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| DOI | 10.32641/RCHPED.V91I6.2580 | ||
| Año | 2020 | ||
| Tipo |
Citas Totales
Autores Afiliación Chile
Instituciones Chile
% Participación
Internacional
Autores
Afiliación Extranjera
Instituciones
Extranjeras
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.
| 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 |