Articles

First Cystic Fibrosis Patient Registry Annual Data Report-Cystic Fibrosis Foundation of Iran

Abstract

Cystic fibrosis (CF), as a fatal genetic condition, is associated with high morbidity and mortality rates. In Iran, limited studies exist on this disease. This study aims to compare the demographic, clinical and paraclinical data of CF patients. This cross-sectional study was conducted in 2014-2015 on 174 CF patients referred to the Tehran Children Medical Center hospital, which is the main referral center for CF. For each patient, the forced  expiratory volume in one second (FEV1) was measured and the comparative demographic, clinical and laboratory data of patients were recorded. Overall, 59% of studied patients were boys (n=102) and 41% were girls (n=72). The mean patient age (and standard deviations) was 7.1 ±5.7 years, with a range of 10 days to 28 years. In 67% of cases, the disease was diagnosed before their first birthday. The patients in this study were classified based on the FEV1 into mild (62%), moderate (33%) and sever (5%), indicating the degree of pulmonary complications. Cultures of respiratory secretions were positive for Pseudomonas aeruginosa and Staphylococcus aureus, in 23% and 16% of cases, respectively. In total, 61% of patients (n=83) were assigned to receive oral azithromycin for prophylaxis. Gastroesophageal reflux (reflux) was the most common gastrointestinal complication (35%), Regarding the complex nature of CF and the necessity of constant monitoring of patients during the life-span, the comparative demographic, clinical and laboratory analysis of patients and registering and standardization of patients’ data, can be a major step in the better understanding of the disease, and thereby increasing the quality of life and life expectancy in the affected population.

Kanavakis E, Efthymiadou A, Strofalis S, Doudounakis S, Traeger-Synodinos J, Tzetis M. Cystic fibrosis in Greece: molecular diagnosis, haplotypes, prenatal diagnosis and carrier identification amongst high-risk individuals. Clinical genetics. 2003;63(5):400-9.

Riordan JR, Rommens JM, Kerem B, Alon N, Rozmahel R, Grzelczak Z, et al. Identification of the cystic fibrosis gene: cloning and characterization of complementary DNA. Science (New York, NY). 1989;245(4922):1066-73.

O'Sullivan BP, Freedman SD. Cystic fibrosis. Lancet (London, England). 2009;373(9678):1891-904.

Mayell SJ, Munck A, Craig JV, Sermet I, Brownlee KG, Schwarz MJ, et al. A European consensus for the evaluation and management of infants with an equivocal diagnosis following newborn screening for cystic fibrosis. Journal of cystic fibrosis : official journal of the European Cystic Fibrosis Society. 2009;8(1):71-8.

Rowe SM, Miller S, Sorscher EJ. Mechanisms of disease: cystic fibrosis. N Engl J Med. 2005;352.

Fanen P, Wohlhuter-Haddad A, Hinzpeter A. Genetics of cystic fibrosis: CFTR mutation classifications toward genotype-based CF therapies. Int J Biochem Cell Biol. 2014;52.

Robinson NB, DiMango E. Prevalence of gastroesophageal reflux in cystic fibrosis and implications for lung disease. Annals of the American Thoracic Society. 2014;11(6):964-8.

Hamutcu R, Woo MS. Advanced cystic fibrosis lung disease in children. Current opinion in pulmonary medicine. 2001;7(6):448-53.

Wilschanski M, Novak I. The Cystic Fibrosis of Exocrine Pancreas. Cold Spring Harbor Perspectives in Medicine. 2013;3(5):a009746.

Ozcelik U, Gocmen A, Kiper N, Coskun T, Yilmaz E, Ozguc M. Sodium chloride deficiency in cystic fibrosis patients. European journal of pediatrics. 1994;153(11):829-31.

Kang SH, Dalcin PdTR, Piltcher OB, Migliavacca RdO. Chronic rhinosinusitis and nasal polyposis in cystic fibrosis: update on diagnosis and treatment. Jornal Brasileiro de Pneumologia. 2015;41(1):65-76.

Stern RC, Izant RJ, Jr., Boat TF, Wood RE, Matthews LW, Doershuk CF. Treatment and prognosis of rectal prolapse in cystic fibrosis. Gastroenterology. 1982;82(4):707-10.

Angelico M, Gandin C, Canuzzi P, Bertasi S, Cantafora A, De Santis A, et al. Gallstones in cystic fibrosis: a critical reappraisal. Hepatology (Baltimore, Md). 1991;14(5):768-75.

Adler AI, Shine B, Haworth C, Leelarathna L, Bilton D. Hyperglycemia and Death in Cystic Fibrosis–Related Diabetes. Diabetes Care. 2011;34(7):1577-8.

de Vries HG, Collee JM, de Walle HE, van Veldhuizen MH, Smit Sibinga CT, Scheffer H, et al. Prevalence of delta F508 cystic fibrosis carriers in The Netherlands: logistic regression on sex, age, region of residence and number of offspring. Human genetics. 1997;99(1):74-9.

McKone EF, Borowitz D, Drevinek P, Griese M, Konstan MW, Wainwright C, et al. Long-term safety and efficacy of ivacaftor in patients with cystic fibrosis who have the Gly551Asp-CFTR mutation: a phase 3, open-label extension study (PERSIST). Lancet Respir Med. 2014;S2213–2600.

