Description of BCG and Tuberculosis Disease in a Cohort of 79 Patients with Chronic Granulomatous Disease.

Autor: León-Lara X; Laboratory of Immunodeficiency, National Institute of Pediatrics, Mexico City, Mexico., Pérez-Blanco U; Laboratory of Immunodeficiency, National Institute of Pediatrics, Mexico City, Mexico., Yamazaki-Nakashimada MA; Department of Clinical Immunology, National Institute of Pediatrics, Mexico City, Mexico., Bustamante-Ogando JC; Laboratory of Immunodeficiency, National Institute of Pediatrics, Mexico City, Mexico.; Department of Clinical Immunology, National Institute of Pediatrics, Mexico City, Mexico., Aguilar-Gómez N; Department of Infectious Diseases, National Institute of Pediatrics, Mexico City, Mexico., Cristerna-Tarrasa H; Department of Infectious Diseases, National Institute of Pediatrics, Mexico City, Mexico., Staines-Boone AT; Department of Clinical Immunology, UMAE # 25, Monterrey, Mexico., Saucedo-Ramírez OJ; Department of Allergy, Children's Hospital 'Federico Gómez', Mexico City, Mexico., Fregoso-Zuñiga E; Department of Immunology, Children's Hospital of Morelia 'Eva Sámano de López Mateos', Michoacan, Mexico., Macías-Robles AP; Department of Pediatric Allergy and Clinical Immunology, UMAE CMNO, Guadalajara, Mexico., Canseco-Raymundo MR; Department of Allergy and Clinical Immunology, UMAE 'La Raza', Mexico City, Mexico., Venancio-Hernández M; Department of Allergy and Clinical Immunology, UMAE 'La Raza', Mexico City, Mexico., Moctezuma-Trejo C; Department of Allergy and Clinical Immunology, UMAE 'La Raza', Mexico City, Mexico., Gámez-González B; Department of Allergy and Clinical Immunology, Chihuahua Pediatric Specialty Hospital, Chihuahua, Mexico., Zarate-Hernández C; CRAIC, University Hospital 'Dr. José Eleuterio González', UANL, Monterrey, Mexico., Ramírez-Rivera R; Pediatrics Department, Specialty Hospital for Children and Women 'Dr Felipe Nuñez Lara', Queretaro, Mexico., Scheffler-Mendoza S; Department of Clinical Immunology, National Institute of Pediatrics, Mexico City, Mexico., Jiménez-Polvo N; Department of Immunology, Children's Hospital of Tlaxcala, Mexico, Tlaxcala, Mexico., Hernández-Nieto L; Department of Allergy and Immunology, Juárez Hospital of Mexico, Mexico City, Mexico., Carmona-Vargas J; Department of Infectious Diseases, Hospital for Children and Women of San Luis Potosí, San Luis Potosí, Mexico., García-Cruz ML; Department of Otorhinolaryngology, INER, Mexico City, Mexico., Zavaleta-Martínez Ó; Department of Immunology, ISSEMyM, Toluca, State of Mexico, Mexico., Román-Montes CM; Clinical Microbiology Laboratory, INCMNSZ, Mexico City, Mexico.; Department of Infectious Diseases, INCMNSZ, Mexico City, Mexico., Cervantes-Parra V; Department of Pediatric Infectious Disease, ISSSTE 1° de Octubre, Mexico City, Mexico., González-Reynoso A; Department of Pediatrics, General Hospital Agustín O' Horan, Mérida, Yucatan, Mexico., Guzmán-Cotaya R; Department of Pediatrics, General Hospital Agustín O' Horan, Mérida, Yucatan, Mexico., Espinosa-Rosales F; FUMENI A.C., Mexico City, Mexico., Saltigeral-Simental P; Department of Infectious Diseases, National Institute of Pediatrics, Mexico City, Mexico., Espinosa-Padilla S; Laboratory of Immunodeficiency, National Institute of Pediatrics, Mexico City, Mexico., Blancas Galicia L; Laboratory of Immunodeficiency, National Institute of Pediatrics, Mexico City, Mexico. blancas.lizbeth@gmail.com.
Jazyk: angličtina
Zdroj: Journal of clinical immunology [J Clin Immunol] 2024 Aug 05; Vol. 44 (8), pp. 171. Date of Electronic Publication: 2024 Aug 05.
DOI: 10.1007/s10875-024-01778-7
Abstrakt: Purpose: Chronic granulomatous disease (CGD) is an inherited immunodeficiency caused by pathogenic variants of genes encoding the enzyme complex NADPH oxidase. In countries where tuberculosis (TB) is endemic and the Bacillus Calmette-Guérin (BCG) vaccine is routinely administered, mycobacteria are major disease-causing pathogens in CGD. However, information on the clinical evolution and treatment of mycobacterial diseases in patients with CGD is limited. The present study describes the adverse reactions to BCG and TB in Mexican patients with CGD.
Methods: Patients with CGD who were evaluated at the Immunodeficiency Laboratory of the National Institute of Pediatrics between 2013 and 2024 were included. Medical records were reviewed to determine the clinical course and treatment of adverse reactions to BCG and TB disease.
Results: A total of 79 patients with CGD were included in this study. Adverse reactions to BCG were reported in 55 (72%) of 76 patients who received the vaccine. Tuberculosis was diagnosed in 19 (24%) patients. Relapse was documented in three (10%) of 31 patients with BGC-osis and six (32%) of 19 patients with TB, despite antituberculosis treatment. There was no difference in the frequency of BCG and TB disease between patients with pathogenic variants of the X-linked CYBB gene versus recessive variants.
Conclusions: This report highlights the importance of considering TB in endemic areas and BCG complications in children with CGD to enable appropriate diagnostic and therapeutic approaches to improve prognosis and reduce the risk of relapse.
(© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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