title: Primary ciliary dyskinesia in adults.
abstract: BACKGROUND
  Primary ciliary dyskinesia is an autosomal recessive genetic disorder leading to structural and/or functional abnormalities of motor cilia. Impaired mucociliary clearance is responsible for the development of a multi-organ disease, which particularly affects the upper and lower airways.
  
  
  BACKGROUND
  In adults, primary ciliary dyskinesia is mainly characterized by bronchiectasis and chronic ear and sinus disorders. Situs inversus is found in half of patients and fertility disorders are commonly associated. Diagnosis is based on specialized tests: reduced level of nasal nitric oxide concentrations is suggestive of primary ciliary dyskinesia, but only a nasal or bronchial biopsy/brushing with analysis of beat pattern by videomicroscopy and/or analysis of cilia morphology by electronic microscopy can confirm the diagnosis. However, the diagnosis is difficult to achieve due to the limited access to these specialized tests and to difficulties in interpreting them. Genetic tests are under development and may provide new diagnostic tools. Treatment is symptomatic, based on airway clearance techniques (e.g., physiotherapy) and systemic and/or inhaled antibiotics. Prognosis is related to the severity of the respiratory impairment, which can be moderate or severe.
  
  
  CONCLUSIONS
  Diagnosis and management of primary ciliary dyskinesia remain poorly defined and should be supported by specialized centers to standardize the diagnosis, improve the treatment and promote research.
authors.affiliation: Department of respiratory medicine, Cochin hospital, Assistance publique-Hôpitaux de Paris, 75014 Paris, France.
authors.forename: I
authors.initials: I
authors.lastname: Honoré
authors.affiliation: Department of respiratory medicine, Cochin hospital, Assistance publique-Hôpitaux de Paris, 75014 Paris, France; Paris Descartes university, Sorbonne Paris Cité, 75005 Paris, France. Electronic address: pierre-regis.burgel@cch.aphp.fr.
authors.forename: P-R
authors.initials: PR
authors.lastname: Burgel
mesh_terms: D000328:Adult; D001987:Bronchiectasis / Q000175:diagnosis / Q000209:etiology; D002923:Cilia / Q000473:pathology; D003937:Diagnosis, Differential; D004427:Ear Diseases / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D007619:Kartagener Syndrome / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D009079:Mucociliary Clearance / Q000502:physiology; D010254:Paranasal Sinus Diseases / Q000175:diagnosis / Q000209:etiology
keywords: Bronchiectasis; Dilatation des bronches; Dyskinésie ciliaire primitive; Kartagener's syndrome; Monoxyde d’azote nasal; Nasal nitric oxide; Primary ciliary dyskinesia; Sinusite; Sinusitis; Syndrome de Kartagener