2020, Number 2
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Rev Cubana Hematol Inmunol Hemoter 2020; 36 (2)
Advances in the diagnosis of chronic granulomatous disease: the first family study in Cuba
Díaz DG, Casado HI, Marsán SV, Macías ACM
Language: Spanish
References: 21
Page: 1-15
PDF size: 557.05 Kb.
ABSTRACT
Introduction: Chronic granulomatous disease is a primary immunodeficiency caused by mutations in the NADPH oxidase enzymes. This compromises the production of oxygen reactive species, which are important against pathogens. The dihydrorhodamine oxidation test is an effective method for diagnosing the disease.
Objective: To demonstrate the usefulness of the dihydrorhodamine oxidation test and the inheritance pattern in confirming the diagnosis of chronic granulomatous disease in a patient.
Methods: A case study of a family with a diagnosis of chronic granulomatous disease. A peripheral blood sample was taken from three individuals and by flow cytometry. The dihydrorhodamine oxidation test was performed under stimulation with phorbolmyristate acetate, and lymphocyte subpopulations were evaluated. The samples were read on a GALLIOS, Beckman Coulter cytometer. The data obtained were analyzed using the computer program Kaluza.
Results: The male patient had a positive dihydrorhodamine oxidation value of 0.87%, which confirmed an inheritance pattern linked to the X chromosome; while the carrier mother and twin sister had values of 46.76% and 37.32%, respectively. Alterations were found in the lymphocyte subpopulations.
Conclusions: The dihydrorhodamine oxidation test is a very effective, fast and simple method that confirms the diagnosis of chronic granulomatous disease and determines the inheritance pattern and phenotype of the disease. In addition, it allows the identification of female carriers according to the distribution of normal neutrophils and those with the CYBB mutation.
REFERENCES
Kutlug S, Sensoy G, Birinci A, Saraymen B, Yavuz Köker M, Yildiran A. Seven chronic granulomatous disease cases in a single-center experience and a review of the literature. Asian Pac J Allergy Immunol. 2018;36:35-41. doi10.12932/AP0859
Medrano A, Morales AE, Valencia R, Hernández DR. Enfermedad granulomatosa crónica. Med Int Méx. 2017;33(3):407-14.
YuJE, Azar AE, Chong HJ, Jongco AM, Prince BT. Considerations in the Diagnosis of Chronic Granulomatous Disease. J Pediatric Infect Dis Soc. 2018;7(S1):S6-11.
Arnold DE. Heimall JR. A Review of Chronic Granulomatous Disease. Adv Ther. 2017;34:2543-57. doi 10.1007/s12325-017-0636-2.
Marsán V, del Valle LO, Macías C, Palma L, García I, Sánchez M. et al. Enfermedad Granulomatosa Crónica. Revista Cubana de Hematología e Inmunología y Hemoter. 2014;30(3):1-6.
Rojas JL, Álvarez JA, Montoya JD, Trujillos CM. Validación de la técnica de dihidrorodamina 123 para el diagnóstico de la enfermedad granulomatosa crónica en Colombia. Inmunología. 2014;33(3):71-80.
Sanabria D, Giménez V, Carpinelli MM, Rolón J. Primera experiencia en Paraguay para determinación de valores de referencia por la técnica dedihidrorodamina (DHR) en la evaluación del estallido respiratorio de neutrófilos en niños sanos. Pediatr (Asunción). 2016;43(1):33-8.
Vowells SJ, Sekhsaria S, Malech HL, Shalit M, Fleisher TA. Flow cytometric analysis of the granulocyte respiratory burst: A comparison study of fluorescent probes. J Immunol Methods. 1995;178:89-97.
Rider NL. Jameson MB y Creech CB. Chronic Granulomatous Disease: Epidemiology, Pathophysiology, and Genetic Basis of Disease. J Pediatric Infect Dis Soc. 2018:7(S1):S2-5.
Marciano BE, Spalding C, Fitzgerald A, Mann D, Brown T, Osgood S, et al. Common Severe Infections in Chronic Granulomatous Disease. Rev Infect Dis. 2015;60(8):1176-83.
Khangura SK, Kamal N, Ho N, Quezado M, Zhao X, Marciano B. Gastrointestinal Features of Chronic Granulomatous Disease Found During Endoscopy. Clin Gastroenterol Hepatol. 2016;14(3):395-402.e5. doi:10.1016/j.cgh.2015.10.030.
Magnani A, Brosselin P, Beaut J, de Vergnes N, Mouy R, Debre M. et al. Inflammatory manifestations in a single-center cohort of patients with chronic granulomatous disease. J Allergy Clin Immunol. 2014;134(3):655-62.
Holland SM. Chronic Granulomatous Disease. Hematol Oncol Clin N Am. 2013;27:89-99.
Delmonte OM y Fleisher TA. Flow cytometry: Surface markers and beyond. J Allergy Clin Immunol. 2018;143(2):528-37.
Marciano BE, Zerbe CS, Falcone L, Ding Li, DeRavin SS, Daub J. X-linked carriers of chronic granulomatous disease: Illness, lyonization, and stability. J Allergy Clin Immunol. 2017;141(1):365-71.
Fleisher TA, Madkaikar M y Rosenzweig SD. Application of Flow Cytometry in the Evaluation of Primary Immunodeficiencies. Indian J Pediatr. 2016;83(5):444-9. doi:10.1007/s12098-015-2011-0
Abraham RS, Aubertb G. Flow Cytometry, a Versatile Tool for Diagnosis and Monitoring of Primary Immunodeficiencies. Clin Vaccine Immunol. 2016;23(4):254-71. doi:10.1128/CVI.00001-16
Vignesh P, Sharma M, Pilania RK, Shandilya JK, Anit K, Rawat A. Myriad Faces of Chronic Granulomatous Disease: All in an Indian Family with Novel CYBB Defect. J Clin Immunol. 2019 Aug;39(6):611-615. doi: 10.1007/s10875-019-00661-0.
Henrickson SE, Jongco AM, Thomsen KF, Garabedian EK, Thomsen IP. Noninfectious Manifestations and Complications of Chronic Granulomatous Disease. J Pediatric Infect Dis Soc. 2018;7(S1):S18-24. DOI: 10.1093/jpids/piy014
Espinoza G, Butte K, Palma V, Norambuena X, Quezada A. Enfermedad granulomatosa crónica: tres casos clínicos con diferentes formas de presentación. Rev Chil Pediatr. 2015;86(2):112-6.
Giardino G, Pia M, Delmonte O, Migliavacca M, Palterer B, Loffredo L. NADPH Oxidase Deficiency: A Multisystem Approach. Oxid Med Cell Longev. 2017;ID4590127:1-23.