title: Clinical, immunological, and molecular analysis in a large cohort of patients with X-linked agammaglobulinemia: an Italian multicenter study.
abstract: A questionnaire-based retrospective clinical and immunological survey was conducted in 73 males with a definite diagnosis of X-linked agammaglobulinemia based on BTK sequence analysis. Forty-four were sporadic and 29 familial cases. At December 2000, the patients' ages ranged from 2 to 33 years; mean age at diagnosis and mean duration of follow-up were 3.5 and 10 years respectively. After the mid-1980s all but 2 were on intravenous immunoglobulin (IVIG) substitution therapy, with residual IgG >500 mg/dl in 94% of the patients at the time of enrollment. Respiratory infections were the most frequent manifestation both prior to diagnosis and over follow-up. Chronic lung disease (CLD) was present in 24 patients, in 15 already at diagnosis and in 9 more by 2000. The cumulative risk to present at diagnosis with CLD increased from 0.17 to 0.40 and 0.78 when the diagnosis was made at the ages of 5, 10, and 15 years respectively. For the 9 patients who developed CLD during follow-up, the duration of follow-up, rather than age at diagnosis; previous administration of intramuscular immunoglobulin; and residual IgG levels had a significant effect on the development of CLD. Chronic sinusitis was present in 35 patients (48%), in 15 already at diagnosis and in 20 by 2000. Sistemic infections such as sepsis and meningitis/meningoencephalitis decreased over follow-up, probably due to optimal protection provided by high circulating IgG levels reached with IVIG.
authors.affiliation: Dipartimento di Pediatria, Università di Brescia, Italy. plebani@master.cci.unibs.it
authors.forename: Alessandro
authors.initials: A
authors.lastname: Plebani
authors.forename: Annarosa
authors.initials: A
authors.lastname: Soresina
authors.forename: Roberto
authors.initials: R
authors.lastname: Rondelli
authors.forename: Giorgio M
authors.initials: GM
authors.lastname: Amato
authors.forename: Chiara
authors.initials: C
authors.lastname: Azzari
authors.forename: Fabio
authors.initials: F
authors.lastname: Cardinale
authors.forename: Gianantonio
authors.initials: G
authors.lastname: Cazzola
authors.forename: Rita
authors.initials: R
authors.lastname: Consolini
authors.forename: Domenico
authors.initials: D
authors.lastname: De Mattia
authors.forename: Grazia
authors.initials: G
authors.lastname: Dell'Erba
authors.forename: Marzia
authors.initials: M
authors.lastname: Duse
authors.forename: Maurilia
authors.initials: M
authors.lastname: Fiorini
authors.forename: Silvana
authors.initials: S
authors.lastname: Martino
authors.forename: Baldassarre
authors.initials: B
authors.lastname: Martire
authors.forename: Massimo
authors.initials: M
authors.lastname: Masi
authors.forename: Virginia
authors.initials: V
authors.lastname: Monafo
authors.forename: Viviana
authors.initials: V
authors.lastname: Moschese
authors.forename: Luigi D
authors.initials: LD
authors.lastname: Notarangelo
authors.forename: Paola
authors.initials: P
authors.lastname: Orlandi
authors.forename: Pietro
authors.initials: P
authors.lastname: Panei
authors.forename: Andrea
authors.initials: A
authors.lastname: Pession
authors.forename: Maria C
authors.initials: MC
authors.lastname: Pietrogrande
authors.forename: Claudio
authors.initials: C
authors.lastname: Pignata
authors.forename: Isabella
authors.initials: I
authors.lastname: Quinti
authors.forename: Vanda
authors.initials: V
authors.lastname: Ragno
authors.forename: Paolo
authors.initials: P
authors.lastname: Rossi
authors.forename: Antonella
authors.initials: A
authors.lastname: Sciotto
authors.forename: Achille
authors.initials: A
authors.lastname: Stabile
mesh_terms: D000293:Adolescent; D000328:Adult; D000077329:Agammaglobulinaemia Tyrosine Kinase; D000361:Agammaglobulinemia / Q000150:complications* / Q000235:genetics* / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D015331:Cohort Studies; D005500:Follow-Up Studies; D008040:Genetic Linkage; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007231:Infant, Newborn; D008171:Lung Diseases / Q000209:etiology; D008297:Male; D009154:Mutation; D011505:Protein-Tyrosine Kinases / Q000235:genetics; D014960:X Chromosome
chemical_list: D016756:Immunoglobulins, Intravenous; D011505:Protein-Tyrosine Kinases; D000077329:Agammaglobulinaemia Tyrosine Kinase; C000625949:BTK protein, human