Whiting P, Al M, Burgers L, Westwood M, Ryder S, Hoogendoorn M, et al. Ivacaftor for the treatment of patients with cystic fibrosis and the G551D mutation: a systematic review and cost-effectiveness analysis. Health technology assessment (Winchester, England). 2014;18(18):1-106.

Modarresi M, Faghihinia J, Baharzadeh F. Cystic Fibrosis Prevalence among a Group of High-Risk Iranian Children. Journal of Isfahan Medical School. 2012;30(180):248-54.

Farrell PM, Rosenstein BJ, White TB, Accurso FJ, Castellani C, Cutting GR, et al. Cystic Fibrosis Foundation: Cystic Fibrosis Foundation. Guidelines for diagnosis of cystic fibrosis in newborns through older adults: Cystic Fibrosis Foundation consensus report. J Pediatr. 2008;153.

Martinez-Pacheco M, Hidalgo-Miranda A, Romero-Cordoba S, Valverde M, Rojas E. MRNA and miRNA expression patterns associated to pathways linked to metal mixture health effects. Gene. 2014;533(2):508-14.

Abe T, Kojima M, Akanuma S, Iwashita H, Yamazaki T, Okuyama R, et al. N-terminal hydrophobic amino acids of activating transcription factor 5 (ATF5) protein confer interleukin 1beta (IL-1beta)-induced stabilization. The Journal of biological chemistry. 2014;289(7):3888-900.

Marson FAdL, Hortencio TDR, Aguiar KCA, Ribeiro JD. Demographic, clinical, and laboratory parameters of cystic fibrosis during the last two decades: a comparative analysis. BMC Pulmonary Medicine. 2015;15(1):3.

Zolin A, Rens Jv, Fox A, Iansa P. The European Cystic Fibrosis Society Patient Registry (ECFSPR) 2013.

Cystic Fibrosis Foundation Patient Registry 2015 Annual Data Report Bethesda, Maryland 2016.

Farjadian S, Moghtaderi M, Kashef S, Alyasin S, Najib K, Saki F. Clinical and genetic features in patients with cystic fibrosis in southwestern iran. Iranian journal of pediatrics. 2013;23(2):212-5.

Schluchter MD, Konstan MW, Davis PB. Jointly modelling the relationship between survival and pulmonary function in cystic fibrosis patients. Statistics in medicine. 2002;21(9):1271-87.

Konstan MW, Morgan WJ, Butler SM, Pasta DJ, Craib ML, Silva SJ, et al. Risk factors for rate of decline in forced expiratory volume in one second in children and adolescents with cystic fibrosis. J Pediatr. 2007;151(2):134-9, 9.e1.

Davis PB, Byard PJ, Konstan MW. Identifying treatments that halt progression of pulmonary disease in cystic fibrosis. Pediatric research. 1997;41(2):161-5.

Konstan MW, Byard PJ, Hoppel CL, Davis PB. Effect of high-dose ibuprofen in patients with cystic fibrosis. N Engl J Med. 1995;332(13):848-54.

Sheikh S, Zemel BS, Stallings VA, Rubenstein RC, Kelly A. Body composition and pulmonary function in cystic fibrosis. Frontiers in pediatrics. 2014;2:33.

Williams JE, Wells JC, Benden C, Jaffe A, Suri R, Wilson CM, et al. Body composition assessed by the 4-component model and association with lung function in 6-12-y-old children with cystic fibrosis. The American journal of clinical nutrition. 2010;92(6):1332-43.

Winstanley C, O’Brien S, Brockhurst MA. Pseudomonas aeruginosa Evolutionary Adaptation and Diversification in Cystic Fibrosis Chronic Lung Infections. Trends in Microbiology. 2016;24(5):327-37.

Moller ME, Alanin MC, Gronhoj C, Aanaes K, Hoiby N, von Buchwald C. Sinus bacteriology in patients with cystic fibrosis or primary ciliary dyskinesia: A systematic review. American journal of rhinology & allergy. 2017;31(5):293-8.

Hewer SL. Inhaled antibiotics in cystic fibrosis: what's new? Journal of the Royal Society of Medicine. 2012;105(Suppl 2):S19-S24.

Hodson ME, McKenzie S, Harms HK, Koch C, Mastella G, Navarro J, et al. Dornase alfa in the treatment of cystic fibrosis in Europe: a report from the Epidemiologic Registry of Cystic Fibrosis. Pediatric pulmonology. 2003;36(5):427-32.

Haupt ME, Kwasny MJ, Schechter MS, McColley SA. Pancreatic enzyme replacement therapy dosing and nutritional outcomes in children with cystic fibrosis. J Pediatr. 2014;164(5):1110-5.e1.

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IssueVol 57, No 1 (2019) QRcode
SectionArticles
DOI https://doi.org/10.18502/acta.v57i1.1751
Keywords
Cystic fibrosis Demographic factors Clinical markers Laboratory indices

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How to Cite
1.
Aghamohammadi A, Keivanfar M, Navaei S, Shirzadi R, Masiha F, Allameh Z, Heydari A, Eslami S, Azizi G, Reisi M, Modaresi M. First Cystic Fibrosis Patient Registry Annual Data Report-Cystic Fibrosis Foundation of Iran. Acta Med Iran. 2019;57(1):33-41.