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Severe combined immunodeficiency, report of chilean patients diagnosed during the 1999-2020 period Inmunodeficiencia combinada severa, reporte de pacientes chilenos diagnosticados durante el período 1999-2020
Indexado
Scopus SCOPUS_ID:85099315983
DOI 10.32641/RCHPED.V91I6.2580
Año 2020
Tipo

Citas Totales

Autores Afiliación Chile

Instituciones Chile

% Participación
Internacional

Autores
Afiliación Extranjera

Instituciones
Extranjeras


Abstract



Severe combined immunodeficiency (SCID) is the most severe form of primary immunodeficiency. To date, there is little local information about this disease. Objective: To describe the epidemiology, complications, prognosis, and use of the BCG vaccine in Chilean patients with SCID. Patients and Method: Retrospective review of the clinical records of patients diagnosed with SCID by clinical immunologists between 1999 and 2020 throughout Chile. SCID was diagnosed according to the criteria proposed by Shearer: T lymphocytes (CD3+) < 300 cells/µL and proliferation 10% of the limit of normality in response to phytohemagglutinin or presence of T lymphocytes of maternal origin. Data collected from the clinical records were: sex, age at diagnosis, consanguinity, region of origin, lymphocyte subpopulations, genetic diagnosis, infectious and non-infectious complications, BCG vaccination and its complications, age at referral to the bone marrow transplant (BMT) center, and cause of non-BMT-related mortality. Results: Between 1999 and 2020, 25 patients were diagnosed with SCID. 78% of them were male, mean age at first manifestation of the disease was 2.3 months (0-7), while the mean age at diagnosis was 3.4 months (0-7). 16% of patients had a family history of SCID. 40% of cases were diagnosed within the Metropolitan Region. The most frequent immuno-phenotype was T-B-NK+ SCID (48%). Genetic studies were done in 69.5% of cases, mutations in the RAG2 gene were the most common etiology of SCID (39%). 88% of SCID patients received the Bacillus Calmette-Guerin (BCG) vaccine before diagnosis, including 2 cases with a known family history of SCID. 36% of those who received the vaccine had BCG-related complications. The mean age at referral to a bone marrow transplant center was 7.4 months (5-16). 11/25 patients died before being transferred to a transplant center. Discussion: There is a clinically significant delay between the first manifestations and the diagnosis of SCID in Chilean patients, as well as an important time gap between the diagnosis of SCID and referral to a center for BMT. Most SCID cases in Chile receive the BCG vaccine, despite a known family history of the disease, and frequently develop vaccine-related complications.

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Disciplinas de Investigación



WOS
Pediatrics
Scopus
Pediatrics, Perinatology And Child Health
SciELO
Health Sciences

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Publicaciones WoS (Ediciones: ISSHP, ISTP, AHCI, SSCI, SCI), Scopus, SciELO Chile.

Colaboración Institucional



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Autores - Afiliación



Ord. Autor Género Institución - País
1 Hoyos-Bachiloglu, Rodrigo Hombre Pontificia Universidad Católica de Chile - Chile
Hospital Dr Sotero del Rio - Chile
2 Rojas, Jorge - Hospital Exequiel González Cortés - Chile
3 BORZUTZKY-SCHACHTER, ARTURO Hombre Pontificia Universidad Católica de Chile - Chile
4 HERNANDEZ-SALAS, PAMELA ANDREA Mujer Hospital Dr. Luis Calvo Mackenna Hospital - Chile
5 Vinet, Ana María - Hospital Hernán Henríquez Aravena - Chile
Universidad de La Frontera - Chile
6 Bustos, Paula - Hospital Dra. Eloísa Díaz I. - Chile
Hospital La Florida Dra. Eloísa Díaz - Chile
7 Fernández, Fabiola - Hospital Clínico Herminda Martin - Chile
8 LAGOS-GOMEZ, MACARENA CECILIA Mujer Hospital Padre Hurtado - Chile
Clínica Las Condes - Chile
9 Strickler, Alexis - Hospital Dr. Eduardo Schütz Schroeder - Chile
10 Marinovic, María Angélica - Clínica Santa María - Chile
11 Casado, Cristina - Hospital Clínico San Borja Arriaran - Chile
12 Poli, María Cecilia - Clínica Alemana - Chile
Hospital de Niños Roberto del Río - Chile
13 King, Alejandra - Hospital Dr. Luis Calvo Mackenna Hospital - Chile
Clínica Alemana - Chile

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Financiamiento



Fuente
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Agradecimientos



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