Skip to main content
Top
Published in: Journal of Clinical Immunology 6/2014

01-08-2014 | Original Research

Clinical and Molecular Features of 38 Children with Chronic Granulomatous Disease in Mainland China

Authors: Huan Xu, Wen Tian, Shu-Juan Li, Lu-Ying Zhang, Wei Liu, Yao Zhao, Zhi-Yong Zhang, Xue-Mei Tang, Mo Wang, Dao-Qi Wu, Ji-Sheng Shi, Yuan Ding, Xiao-Dong Zhao, Xi-Qiang Yang, Li-Ping Jiang

Published in: Journal of Clinical Immunology | Issue 6/2014

Login to get access

Abstract

Purpose

Chronic granulomatous disease (CGD) is an inherited disorder, with phagocytes failing to produce antimicrobial superoxide due to deficient NADPH oxidase activity. Mutations in the gene encoding CYBB are responsible for the majority of the CGD cases. To date, there have been no reports on large samples of children with CGD in China. Therefore, in this study, we described the clinical and molecular features of 38 suspected CGD patients from 36 unrelated Chinese families.

Methods

Clinical diagnosis was performed using dihydrorhodamine assays detected by flow cytometry. Molecular analysis was used to identify underlying CGD-causative genes.

Results

The mean age of onset in our 38 patients was 3.4 months, while the mean age at diagnosis was 31.7 months. Apart from recurrent pneumonia and abscesses, tuberculosis (TB) and Bacille Calmette-Guerin (BCG) infections were notable features in our cohort. Overall, 17 cases died and patient 1 did not participate in the follow-up period . In total, we identified 29 different CYBB gene mutations in 31 patients. We found NCF1 and CYBA mutations in 3 and 2 patients, respectively. In addition, we identified 31 carriers and prenatally diagnosed 4 CGD and 4 healthy fetuses.

