MRI and Biomarkers in Early Detection of Pulmonary Changes in Ataxia-Telangiectasia

磁共振成像和生物标志物在毛细血管扩张性共济失调症肺部病变早期检测中的应用

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Abstract

BACKGROUND Respiratory diseases remain the main reason of severe complications and/or death in patients with ataxia-telangiectasia (A-T). Appropriate selection of diagnostics for these diseases is important, especially since A-T is characterized by radiosensitivity. The aim of the study was to assess whether lung magnetic resonance imaging (MRI) combined with the measurement of the acute-phase proteins: C-reactive protein (CRP) and serum amyloid A (SAA) in serum could be a useful diagnostic tool for early detection of lung lesions in patients with AT. MATERIAL AND METHODS Chest MRI was performed in 27 A-T patients - 14 males and 13 females, age range 3-32.8 years). SAA and CRP were measured in simultaneously collected serum samples by nephelometry and immunoturbidimetry, respectively. RESULTS Patients were qualified into 4 categories based on MRI findings. Group 0 consisted of 14 patients without any pulmonary changes. Group 1 consisted of 3 patients with sporadic enlarged lymph nodes. Group 2 consisted of 6 patients with single streaked changes. Group 3 consisted of 4 patients with severe bronchial and parenchymal alterations. Elevated serum SAA were correlated with pulmonary changes in group 3 (4/11) and group 2 (3/11), while CRP was elevated only in 2 patients from group 3. MRI was repeated in 11 out of 27 patients. Two patients had progression, 1 had regression, and the rest showed no changes. CONCLUSIONS Lung alterations in patients with A-T and higher radiation sensitivity can be evaluated by a radiation-free MRI technique. We found a strong correlation between concentration of SAA and progression of lung damage.

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