Clinical aspects and main diagnostic methods of Chediak-Higashi syndrome

Chediak-Higashi syndrome is a disorder caused by a mutation in the LYST gene and characterized by immunodeficiency, oculocutaneous albinism, and neurological dysfunction resulting from changes in neutrophils. Homozygotes die in the first decade of life. The study is a literature review from different sources. We extracted articles published between 2000 and 2018 from SciELO, LILACS, MEDLINE (via PubMed), and Google Scholar databases. Our main objective was to report pathophysiology, clinical presentation, and the most common diagnostic methods. The syndrome affects the hematological and neurological systems, and laboratory diagnosis is first made by the presence of giant granules in leukocytes, mainly neutrophils in peripheral blood and bone marrow. A definitive diagnosis is made by cytochemical reaction (myeloperoxidase) and detection of mutation by molecular methods. (AU)

Chédiak-Higashi syndrome: presentation of seven cases

Context: Chédiak-Higashi Syndrome (CHS) is a rare autosomal recessive disease characterized by recurrent infections, giant cytoplasmic granules, and oculocutaneous albinism. Objective: To describe clinical and laboratory findings from CHS patients. Design: Case report. Setting: The patients were admitted into the Allergy and Immunology Unit of the Instituto da Criança, a tertiary public care institution. Cases Report: Seven patients had oculocutaneous albinism, recurrent infections and giant cytoplasmic granules in the leukocyte. One patient had low IgG levels and three showed impaired bactericidal activity of neutrophils. Six patients died of infectious complications during the accelerated phase. Therapy included ascorbic acid and antibiotics. Chemotherapy was used for the accelerated phase in two patients. Bone marrow transplantation (BMT) was proposed for one patient. Discussion: The authors emphasize the need for early diagnosis and therapy of CHS. BMT should be indicated before the accelerated phase of the disease has developed.

Síndrome de Chediak-Higashi: relato de caso e revisäo de literatura / Chediak-Higashi syndrome: case report and literature review

Objetivo: Apresentar o caso de paciente parda portadora de síndrome de Chediak-Higashi (SCH). Método: Além dos dados de história clínica e de exame físico a paciente foi submetida a investigação laboratorial para imunodeficiência. Resultados: As principais manifestações clínicas da paciente eram albinismo parcial óculo-cutâneo e infecções de repetição. Os exames laboratoriais revelaram a presença de inclusões intracitoplasmáticas gigantes em leucócitos do sangue periférico e em células precursoras na medula óssea. A avaliação funcional dos leucócitos do sangue periférico foi normal. Quatro meses após o diagnóstico, a criança desenvolveu a fase linfoproliferativa evoluindo para óbito. Conclusões: São discutidas as principais alterações laboratoriais que caracterizam a SCH, tece-se comentários sobre os possíveis fatores etiológicos, bem como os avanços no seu tratamento.