Conclusions

The results of our study demonstrate that children with BCG infections or recurrent TB infections should have immune function screening tests performed. Moreover, newborns with family histories of primary immunodeficiency diseases should avoid of BCG vaccination. Molecular analysis is an important tool for identifying patients, carriers, and high-risk CGD fetuses.
Literature
1.
go back to reference Holland SM. Chronic granulomatous disease. Hematology/Oncology Clinics of North America. 2013;27:89–99.CrossRefPubMed Holland SM. Chronic granulomatous disease. Hematology/Oncology Clinics of North America. 2013;27:89–99.CrossRefPubMed
2.
go back to reference Holland SM. Chronic granulomatous disease. Clinical Reviews in Allergy and Immunology. 2010;38:3–10.CrossRefPubMed Holland SM. Chronic granulomatous disease. Clinical Reviews in Allergy and Immunology. 2010;38:3–10.CrossRefPubMed
3.
go back to reference Mahdaviani SA, Mohajerani SA, Rezaei N, et al. Pulmonary manifestations of chronic granulomatous disease. Expert Review of Clinical Immunology. 2013;9:153–60.CrossRefPubMed Mahdaviani SA, Mohajerani SA, Rezaei N, et al. Pulmonary manifestations of chronic granulomatous disease. Expert Review of Clinical Immunology. 2013;9:153–60.CrossRefPubMed
5.
go back to reference Segal BH, Leto TL, Gallin JI, et al. Genetic, biochemical, and clinical features of chronic granulomatous disease. Medicine (Baltimore). 2000;79:170–200.CrossRef Segal BH, Leto TL, Gallin JI, et al. Genetic, biochemical, and clinical features of chronic granulomatous disease. Medicine (Baltimore). 2000;79:170–200.CrossRef
7.
go back to reference Köker MY, Camcıoğlu Y, van Leeuwen K, et al. Clinical, functional, and genetic characterization of chronic granulomatous disease in 89 Turkish patients. The Journal of Allergy and Clinical Immunology. 2013;132:1156–63.CrossRefPubMed Köker MY, Camcıoğlu Y, van Leeuwen K, et al. Clinical, functional, and genetic characterization of chronic granulomatous disease in 89 Turkish patients. The Journal of Allergy and Clinical Immunology. 2013;132:1156–63.CrossRefPubMed
9.
go back to reference Lee PP, Chan KW, Jiang L, 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. Pediatric Infectious Disease Journal. 2008;27:224–30.CrossRefPubMed Lee PP, Chan KW, Jiang L, 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. Pediatric Infectious Disease Journal. 2008;27:224–30.CrossRefPubMed
10.
go back to reference Liese J, Kloos S, Jendrossek V, et al. Long-term follow-up and outcome of 39 patients with chronic granulomatous disease. Journal of Pediatrics. 2000;137:687–93.CrossRefPubMed Liese J, Kloos S, Jendrossek V, et al. Long-term follow-up and outcome of 39 patients with chronic granulomatous disease. Journal of Pediatrics. 2000;137:687–93.CrossRefPubMed
11.
go back to reference Martire B, Rondelli R, Soresina 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. Clinical Immunology. 2008;126:155–64.CrossRefPubMed Martire B, Rondelli R, Soresina 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. Clinical Immunology. 2008;126:155–64.CrossRefPubMed
12.
go back to reference Williams DA, Tao W, Yang F, et al. Dominant negative mutation of the hematopoietic- specific Rho GTPase, Rac2, is associated with a human phagocyte immunodeficiency. Blood. 2000;96:1646–54.PubMed Williams DA, Tao W, Yang F, et al. Dominant negative mutation of the hematopoietic- specific Rho GTPase, Rac2, is associated with a human phagocyte immunodeficiency. Blood. 2000;96:1646–54.PubMed
13.
go back to reference Kim HY, Kim HJ, Ki CS, et al. Rapid determination of chimerism status using dihydrorhodamine assay in a patient with X-linked chronic granulomatous disease following hematopoietic stem cell transplantation. Annals of Laboratory Medicine. 2013;33:288–92.CrossRefPubMedPubMedCentral Kim HY, Kim HJ, Ki CS, et al. Rapid determination of chimerism status using dihydrorhodamine assay in a patient with X-linked chronic granulomatous disease following hematopoietic stem cell transplantation. Annals of Laboratory Medicine. 2013;33:288–92.CrossRefPubMedPubMedCentral
14.
go back to reference Vowells SJ, Sekhsaria S, Malech HL, et al. Flow cytometric analysis of the granulocyte respiratory burst: a comparison study of fluorescent probes. Journal of Immunological Methods. 1995;178:89–97.CrossRefPubMed Vowells SJ, Sekhsaria S, Malech HL, et al. Flow cytometric analysis of the granulocyte respiratory burst: a comparison study of fluorescent probes. Journal of Immunological Methods. 1995;178:89–97.CrossRefPubMed
15.
