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Primary ciliary dyskinesia presentation in 60 children according to ciliary ultrastructure

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Abstract

Primary ciliary dyskinesia (PCD) is an inherited disease related to ciliary dysfunction, with heterogeneity in clinical presentation and in ciliary ultrastructural defect. Our study intended to determine if there are phenotypic differences in patients with PCD based on ciliary ultrastructural abnormality. In this retrospective study carried out among 60 children with a definitive diagnosis of PCD, we analyzed clinical, radiological, and functional features at diagnosis and at last recorded visit, according to cilia defect (absence of dynein arms: DAD group, n = 36; abnormalities of the central complex: CCA group, n = 24). Onset of respiratory symptoms occurred later in the CCA than in the DAD group (9.5 versus 0.5 months, p = 0.03). Situs inversus was only observed in the DAD group, while respiratory disease in siblings were more frequent in the CCA group (p = 0.003). At diagnosis, clinical presentation was more severe in the CCA group: frequency of respiratory tract infections (p = 0.008), rhinosinusitis (p = 0.02), otitis complications (p = 0.0001), bilateral bronchiectasis (p = 0.04), and number of hypoxemic patients (p = 0.03). Pulmonary function remained stable in both groups, but outcome was better in the CCA than in the DAD group: less antibiotic therapy and hypoxemic patients (p = 0.004). In conclusion, our results underlined the relationship between the severity of clinical presentation and the ultrastructural ciliary defect.

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Acknowledgments

The authors are grateful to the children and their families who participated in this study and thank all referring physicians. This work was supported by grants from the Legs Poix from the Chancellerie des Universités, the Assistance Publique-Hôpitaux de Paris (PHRC AOM06053, P060245), the Milena Carvajal ProKartagener Foundation, and the Fondation pour la Recherche Médicale (DEQ20120323689).

Conflict of interest

All of the authors are aware and agree to the content of the paper and approve its submission. None of the authors have any financial relationship with commercial or other associations that might pose a conflict of interest.

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Authors and Affiliations

  1. Centre de reference des maladies respiratoires rares, Service de pneumologie pediatrique, Hopital Armand-Trousseau and INSERM UMR S-938, AP-HP, 75571, Paris Cedex 12, France

    Christelle Vallet, Sylvain Blanchon, Brigitte Fauroux, Annick Clément & Aline Tamalet

  2. Cytogenetique et embryologie medicales, Service de genetique et embryologie medicales Hopital Armand-Trousseau, AP-HP, 75571, Paris Cedex 12, France

    Estelle Escudier & Serge Amselem

  3. INSERM Unite U933, Universite Pierre et Marie Curie, Paris, France

    Estelle Escudier & Serge Amselem

  4. Service de sante publique, Groupe hospitalier Henri-Mondor—Albert Chenevier, AP-HP, 94010, Creteil, France

    Françoise Roudot-Thoraval

  5. Service d’explorations fonctionnelles respiratoires, Hopital Armand-Trousseau, AP-HP, 75571, Paris Cedex 12, France

    Nicole Beydon & Michèle Boulé

  6. Service d’anatomo-pathologie (laboratoire de microscopie electronique), Hopital intercommunal, 94010, Creteil, France

    Anne Marie Vojtek

  7. Service de pneumologie pédiatrique, Hôpital Armand Trousseau, Paris, 75012, France

    Aline Tamalet

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  1. Christelle Vallet
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  2. Estelle Escudier
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  3. Françoise Roudot-Thoraval
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  5. Brigitte Fauroux
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  8. Anne Marie Vojtek
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  9. Serge Amselem
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  10. Annick Clément
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  11. Aline Tamalet
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Correspondence to Aline Tamalet.

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Vallet, C., Escudier, E., Roudot-Thoraval, F. et al. Primary ciliary dyskinesia presentation in 60 children according to ciliary ultrastructure. Eur J Pediatr 172, 1053–1060 (2013). https://doi.org/10.1007/s00431-013-1996-5

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  • DOI: https://doi.org/10.1007/s00431-013-1996-5

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