.PubMed
Metadaten
Titel
Inheritance Pattern and Clinical Aspects of 93 Iranian Patients with Chronic Granulomatous Disease
verfasst von
Fatemeh Fattahi
Mohsen Badalzadeh
Leyla Sedighipour
Masoud Movahedi
Mohammad Reza Fazlollahi
Seyed Davood Mansouri
Ghamar Taj Khotaei
Mohammad Hassan Bemanian
Fatemeh Behmanesh
Amir Ali Hamidieh
Nasrin Bazargan
Setareh Mamishi
Fariborz Zandieh
Zahra Chavoshzadeh
Iraj Mohammadzadeh
Seyed Alireza Mahdaviani
Seyed Ahmad Tabatabaei
Najmeddin Kalantari
Shaghayegh Tajik
Marzieh Maddah
Zahra Pourpak
Mostafa Moin
Publikationsdatum
01.10.2011
Verlag
Springer US
Erschienen in
Journal of Clinical Immunology / Ausgabe 5/2011
Print ISSN: 0271-9142
Elektronische ISSN: 1573-2592
DOI
https://doi.org/10.1007/s10875-011-9567-x

Weitere Artikel der Ausgabe 5/2011

Journal of Clinical Immunology 5/2011 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Mehr Lebenszeit mit Abemaciclib bei fortgeschrittenem Brustkrebs?

24.05.2024 Mammakarzinom Nachrichten

In der MONARCHE-3-Studie lebten Frauen mit fortgeschrittenem Hormonrezeptor-positivem, HER2-negativem Brustkrebs länger, wenn sie zusätzlich zu einem nicht steroidalen Aromatasehemmer mit Abemaciclib behandelt wurden; allerdings verfehlte der numerische Zugewinn die statistische Signifikanz.

ADT zur Radiatio nach Prostatektomie: Wenn, dann wohl länger

24.05.2024 Prostatakarzinom Nachrichten

Welchen Nutzen es trägt, wenn die Strahlentherapie nach radikaler Prostatektomie um eine Androgendeprivation ergänzt wird, hat die RADICALS-HD-Studie untersucht. Nun liegen die Ergebnisse vor. Sie sprechen für länger dauernden Hormonentzug.

„Überwältigende“ Evidenz für Tripeltherapie beim metastasierten Prostata-Ca.

22.05.2024 Prostatakarzinom Nachrichten

Patienten mit metastasiertem hormonsensitivem Prostatakarzinom sollten nicht mehr mit einer alleinigen Androgendeprivationstherapie (ADT) behandelt werden, mahnt ein US-Team nach Sichtung der aktuellen Datenlage. Mit einer Tripeltherapie haben die Betroffenen offenbar die besten Überlebenschancen.

So sicher sind Tattoos: Neue Daten zur Risikobewertung

22.05.2024 Melanom Nachrichten

Das größte medizinische Problem bei Tattoos bleiben allergische Reaktionen. Melanome werden dadurch offensichtlich nicht gefördert, die Farbpigmente könnten aber andere Tumoren begünstigen.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.