go back to reference Sun J, Wang Y, Liu D, et al. Prenatal diagnosis of X-linked chronic granulomatous disease by percutaneous umbilical blood sampling. Scandinavian Journal of Immunology. 2012;76:512–8.CrossRefPubMed Sun J, Wang Y, Liu D, et al. Prenatal diagnosis of X-linked chronic granulomatous disease by percutaneous umbilical blood sampling. Scandinavian Journal of Immunology. 2012;76:512–8.CrossRefPubMed
16.
go back to reference Yavuz Köker M, Metin A, Ozgür TT, et al. Prenatal diagnosis of chronic granulomatous disease in a male fetus. Iranian Journal of Allergy, Asthma, and Immunology. 2009;8:57–61.PubMed Yavuz Köker M, Metin A, Ozgür TT, et al. Prenatal diagnosis of chronic granulomatous disease in a male fetus. Iranian Journal of Allergy, Asthma, and Immunology. 2009;8:57–61.PubMed
17.
go back to reference Åhlin A, Fugeläng J, de Boer M, et al. Chronic granulomatous disease - haematopoietic stem cell transplantation versus conventional treatment. Acta Paediatrica. 2013;102:1087–94.PubMed Åhlin A, Fugeläng J, de Boer M, et al. Chronic granulomatous disease - haematopoietic stem cell transplantation versus conventional treatment. Acta Paediatrica. 2013;102:1087–94.PubMed
18.
go back to reference Hesseling AC, Rabie H, Marais BJ, et al. Bacille Calmette-Guérin vaccine-induced disease in HIV-infected and HIV-uninfected children. Clinical Infectious Diseases. 2006;42:548–58.CrossRefPubMed Hesseling AC, Rabie H, Marais BJ, et al. Bacille Calmette-Guérin vaccine-induced disease in HIV-infected and HIV-uninfected children. Clinical Infectious Diseases. 2006;42:548–58.CrossRefPubMed
19.
go back to reference Huard RC, Lazzarini LC, Butler WR. PCR-based method to differentiate the subspecies of the mycobacterium tuberculosis complex on the basis of genomic deletions. Journal of Clinical Microbiology. 2003;41:1637–50.CrossRefPubMedPubMedCentral Huard RC, Lazzarini LC, Butler WR. PCR-based method to differentiate the subspecies of the mycobacterium tuberculosis complex on the basis of genomic deletions. Journal of Clinical Microbiology. 2003;41:1637–50.CrossRefPubMedPubMedCentral
20.
go back to reference Fattahi F, Badalzadeh M, Sedighipour L, et al. Inheritance pattern and clinical aspects of 93 Iranian patients with chronic granulomatous disease. Journal of Clinical Immunology. 2011;31:792–801.CrossRefPubMed Fattahi F, Badalzadeh M, Sedighipour L, et al. Inheritance pattern and clinical aspects of 93 Iranian patients with chronic granulomatous disease. Journal of Clinical Immunology. 2011;31:792–801.CrossRefPubMed
21.
go back to reference Winkelstein JA, Marino MC, Johnston Jr RB, et al. Chronic granulomatous disease. Report on a national registry of 368 patients. Medicine (Baltimore). 2000;79:155–69.CrossRef Winkelstein JA, Marino MC, Johnston Jr RB, et al. Chronic granulomatous disease. Report on a national registry of 368 patients. Medicine (Baltimore). 2000;79:155–69.CrossRef
22.
go back to reference Wolach B, Gavrieli R, de Boer M, et al. Chronic granulomatous disease in Israel: clinical, functional and molecular studies of 38 patients. Clinical Immunology. 2008;129:103–14.CrossRefPubMed Wolach B, Gavrieli R, de Boer M, et al. Chronic granulomatous disease in Israel: clinical, functional and molecular studies of 38 patients. Clinical Immunology. 2008;129:103–14.CrossRefPubMed
23.
go back to reference Shojaei H, Rahimi-Hajiabadi H, Heidarieh P, et al. Molecular microbiological investigation of post-vaccination bacille Calmette-Guérin infection in Iranian patients. The International Journal of Tuberculosis and Lung Disease. 2011;15:1497–503.CrossRefPubMed Shojaei H, Rahimi-Hajiabadi H, Heidarieh P, et al. Molecular microbiological investigation of post-vaccination bacille Calmette-Guérin infection in Iranian patients. The International Journal of Tuberculosis and Lung Disease. 2011;15:1497–503.CrossRefPubMed
24.
go back to reference Norouzi S, Aghamohammadi A, Mamishi S, et al. Bacillus calmette-guérin (BCG) complications associated with primary immunodeficiency diseases. Journal of Infection. 2012;64:543–54.CrossRefPubMedPubMedCentral Norouzi S, Aghamohammadi A, Mamishi S, et al. Bacillus calmette-guérin (BCG) complications associated with primary immunodeficiency diseases. Journal of Infection. 2012;64:543–54.CrossRefPubMedPubMedCentral
25.
go back to reference Dankner WM, Waecker NJ, Essey MA, et al. Mycobacterium bovis infections in San Diego: a clinicoepidemiologic study of 73 patients and a historical review of a forgotten pathogen. Medicine (Baltimore). 1993;72:11–37.CrossRef Dankner WM, Waecker NJ, Essey MA, et al. Mycobacterium bovis infections in San Diego: a clinicoepidemiologic study of 73 patients and a historical review of a forgotten pathogen. Medicine (Baltimore). 1993;72:11–37.CrossRef
26.
go back to reference Hanoglu D, Ozgür TT, Ayvaz D, et al. Chronic granulomatous disease presenting with hypogammaglobulinemia. Journal of Investigational Allergology and Clinical Immunology. 2011;21:310–2.PubMed Hanoglu D, Ozgür TT, Ayvaz D, et al. Chronic granulomatous disease presenting with hypogammaglobulinemia. Journal of Investigational Allergology and Clinical Immunology. 2011;21:310–2.PubMed
27.
go back to reference Patiroglu T, Gungor HE, Lazaroski S, et al. Chronic granulomatous disease with markedly elevated IgE levels mimicking hyperimmunoglobulin E syndrome. Acta Microbiologica et Immunologica Hungarica. 2013;60:155–62.CrossRefPubMed Patiroglu T, Gungor HE, Lazaroski S, et al. Chronic granulomatous disease with markedly elevated IgE levels mimicking hyperimmunoglobulin E syndrome. Acta Microbiologica et Immunologica Hungarica. 2013;60:155–62.CrossRefPubMed
28.
go back to reference Heyworth PG, Noack D, Cross AR. Identification of a novel NCF-1 (p47-phox) pseudogene not containing the signature GT deletion: significance for A47° chronic granulomatous disease carrier detection. Blood. 2002;100:1845–51.CrossRefPubMed Heyworth PG, Noack D, Cross AR. Identification of a novel NCF-1 (p47-phox) pseudogene not containing the signature GT deletion: significance for A47° chronic granulomatous disease carrier detection. Blood. 2002;100:1845–51.CrossRefPubMed
29.
go back to reference El Kares R, Barbouche MR, Elloumi-Zghal H, et al. Genetic and mutational heterogeneity of autosomal recessive chronic granulomatous disease in Tunisia. Journal of Human Genetics. 2006;51:887–95.CrossRefPubMed El Kares R, Barbouche MR, Elloumi-Zghal H, et al. Genetic and mutational heterogeneity of autosomal recessive chronic granulomatous disease in Tunisia. Journal of Human Genetics. 2006;51:887–95.CrossRefPubMed
30.
go back to reference Noack D, Heyworth PG, Kyono W, et al. A second case of somatic triple mosaicism in the CYBB gene causing chronic granulomatous disease. Human Genetics. 2001;109(2):234–8.CrossRefPubMed Noack D, Heyworth PG, Kyono W, et al. A second case of somatic triple mosaicism in the CYBB gene causing chronic granulomatous disease. Human Genetics. 2001;109(2):234–8.CrossRefPubMed
31.
go back to reference de Boer M, Bakker E, Van Lierde S, et al. Somatic triple mosaicism in a carrier of X-linked chronic granulomatous disease. Blood. 1998;91(1):252–7.PubMed de Boer M, Bakker E, Van Lierde S, et al. Somatic triple mosaicism in a carrier of X-linked chronic granulomatous disease. Blood. 1998;91(1):252–7.PubMed
32.
go back to reference Kang EM, Malech HL. Advances in treatment for chronic granulomatous disease. Immunologic Research. 2009;43:77–84.CrossRefPubMed Kang EM, Malech HL. Advances in treatment for chronic granulomatous disease. Immunologic Research. 2009;43:77–84.CrossRefPubMed
33.
go back to reference The International Chronic Granulomatous Disease Cooperative Study Group. A controlled trial of interferon-gamma to prevent infection in chronic granulomatous disease. New England Journal of Medicine. 1991;324:509–16.CrossRef The International Chronic Granulomatous Disease Cooperative Study Group. A controlled trial of interferon-gamma to prevent infection in chronic granulomatous disease. New England Journal of Medicine. 1991;324:509–16.CrossRef
34.
go back to reference Güngör T, Teira P, Slatter M, et al. Reduced-intensity conditioning and HLA-matched haemopoietic stem-cell transplantation in patients with chronic granulomatous disease: a prospective multicentre study. Lancet. 2014;383(9915):436–48.CrossRefPubMed Güngör T, Teira P, Slatter M, et al. Reduced-intensity conditioning and HLA-matched haemopoietic stem-cell transplantation in patients with chronic granulomatous disease: a prospective multicentre study. Lancet. 2014;383(9915):436–48.CrossRefPubMed
Metadata
Title
Clinical and Molecular Features of 38 Children with Chronic Granulomatous Disease in Mainland China
Authors
Huan Xu
Wen Tian
Shu-Juan Li
Lu-Ying Zhang
Wei Liu
Yao Zhao
Zhi-Yong Zhang
Xue-Mei Tang
Mo Wang
Dao-Qi Wu
Ji-Sheng Shi
Yuan Ding
Xiao-Dong Zhao
Xi-Qiang Yang
Li-Ping Jiang
Publication date
01-08-2014
Publisher
Springer US
Published in
Journal of Clinical Immunology / Issue 6/2014
Print ISSN: 0271-9142
Electronic ISSN: 1573-2592
DOI
https://doi.org/10.1007/s10875-014-0061-0

Other articles of this Issue 6/2014

Journal of Clinical Immunology 6/2014 Go to the issue